MAMMOGRAPHIC SCREENING COVERAGE IN ELDERLY WOMEN IN BRAZIL

Objective: The aim of this study was to assess trends in breast cancer screening in the Unified Health System (SUS) in women over 70 years of age, during 2010–2021, and to assess the frequency of malignant lesions in this group, from 2014 to 2021. Methods: This is an ecological study on breast cancer screening in elderly women in the SUS in Brazil from 2010 to 2021. Data were extracted from the Outpatient Information System of the SUS Informatics Department and the Cancer Information System. Coverage was calculated from the ratio between the number of mammograms performed and the number expected for the population at risk. Results: We observed that in Brazil there was an average mammographic coverage of 6.7% in this age group. The south region had the highest coverage with an average of 8.9% for the period, while the north region had the lowest rate of 3.1%. Among the states, São Paulo and Paraná, with 9.9% and 9.6% respectively, had the highest rates. There was a reduction in the coverage rate in the analyzed period, more pronounced in 2020–2021 due to the COVID-19 pandemic, caused by the reduction in the active demand of women for health treatment in this context. The number of examinations with a diagnosis of the malignant lesion followed a pattern and increased until 2019, followed by a decrease in 2020, due to COVID-19 and an increasing trend in 2021. The total number of examinations in the analyzed period was 13,090, an increase of 1,604% compared to 2014. The states that showed most participation in these results were São Paulo (16%), Minas Gerais (16%), Paraná (14%), and Pernambuco (13%). Conclusion: The number of breast cancer cases in elderly women has increased, but screening has not followed this trend. It is necessary to rethink the assistance to this age group, discussing public health measures that address this reality.