Inequities in access to mammographic screening in Brazil

Datos Bibliográficos

ID5223207
AutoresMário Círio Nogueira (0000-0001-9688-4557, Universidade Federal de Juiz de Fora), Vívian Asssis Fayer (0000-0003-2529-5039, Universidade Federal de Juiz de Fora), Camila Soares Lima Corrêa (0000-0003-4315-7123, Universidade Federal de Juiz de Fora), Maximiliano Ribeiro Guerra (0000-0003-0234-7190, Universidade Federal de Juiz de Fora), Bianca De Stavola (0000-0001-7853-0528, London School of Hygiene and Tropical Medicine, UK), Isabel Dos-Santos-Silva (0000-0002-6596-8798, London School of Hygiene and Tropical Medicine, UK), Maria Teresa Bustamante-Teixeira (0000-0003-0727-4170, Universidade Federal de Juiz de Fora), Gláucia Alves E Silva (0000-0001-8734-2799, Universidade do Estado do Rio de Janeiro)
Año2019
Volumen35
Número6
Páginase00099817-e00099817
Fecha de publicación2019-01-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaCadernos de Saude Publica (JOURNAL)
Identificadores de la revistaISSN: 0102-311X • E-ISSN: 1678-4464
EditorialFapUNIFESP (SciELO) (PUBLISHER)
DOI10.1590/0102-311x00099817
PMID31291424
OpenAlexW2955080969
SCIELO_PIDS0102-311X2019000705015
IdiomaEN
Citas recibidas12
Referencias citadas29

Our objectives with this study were to describe the spatial distribution of mammographic screening coverage across small geographical areas (micro-regions) in Brazil, and to analyze whether the observed differences were associated with spatial inequities in socioeconomic conditions, provision of health care, and healthcare services utilization. We performed an area-based ecological study on mammographic screening coverage in the period of 2010-2011 regarding socioeconomic and healthcare variables. The units of analysis were the 438 health micro-regions in Brazil. Spatial regression models were used to study these relationships. There was marked variability in mammographic coverage across micro-regions (median = 21.6%; interquartile range: 8.1%-37.9%). Multivariable analyses identified high household income inequality, low number of radiologists/100,000 inhabitants, low number of mammography machines/10,000 inhabitants, and low number of mammograms performed by each machine as independent correlates of poor mammographic coverage at the micro-region level. There was evidence of strong spatial dependence of these associations, with changes in one micro-region affecting neighboring micro-regions, and also of geographical heterogeneities. There were substantial inequities in access to mammographic screening across micro-regions in Brazil, in 2010-2011, with coverage being higher in those with smaller wealth inequities and better access to health care

Breast cancer · Ecological study · Economic growth · Environmental health · Geography · Health care · Inequality · Interquartile range · Mammography · Population · Socioeconomic status · Socioeconomics · Sociology · Colorectal Cancer Screening and Detection · Demography · Global Cancer Incidence and Screening · Health disparities and outcomes · Medicine