Difficult Access and Poor Productivity: Mammography Screening in Brazil

Area of Science:

• Public Health
• Radiology
• Health Services Research

Background:

• Access to mammographic screening can be limited by socioeconomic factors, equipment availability, and geographical distribution.
• This study examines breast cancer screening access within Brazil's public health system (SUS).

Purpose of the Study:

• To evaluate mammography equipment availability and utilization for breast cancer screening in Brazil.
• To assess geographical distribution and accessibility of mammography services within the SUS.
• To compare the number of required mammograms with actual procedures performed.

Main Methods:

• Ecological study analyzing mammography machine availability and distribution across Brazil in 2016.
• Calculation of required mammography machines based on clinical indications.
• Georeferencing of machines and analysis of travel distance (≤60 km) for access.
• Comparison of mammogram production capacity versus actual number of exams performed.

Main Results:

• Brazil had 4,628 mammography machines in 2016, with 2,113 (47%) available to the SUS.
• Only 2,068 machines were needed for screening, far fewer than available.
• Mammography services operated at only 29% of their total capacity, performing 4,073,079 exams against a potential of 14,279,654.
• Geographical access within 60 km was met in most areas.

Conclusions:

• Mammography screening access in Brazil via the SUS is not limited by equipment quantity or geographical distribution.
• The primary barrier to effective breast cancer screening is the low volume of mammograms performed relative to capacity and need.