0214/2023 - DESIGUALDADES SOCIAIS NO DIAGNÓSTICO DO CANCER DO COLO DO ÚTERO NO BRASIL: UM ESTUDO DE BASE HOSPITALAR SOCIAL INEQUALITIES IN THE DIAGNOSIS OF CERVICAL CANCER IN BRAZIL: A HOSPITAL-BASED STUDY
O estudo visa analisar a prevalência de estadiamento avançado ao diagnóstico do câncer do colo do útero e sua associação com indicadores individuais e contextuais socioeconômicos e de oferta de serviços de saúde no Brasil. Estudo transversal, realizado com casos de câncer do colo do útero em mulheres de 18 a 99 anos, no período de 2006 a 2015 (n=65.685), extraídos do Integrador de Registros Hospitalares de Câncer. Variáveis contextuais foram coletadas no Atlas do Desenvolvimento Humano; Cadastro Nacional de Estabelecimentos de Saúde e Sistema de Informações Ambulatoriais. Usou-se o modelo de Regressão de Poisson Multinível com intercepto aleatório. A prevalência de diagnóstico em estádio avançado foi de 48,4%, apresentando associação com idades mais avançadas (RP 1,06;IC 1,01-1,10), raça/cor da pele preta, parda e indígena (RP 1,04;IC 1,01-1,07), menores níveis de escolaridade (RP 1,28;IC 1,16-1,40), ausência de parceiro conjugal (RP 1,10;IC 1,07-1,13), encaminhamento do tipo público ao serviço de saúde (RP 1,07;IC 1,03-1,11) e menor taxa de realização de exame citopatológico (RP 1,08;IC 1,01-1,14). Os resultados reforçam a necessidade de melhorias no programa nacional de prevenção do câncer do colo do útero em áreas com baixa cobertura da citologia oncótica.
Palavras-chave:
Disparidades nos Níveis de Saúde; Câncer do colo do útero; Registros hospitalares; Diagnóstico tardio.
Abstract:
The study aims to analyze the prevalence of advanced stage diagnosis of cervical cancer and its association with individual and contextual socioeconomic and healthcare service indicators in Brazil. A cross-sectional study was conducted using cervical cancer cases in women aged 18 to 99 years,2006 to 2015 (n=65,685), extractedthe Hospital Cancer Registry Integrator (HCR). Contextual variables were collectedthe Atlas of Human Development in Brazil; the National Registry of Health Institutions (NRHI); and the Outpatient Information System. A multilevel Poisson Regression was carried out with random intercept. The prevalence of advanced stage diagnosis was 48.4%, showing an association with younger age groups (RP 1.06; CI 1.01-1.10), race/skin color black, brown, and indigenous (RP 1.04; CI 1.01-1.07), lower education levels (RP 1.28; CI 1.16-1.40), absence of marital partner (RP 1.10; CI 1.07-1.13), public type forwarding to the health service (RP 1.07; CI 1.03-1.11), and lower rates of cytological examination (RP 1.08; CI 1.01-1.14). The results reinforce the need for improvements in the national program for cervical cancer prevention in areas with low coverage of oncotic cytology.
Keywords:
Health Status Disparities; Cervical Cancer; Hospital Records; Delayed Diagnosis.
SOCIAL INEQUALITIES IN THE DIAGNOSIS OF CERVICAL CANCER IN BRAZIL: A HOSPITAL-BASED STUDY
Resumo (abstract):
The study aims to analyze the prevalence of advanced stage diagnosis of cervical cancer and its association with individual and contextual socioeconomic and healthcare service indicators in Brazil. A cross-sectional study was conducted using cervical cancer cases in women aged 18 to 99 years,2006 to 2015 (n=65,685), extractedthe Hospital Cancer Registry Integrator (HCR). Contextual variables were collectedthe Atlas of Human Development in Brazil; the National Registry of Health Institutions (NRHI); and the Outpatient Information System. A multilevel Poisson Regression was carried out with random intercept. The prevalence of advanced stage diagnosis was 48.4%, showing an association with younger age groups (RP 1.06; CI 1.01-1.10), race/skin color black, brown, and indigenous (RP 1.04; CI 1.01-1.07), lower education levels (RP 1.28; CI 1.16-1.40), absence of marital partner (RP 1.10; CI 1.07-1.13), public type forwarding to the health service (RP 1.07; CI 1.03-1.11), and lower rates of cytological examination (RP 1.08; CI 1.01-1.14). The results reinforce the need for improvements in the national program for cervical cancer prevention in areas with low coverage of oncotic cytology.
Palavras-chave (keywords):
Health Status Disparities; Cervical Cancer; Hospital Records; Delayed Diagnosis.
Oliveira, N.P.D, Cancela, M.C, Martins, L.F.L, Castro, J.L., Meira, K.C, Souza, D.L.B. DESIGUALDADES SOCIAIS NO DIAGNÓSTICO DO CANCER DO COLO DO ÚTERO NO BRASIL: UM ESTUDO DE BASE HOSPITALAR. Cien Saude Colet [periódico na internet] (2023/Ago). [Citado em 01/07/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/desigualdades-sociais-no-diagnostico-do-cancer-do-colo-do-utero-no-brasil-um-estudo-de-base-hospitalar/18840
