Breast cancer mammographic screening in public and private health care systems [Rastreamento mamográfico do câncer de mama em serviços de saúde públicos e privados]

Abstract

Purpose: to evaluate the characteristics of mammography use and the social demographic profile of women accessing public and private health care services. Methods: a cross-sectional study was carried out in the city of Taubaté, southeast Brazil. Six hundred and forty-three women who underwent mammographic examinations in the available healthcare services were interviewed, 472 of them in public and 171 in private health services. The social demographic and reproductive profiles of the women interviewed and the characteristics of the mammography use, such as the proportion of the women interviewed who had been previously screened, the age when the screening began, the interval between the screenings and their frequency, were evaluated by means of the Fisher exact, Wilcoxon and χ 2 tests. Results: the mean age of the interviewed women was similar in both studied groups. The proportion of women previously screened -54.2 and 79.5% in public and private services, respectively - as well as the age when the screening began -46.8 years (SD 10.2%)in public services and 40.2 years (SD7.7) in private services - differed significantly (p<0.01). Twenty-five percent of women older than 50 years did not follow the adequate standards of periodic screening. Conclusions: the way of accessing health services has influenced the proportion of women previously screened and the age at which this screening began, being more adequate in the private health system. Although there was a later start in the public health services, the age when the mammographic screening began was earlier than the current official recommendations. There has been a failure of compliance with mammographic screening in women older than 50 years, in both researched groups.