Breast cancer screening in women aged 60–69 years: a nationwide analysis comparing Brazil and the midwest region using public health data

Abstract

Introduction: Breast cancer screening through mammography is recommended for women aged 50–69 years and plays a crucial role in early detection and mortality reduction. However, disparities in access and coverage persist across all Brazilian regions. This study aimed to evaluate mammography screening trends in women aged 60–69 years, comparing Brazil and the Midwest region. Methods: A cross-sectional ecological study was conducted using secondary data from the Brazilian public health database (DATASUS). Mammography screening procedures (code 0204030188) performed in women aged 60–69 years between 2019 and 2023 were analyzed, with trend projection to 2025. Data were stratified by region (Brazil vs. Midwest). Descriptive analysis was performed to evaluate temporal trends and regional differences. Results: A marked reduction in the number of screening mammograms was observed in 2020, with an estimated decrease of approximately 40% compared to 2019, consistent with the impact of the COVID-19 pandemic. After 2021, a gradual recovery in screening volume was identified; however, the levels remained below pre-pandemic values in several periods. The Midwest region showed similar temporal behavior but with relatively lower absolute screening volume compared to the national data. Regional disparities persisted, suggesting unequal access to screening services. Conclusion: Mammography screening in women aged 60–69 years in Brazil was significantly affected by the COVID-19 pandemic, with incomplete recovery in subsequent years. The Midwest region follows national trends but maintains a lower screening volume, highlighting persistent regional inequalities. Strengthening screening programs and improving access are essential to enhance early detection.