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Using SUS outpatient data and the Oncology—Brazil Panel, Poisson regression assessed trends in screening coverage and staging across Brazil and its macro-regions. Results show reduced screening (annual percent change −5.9) and a 31.5% decline in notified cases during 2020–2021 versus 2018–2019, alongside a 10.7% rise in stage III/IV.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/covid-19-and-breast-cancer-in-brazil/382158/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/covid-19-and-breast-cancer-in-brazil/382158.png","ImageObject",300,407,{"name":92,"@type":93},"Logic","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-25","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study’s main objective?","Question",{"text":112,"@type":113},"To evaluate COVID-19 effects on breast cancer screening coverage and clinical stage at diagnosis among women aged 50–69 receiving care in Brazil’s public healthcare network (SUS) from 2013–2021.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did the researchers analyze changes over time?",{"text":117,"@type":113},"They conducted an ecological study using Poisson regression to analyze trends in screening and clinical staging, drawing on a secondary database from SUS outpatient data and the Oncology—Brazil Panel.",{"name":119,"@type":110,"acceptedAnswer":120},"What key changes were observed during 2020–2021?",{"text":121,"@type":113},"Breast cancer screening decreased and the number of notified cases fell by 31.5% compared with 2018–2019. At the same time, the proportion of stage III/IV cases increased by 10.7%, surpassing early-stage cases.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},382158,1790465921,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},1099513958762,"https://ap-avatar.wpscdn.com/avatar/1000023916a998db790?x-image-process=image/resize,m_fixed,w_180,h_180&k=1784791008015729253","Edited by:  \nAylene Bousquat, University of São Paulo, Brazil  \n*Correspondence:  \nAline Ferreira Bandeira Melo Rocha [alinebandeirageriatra@gmail.com](alinebandeirageriatra@gmail.com)  \nReceived: 13 October 2022  \nAccepted: 24 February 2023  \nPublished: 03 March 2023  \nCitation: Rocha AFBM, Freitas-Junior R, Ferreira GLR, Rodrigues DCN and Rahal RMS (2023) COVID-19 and Breast Cancer in Brazil.  \nInt J Public Health 68:1605485.  \ndoi: 10.3389/ijph.2023.1605485  \nCOVID-19 and Breast Cancer in Brazil  \nAline Ferreira Bandeira Melo Rocha 1 *, Ruffo Freitas-Junior2, Glalber Luiz Rocha Ferreira 3, Danielle Cristina Netto Rodrigues 2 and Rosemar Macedo Sousa Rahal 2  \n1Postgraduate Program in Health Sciences, Federal University of Goiás, Goiânia, Brazil, 2Advanced Center for Breast Diagnosis (CORA), Federal University of Goiás, Goiânia, Brazil, 3Goiás State Education Department, Goiânia, Brazil  \nObjectives: This study aimed to evaluate COVID-19 effects on breast cancer screening and clinical stage at diagnosis in patients of 50–69 years of age receiving care within the public healthcare network (SUS) in 2013–2021 in Brazil and its macro-regions.  \nMethods: This ecological study used Poisson regression to analyze trends in screening and staging. A secondary database was formed using SUS sources: outpatient data system of the SUS network and Oncology—Brazil Panel.  \nResults: There was a reduction in screening, with an annual percent change of −5 .9 (p \u003C 0.022) . The number of notified cases fell by 31 .5% in 2020–2021 compared to 2018–2019. There was a 10 .7% increase in the proportion of stage III/IV cases (p \u003C 0.001) in 2020–2021 compared to 2013–2019, now surpassing the number of cases of early stage breast cancer.  \nConclusion: COVID-19 led to a reduction in breast cancer screening and an expressive increase in advanced tumors in users of the public healthcare network. Urgent interventions in public policies are required as the negative effects of the pandemic on the diagnosis/treatment of breast cancer are becoming apparent even earlier than expected.  \nKeywords: breast cancer, COVID-19, Brazil, breast cancer screening, clinical staging of breast cancer  \nINTRODUCTION  \nThe COVID-19 pandemic impacted healthcare services worldwide due to the need to prioritize resources for urgencies and reduce dissemination of the virus at healthcare services (1) . Consequently, there were negative repercussions on elective procedures, including cancer screening (2–4), which was paused in Brazil and in the vast majority of countries (2, 5, 6) .  \nAccording to data published by the World Health Organization, over half the countries investigated interrupted treatment services for hypertension either partially or totally, while 49% interrupted the treatment of diabetes and its complications; 42% interrupted cancer treatment; and 31% suspended cardiovascular emergencies. Furthermore, 50% of these countries reported a reduction in public screening programs (7) . National and international medical societies published recommendations on cancer care, taking individual risks and benefits to patients into consideration (4, 8–11) .  \nAs the pandemic progressed and vaccination programs were implemented, the restrictive measures hitherto imposed were eased somewhat, allowing healthcare managers and professionals to evaluate whether to begin offering elective procedures, particularly the screening, diagnosis and early treatment of malignant neoplasms (3, 12) . Deciding on these  \nInt J Public Health | Owned by SSPH+ | Published by Frontiers 1 March 2023 | Volume 68 | Article 1605485  \nFIGURE 1 | Trend in the rate of breast cancer screening coverage within the public healthcare system in Brazil between 2013–2019 and 2013–2021 in women of 50–69 years of age (Poisson regression model) . Brazil, 2013–2021 . APC, Annual Percentual Change; 95%CI, 95% Confidence Interval.  \nissues was of utmost importance in view of the real risk that the delay in cancer treatment duri","cbCaihwge0EPhZue","https://ap.wps.com/l/cbCaihwge0EPhZue","pdf",817322,"English","# Introduction\n## Methods\n## Results\n## Conclusion\n# Figure 1","[{\"question\":\"What was the study’s main objective?\",\"answer\":\"To evaluate COVID-19 effects on breast cancer screening coverage and clinical stage at diagnosis among women aged 50–69 receiving care in Brazil’s public healthcare network (SUS) from 2013–2021.\"},{\"question\":\"How did the researchers analyze changes over time?\",\"answer\":\"They conducted an ecological study using Poisson regression to analyze trends in screening and clinical staging, drawing on a secondary database from SUS outpatient data and the Oncology—Brazil Panel.\"},{\"question\":\"What key changes were observed during 2020–2021?\",\"answer\":\"Breast cancer screening decreased and the number of notified cases fell by 31.5% compared with 2018–2019. At the same time, the proportion of stage III/IV cases increased by 10.7%, surpassing early-stage cases.\"}]","COVID-19 and Breast Cancer in Brazil | PDF",1790249331,18]