Avaliação das ações de controle do câncer de mama no estado de São Paulo: uma abordagem a partir dos Sistemas de Informação do Sistema Único de Saúde.

Abstract

Evaluation of breast cancer control actions in São Paulo state, Brazil: an approach based on the Information Systems of the Unified Health System This study aimed to evaluate breast cancer control actions in women in the state of São Paulo, between 2010 and 2012, based on data from the Brazilian Health Information Systems. The first article is a descriptive study that evaluated the coverage of mammograms and adequacy to the Brazilian guidelines of breast cancer control actions in women residing in the metropolitan region or inland towns of São Paulo state, Brazil, between 2010 and 2012. The results showed an increase in waiting times for performance and for obtain the result of diagnostic mammography, and a reduction in the capacity of diagnostic confirmation for suspected lesions of malignancy between 2011 and 2012 in the metropolitan region, such findings was not notice in the inland towns of São Paulo for the same period. The second article is an evaluation of the waiting times for carrying out diagnostic and therapeutic procedures in women residing in the São Paulo state, Brazil, who used the Unified Heath System. We made linkage between of the study population (cohort of 13,565 women with mammography BI-RADS® 4 or 5, performed in 2010 and registered in SISMAMA), and the nominal databases of Brazilian Ambulatory, Hospital and Mortality Information Systems, to obtain of follow-up in the years 2010, 2011 and 2012. We identified 30% of biopsy performed within 30 days and 22% treatment initiated within 60 days. The main factors associated with waiting times were type of BI-RADS®, staging, diagnostic unit and perform diagnosis and treatment in the same service. The results showed that the use of data from health information systems is a viable and economical alternative for monitoring and evaluating actions performed in the health context. These findings points the importance of implementing an organized screening model to obtain better results in the control actions of breast cancer, as well as highlights the need to optimize the services provided and guarantee access to diagnostic confirmation and treatment services among women with altered mammography results.