A Estratégia de Saúde da Família no Estado do Rio de Janeiro e o rastreamento do câncer de mama

Abstract

The magnitude of breast cancer in Brazil, with the changes that have occurred in the patterns of aging and illness of the population, produces the need to evaluate the strategies used so far by the Unified Health System to cope with it. The rates of breast cancers tend to increase because they are associated mainly with risk factors related to lifestyle that are not subject to primary prevention, screening ends up being the main resource for the control of the disease. The Family Health Strategy presents itself as the main form of organization of health services and a priority gateway for users of the system, which characterizes its leading role in providing the appropriate response to emerging demands. This study aimed to analyze the evolution of coverage by the Family Health Strategy and the performance of mammographic screening by women aged 50 to 69 years, living in the cities of the State of Rio de Janeiro. This is a temporal series study and spatial distribution with data available from the SUS Information Systems having the municipalities of the State of Rio de Janeiro from 2008 to 2018 as the unit of analysis. The Coverage of the Family Health Strategy increased by 87% in the State of Rio de Janeiro, with a statistically significant growth trend in 42% of the regions. Primary Care showed a growth trend in the period from 2008 to 2018, compatible with the trend observed for the FHS, reflecting the increase in the proportion of the FHS as a component of Primary Care in the studied regions, although the expansion occurred unevenly resulting in disparities assistance provided. The average coverage of mammographic screening in the State of Rio de Janeiro varied from 20% in 2008, reaching 34% in 2014 and returning to 26% in 2018, it is necessary to deepen the understanding of the causes of this decrease in the most recent period and its relationship with the registration of procedures and Primary Care services. The Family Health Strategy needs efforts to encourage expansion and consolidation as a PHC modality in a homogeneous way, aiming to guarantee and increase the impacts observed in indicators sensitive to the provision of health services. Constant monitoring of mammographic screening enables situational diagnosis, which is essential to support the adoption of measures to reduce the disparity in access to health and the organization of early detection actions, with repercussions in reducing breast cancer mortality.