The Impact of the COVID-19 Pandemic on Cancer Care in Brazil: From Screening to Treatment
DOI:
https://doi.org/10.32635/2176-9745.RBC.2025v71n1.4848Keywords:
Early Detection of Cancer/statistics & numerical data, Medical Oncology/statistics & numerical data, Epidemiological Monitoring, Coronavirus Infections, SARS-CoV-2Abstract
Introduction: The COVID-19 pandemic has had a significant impact in Brazil, resulting in more than 700,000 deaths. The entire health system has been affected, including cancer care. Objective: To quantify the impact of the pandemic on the offer of cancer care procedures in Brazil. Method: Time series analysis based on data from the Brazilian National Health System. The monthly frequency of confirmed COVID-19 cases and cancer-related procedures, including breast and cervical screening tests and diagnostic and treatment procedures for all types of cancer were calculated for the pre-pandemic year (2019) and the pandemic period (2020-2022). Joinpoint regression was used to calculate monthly percentage changes (MPC). Results: A decrease in all cancer-related procedures, except chemotherapy and radiotherapy, was identified during the pandemic. The most significant declines occurred from April to June 2020, which closely aligns with Brazil's lockdown period, and from December 2021 to February 2022, coinciding with the spread of the Omicron variant in the country. During Brazil's initial wave of COVID-19, screening tests experienced significant declines. Pap smears decreased 44.90% (95%CI -49.21 to -35.71) and mammograms, 45.79% (95%CI -44.88% to -28.85). Conclusion: A gradual resumption of procedures has occurred, with levels returning to those observed prior to the pandemic in 2022. It is expected that an increase in the offer of these procedures will eventually mitigate the consequences of probable delays in cancer diagnosis and treatment.
Downloads
References
Pradhan NA, Samnani AABA, Abbas K, tel. Resilience of primary healthcare system across low- and middle-income countries during COVID-19 pandemic: a scoping review. Health Res Policy Syst. 2023;21(1):98. DOI: https://doi.org/10.1186/s12961-023-01031-4
Tuczyńska M, Matthews-Kozanecka M, Baum E. Accessibility to non-Covid health services in the world during the Covid-19 pandemic: review. Front Public Health. 2021;9:760795. doi: https://doi.org/10.3389/fpubh.2021.760795 DOI: https://doi.org/10.3389/fpubh.2021.760795
Ferrara P, Dallagiacoma G, Alberti F, et al. Prevention, diagnosis and treatment of cervical cancer: a systematic review of the impact of Covid-19 on patient care. Prev Med. 2022;164:107264. DOI: https://doi.org/10.1016/j.ypmed.2022.107264
Teglia F, Angelini M, Astolfi L, et al. Global Association of Covid-19 pandemic measures with cancer screening: a systematic review and meta-analysis. JAMA Oncol. 2022;8(9):1287-93. DOI: https://doi.org/10.1001/jamaoncol.2022.2617
Teglia F, Angelini M, Casolari G, et al. Global Association of COVID-19 pandemic measures with cancer treatment: a systematic review and meta-analysis. Cancers. 2022;14(22):5490. DOI: https://doi.org/10.3390/cancers14225490
Villain P, Carvalho AL, Lucas E, et al. Cross-sectional survey of the impact of the COVID-19 pandemic on cancer screening programs in selected low- and middle-income countries: study from the IARC COVID-19 impact study group. Int J Cancer. 2021;149(1):97-107. DOI: https://doi.org/10.1002/ijc.33500
Sott MK, Bender MS, Silva Baum K. Covid-19 outbreak in brazil: health, social, political, and economic implications. Int J Health Serv. 2022;00207314221122658. DOI: https://doi.org/10.1177/00207314221122658
Data WHO [Internet]. Geneva: WHO; 2020. Number of COVID-19 cases reported to WHO. [acesso 2024 fev 9]. Disponível em: https://data.who.int/dashboards/covid19/cases
Migowski A, Corrêa FM. Recommendations for early detection of cancer during covid-19 pandemic in 2021. Revista APS. 2020;23(1):241-6.
Gilardino RE, Valanzasca P, Rifkin SB. Has Latin America achieved universal health coverage yet? Lessons from four countries. Arch Public Health. 2022;80(1):1-11. DOI: https://doi.org/10.1186/s13690-022-00793-7
Migowski A, Atty ATM, Tomazelli JG, et al. 30 years of oncological care in the brazilian National Health System. Rev Bras Cancerol. 2018;64(2):247-50. doi: https://doi.org/10.32635/2176-9745.RBC.2018v64n2.84 DOI: https://doi.org/10.32635/2176-9745.RBC.2018v64n2.84
Corrêa FM, Migowski A, Almeida LM, et al. Cervical cancer screening, treatment and prophylaxis in Brazil: current and future perspectives for cervical cancer elimination. Front Med. 2022;9. doi: https://doi.org/10.3389/fmed.2022.945621 DOI: https://doi.org/10.3389/fmed.2022.945621
Renna Junior NL, Silva GA. Temporal trend and associated factors to advanced stage at diagnosis of cervical cancer: analysis of data from hospital based cancer registries in Brazil, 2000-2012. Epidemiol Serv Saúde. 2018;27(1):e2017285. doi: https://doi.org/10.5123/S1679-49742018000100013 DOI: https://doi.org/10.1055/s-0038-1624580
Oliveira NPD, Cancela MC, Martins LFL, et al. Spatial distribution of advanced stage diagnosis and mortality of breast cancer: socioeconomic and health service offer inequalities in Brazil. PLoS ONE. 2021;16(2):e0246333. doi: https://doi.org/10.1371%2Fjournal.pone.0246333 DOI: https://doi.org/10.1371/journal.pone.0246333
SIA-SUS: Sistema de Informações Ambulatoriais do SUS [Internet]. Brasília (DF): DATASUS. [data desconhecida] – [acesso 2024 ago 3]. Disponível em: http://sia.datasus.gov.br/principal/index.php
SIH-SUS: Sistema de Informações Hospitalares do SUS [Internet]. Brasília (DF): DATASUS. [data desconhecida] – [acesso 2024 ago 3]. Disponível em: https://datasus.saude.gov.br/acesso-a-informacao/morbidade-hospitalar-do-sus-sih-sus/
DATASUS: [Internet]. Brasília (DF): DATASUS. [data desconhecida]. Transferência de Arquivos [acesso 2024 fev 9]. Disponível em: https://datasus.saude.gov.br/transferencia-de-arquivos/
Instituto Brasileiro de Geografia e Estatística. Censo demográfico 2022: população e domicílios - primeiros resultados do universo. Rio de Janeiro: 2022.
Painel Coronavírus [Internet]. Brasília, DF: Ministério da Saúde; 2023. [acesso 2024 out 9]. Disponível em: https://covid.saude.gov.br/
Ministério da Saúde (BR). Portaria no 263, de 22 de fevereiro de 2019. Atualiza os procedimentos radioterápicos da Tabela de Procedimentos, Medicamentos, Órteses, Próteses e Materiais Especiais do Sistema Único de Saúde (SUS). Diário Oficial da União, Brasília, DF. 2019 fev 25; Seção 1:75.
R: The R Project for Statistical Computing [Internet]. Version 3.4.3. [data desconhecida]: The R foundation. [acesso 2024 ago 3]. Disponível em: https://www.R-project.org/
Joinpoint Trend Analysis [Internet]. Version 5.0.2. Bethesda (MD): National Cancer Institute. 2020 abr 22 – [acesso 2024 ago 3]. Disponivel em: https://surveillance.cancer.gov/joinpoint/
Conselho Nacional de Saúde (BR). Resolução n° 510, de 7 de abril de 2016. Dispõe sobre as normas aplicáveis a pesquisas em Ciências Humanas e Sociais cujos procedimentos metodológicos envolvam a utilização de dados diretamente obtidos com os participantes ou de informações identificáveis ou que possam acarretar riscos maiores do que os existentes na vida cotidiana, na forma definida nesta Resolução [Internet]. Diário Oficial da União, Brasília, DF. 2016 maio 24 [acesso 2024 ago 3]; Seção I:44. Disponível em: http://bvsms.saude.gov.br/bvs/saudelegis/cns/2016/res0510_07_04_2016.html
Yong JH, Mainprize JG, Yaffe MJ, et al. The impact of episodic screening interruption: COVID-19 and population-based cancer screening in Canada. J Med Screen. 2021;28(2):100-7. DOI: https://doi.org/10.1177/0969141320974711
Renna Junior NL, Silva GA. Late-Stage diagnosis of breast cancer in Brazil: analysis of data from hospital-based cancer registries (2000-2012). Rev Bras Ginecol Obstet. 2018;40(3):127-36. doi: https://doi.org/10.1055/s-0038-1624580 DOI: https://doi.org/10.1055/s-0038-1624580
Medeiros GC, Thuler LCS, Bergmann A. delay in breast cancer diagnosis: a brazilian cohort study. Public Health. 2019;167:88-95. DOI: https://doi.org/10.1016/j.puhe.2018.10.012
Angelini M, Teglia F, Astolfi L, et al. Decrease of cancer diagnosis during Covid-19 pandemic: a systematic review and meta-analysis. Eur J Epidemiol. 2023;38(1):31-8. DOI: https://doi.org/10.1007/s10654-022-00946-6
Ministério da Saúde (BR). Portaria GM/MS No 3.712, de 22 de dezembro de 2020. Institui, em caráter excepcional, incentivo financeiro federal de custeio para o fortalecimento do acesso às ações integradas para rastreamento, detecção precoce e controle do Câncer no Sistema Único de Saúde. [Internet]. Diário Oficial da União, Brasília, DF. 2020 dez 23; Edição: 245; Seção: 1:98. Disponível em: https://www.in.gov.br/web/dou/-/portaria-gm/ms-n-3.712-de-22-de-dezembro-de-2020-295788198
Malagón T, Yong JHE, Tope P, et al. Predicted long-term impact of Covid-19 pandemic-related care delays on cancer mortality in Canada. Int J Cancer. 2022;150(8):1244-54. DOI: https://doi.org/10.1002/ijc.33884
Luo Q, O’Connell DL, Yu XQ, et al. Cancer incidence and mortality in Australia from 2020 to 2044 and an exploratory analysis of the potential effect of treatment delays during the Covid-19 pandemic: a statistical modelling study. Lancet Public Health. 2022;7(6):e537-48. DOI: https://doi.org/10.1016/S2468-2667(22)00090-1
Daniels V, Saxena K, Roberts C, et al. Impact of reduced human papillomavirus vaccination coverage rates due to COVID-19 in the United States: a model based analysis. Vaccine. 2021;39(20):2731-5. DOI: https://doi.org/10.1016/j.vaccine.2021.04.003
Silva TMRD, Nogueira de Sá ACMG, Beinner MA, et al. Impact of the Covid-19 pandemic on human papillomavirus vaccination in Brazil. Int J Public Health. 2022;67:1604224. DOI: https://doi.org/10.3389/ijph.2022.1604224
Alagoz O, Lowry KP, Kurian AW, et al. Impact of the COVID-19 pandemic on breast cancer mortality in the us: estimates from collaborative simulation modeling. J Natl Cancer Inst. 2021;113(11):1484-94. DOI: https://doi.org/10.1093/jnci/djab097
Published
How to Cite
Issue
Section
License
Os direitos morais e intelectuais dos artigos pertencem aos respectivos autores, que concedem à RBC o direito de publicação.
This work is licensed under a Creative Commons Attribution 4.0 International License.
