Análise da sobrevivência líquida em 5 anos de mulheres com câncer de mama e de colo do útero tratadas no Sistema Único de Saúde

Abstract

Background: Breast cancer and cervical cancer are significant causes of morbidity and mortality among women worldwide. Primary prevention alone is not sufficient to control the burden of cancer, making it essential to improve the survival rates of incident cases. Monitoring cancer survival allows for the study of healthcare system challenges in cancer control, with a territorial focus. This study aims to analyze subnational differences in the net survival of these two types of cancer in Brazil and the changes between 2002 and 2015. Methods: A non-concurrent cohort was used, based on an integrated database from the Brazilian Unified Health System (SUS) information systems. The study included women over 17 years of age treated for breast or cervical cancer between 2002 and 2015. Expanded summary mortality tables were created for each location and year. The 5-year net survival was measured using the Pohar Perme estimator with a cohort approach. Results: A total of 217,543 women with breast cancer and 65,895 with cervical cancer were included. The expanded mortality tables accurately represented mortality across regions and states, with an average difference of -2.39 years in life expectancy at birth for women. The initial 5-year net survival rate for breast cancer patients was 84.3%, with an increase of 3.65 percentage points. For cervical cancer, the initial estimate was 57.4%, with a decrease of 3.88 percentage points. Survival decreased as the cancer stage advanced, regardless of the cancer type. Discussion: The net survival of women with breast cancer was higher than findings in the literature, while that of cervical cancer was similar. The Southeast and South regions faced challenges in cancer control, potentially related to healthcare service congestion and a lack of coordination within the healthcare network, despite having a higher concentration of oncology services. Regions with lower development showed higher net survival rates, which may be explained by difficulties in the coverage of the Mortality Information System. It is necessary to enhance the surveillance of cancer patient survival in Brazil to monitor the effectiveness of health policies for cancer control.