Impacto dos fatores epidemiológicos nos achados mamográficos de malignidade: análise comparativa entre Brasil e Goiânia de 2015 a 2024

Abstract

INTRODUCTION: Breast cancer is the most frequent neoplasm among Brazilian women, with high mortality rates. Epidemiological factors influence access to diagnosis and clinical outcomes, with regional and sociodemographic disparities. OBJECTIVES: To evaluate the association between epidemiological factors and malignant findings in mammograms in Brazil and in Goiânia, from 2015 to 2024. METHODS: Ecological study involving women aged ≥40 years, using data from SISCAN. Multinomial logistic regression was applied to assess the association between variables and BI-RADS categories, and Prais-Winsten regression was used for temporal trend analysis. The significance level was set at 5%. RESULTS: Age group, race/skin color, and high-risk status showed statistically significant associations with malignant findings. In Brazil, a higher incidence was observed in women aged 45 years and older, while in Goiânia, findings were concentrated in older age groups (55 years and above). Yellow-skinned women presented the highest annual growth rate in malignant nodule diagnoses. A family history of cancer was associated with an increase in suspicious and confirmed cancer findings. Temporal analysis revealed an increase in the number of mammograms performed and in malignancy diagnoses nationwide. DISCUSSION: Differences between Goiânia and the national scenario indicate regional disparities in access to early diagnosis. The higher concentration of cases in older age groups in Goiânia suggests possible barriers in screening younger women. Racial inequality observed in the results reflects socioeconomic and healthcare access patterns. Data limitations, such as underreporting of risk factors and exam types, affected some statistical analyses. CONCLUSION: The study reinforces the effectiveness of mammographic screening for women aged 50 to 69 years, according to national guidelines. It highlights the need to improve the quality of epidemiological records and to develop targeted strategies for high-risk populations, aiming to reduce regional and racial disparities in breast cancer diagnosis.