Technical, social, and economic characteristics of mammography screening in Goiás: ecological study after the implementation of a mammography quality control program

Abstract

Objective: The aim of this study was to evaluate technical, social, and economic aspects characterizing opportunistic breast cancer screening in a state in central Brazil. Methods: A survey was conducted to quantify the number of mammography machines and evaluate the imaging technology, the geographical distribution of the scanners, the number of mammograms performed at each center, the cost of the exams, and sources of payment. Data from this study were compared with data from a similar study conducted in 2008. Results: In Goiás, 164 mammography units were operational, with 66 (40%) serving the Sistema Único de Saúde (SUS). Approximately 400,896 scans were performed in 2019, averaging 204 scans/month (ranging from 5 to 1,000), at a cost of R$ 41,931,120.00. Screening coverage was 31.2%, with 6.4% of these scans being performed within the SUS. No correlation was found between the municipal Human Development Index (HDI) and mammography coverage in the health regions (HRs) (p=0.10). Compared with the 2008 results, the percentage of computed radiography systems increased from 24.3% to 86.7%, and digital radiography was introduced (7.3%). Conclusion: In 2019, breast cancer screening coverage in Goiás reached 31.1%, with 6.4% of scans being conducted within the SUS. The geographic distribution of mammography units is heterogeneous, and productivity is low. Compared to 2008, availability increased, and the standard of the equipment improved.