The negative impact of the COVID-19 pandemic on breast cancer tackle in Brazil’s public and private healthcare system: time series study between 2014 and 2022

Abstract

Background: The COVID-19 pandemic has overwhelmed the healthcare systems of many countries and negatively impacted the care of other diseases. Objective: To evaluate the trend of screening mammograms, oncological breast surgeries, and breast cancer hospitalizations in Brazil’s public and private healthcare system between 2014 and 2022. Method: This ecological time series study uses the inflection point regression model and semester percentage change (SPC). We use the open-access dataset of the different healthcare systems in Brazil. We analyzed the trend of the variables in the pre-pandemic and the effect of the pandemic on the total time series. Results: In 2020, compared to 2019, the decrease in screening mammograms, oncological breast surgeries, and breast cancer hospitalization was − 41.44%, -23.13%, and − 10.52% (public health system) and − 29.49%, -18.96%, and − 15.35% (private healthcare system). In the public healthcare system, the pandemic has enhanced the decreasing trend of mammograms (SPC − 1.6% before and − 3.4% after), has reverted the stationary trend of oncological breast surgeries to decreasing (SPC − 1.0%), has slowed the increasing trend of breast cancer hospitalization (SPC 1.8% before and 0.9% after). In the private healthcare system, the pandemic has reverted the stationary trend of mammograms to decreasing (SPC − 1.0%), has slowed the increasing trend of breast cancer surgeries (SPC 2.3% before and 0.8% after), has reverted the growing trend of breast cancer hospitalization (SPC 3.9%) to stationary. Conclusion: During the COVID-19 pandemic, there was an increase in inequalities between healthcare systems, especially in breast cancer screening.