Brasil enfrenta desafios na prevenção e redução do câncer de mama

O Brasil figura, em 2018, na segunda faixa mais alta de incidência de câncer de mama entre os todos os países com uma taxa de 62,9 casos por 100 mil mulheres (taxa padrão utilizada mundialmente). Os países são agrupados em cinco faixas.

Quanto à taxa de mortalidade de câncer de mama, o Brasil está situado na segunda faixa mais baixa com uma taxa de 13 por 100 mil, ao lado de países desenvolvidos como EUA, Canadá e Austrália, e melhor de que alguns deles, como a França e o Reino Unido.

Um dos desafios é a redução das desigualdades entre as regiões e classes sociais. A mortalidade por câncer de mama está ligada principalmente ao acesso a diagnóstico e tratamento adequado no tempo oportuno. O objetivo é diagnosticar o câncer o mais precocemente possível, ainda nos estágios iniciais da doença, quando o tratamento é mais efetivo. Ano a ano, o Brasil vem conseguindo aumentar o percentual de casos diagnosticados nos estágios in situ e I de 17,3% em 2000 para 27,6% em 2015. Mas essa proporção continua muita baixa na região Norte (12,7%), em contraste com as regiões Sul (29,2%) e Sudeste (30,8%).

A desigualdade regional e social também se evidencia no acesso ao exame de mamografia de rastreamento, que deve ser realizado a cada dois anos por todas as mulheres na faixa etária de 50 a 69 anos. O percentual de mulheres brasileiras nessa faixa que fizeram o exame em 2013, de acordo com a última Pesquisa Nacional de Saúde, foi de 60%, mas de apenas 38,7% na região Norte e 47,9% no Nordeste, bem abaixo das regiões Sul (64,5%) e Sudeste (67,9%).

Por nível de instrução, o índice médio de mulheres brasileiras com nível superior nesse faixa etária que realizou uma mamografia foi de 80%, mas de 50% entre as mulheres sem instrução e fundamental incompleto.

Segundo o INCA, são estimados 59.700 casos novos de câncer de mama em 2019.

O desafio da obesidade

Entre os fatores que aumentam o risco de desenvolvimento do câncer de mama, alguns podem ser evitados e outros não. O envelhecimento, histórico familiar da doença e mutações genéticas herdadas são fatores que não podem ser evitados pela mulher.

Quanto à exposição das mamas à radiação ionizante, outro fator de risco, é possível reduzi-lo ao não se realizar exames desnecessários. Em alguns casos, como nas sessões de radioterapia relacionada ao tratamento de um outro câncer, a exposição à radiação é inevitável.

Três dos fatores de risco evitáveis estão ligados a estilo de vida: estar acima do peso, levar uma vida sedentária e tomar mais do que uma dose de bebida alcoólica por dia. Outro fator de risco evitável é o uso de hormônios após a menopausa, opção que deve ser descartada pela mulher.

Os especialistas do INCA estão particularmente preocupados com o excesso de peso corporal e o sedentarismo, fatores de risco não só para mama, como também para vários outros tipos de câncer e outras doenças. Segundo a pesquisa Vigitel 2018, realizada nas capitais brasileiras e DF, 53,9% das mulheres estão com excesso de peso e 20,7% estão obesas, proporções que cresceram muito neste século. A recomendação é que todos se exercitem regularmente durante uma média de 3 a 4 horas por semana e adotem uma dieta saudável, de acordo com o Guia Alimentar para a População Brasileira, que pode ser obtido em http://bvsms.saude.gov.br/bvs/publicacoes/guia_alimentar_populacao_brasileira_2ed.pdf

Rede de solidariedade

Cabe às instituições envolvidas com o cuidado do câncer de mama e à sociedade brasileira unirem esforços para reduzir as desigualdades socioeconômicas e regionais de acesso a informações de prevenção, diagnóstico precoce e tratamento do câncer de mama.

Profissionais de saúde e mulheres devem conhecer os sinais e sintomas de alerta para o câncer de mama e o sistema de saúde deve estar preparado para priorizar os casos suspeitos e fornecer investigação diagnóstica no tempo adequado.

As informações sobre riscos e possíveis benefícios dos exames de rotina devem ser amplamente divulgadas para toda a sociedade. As mulheres na faixa de 50 a 69 anos devem realizar mamografias de rotina uma vez a cada dois anos. É importante também que os profissionais estejam atualizados em relação às condutas relacionadas aos laudos da mamografia.

Amigos, vizinhos, colegas de trabalho, grupos religiosos, ONGs etc., todos podem, e devem, contribuir no apoio a pacientes e familiares de todas as formas possíveis, por exemplo, na multiplicação de informações corretas e encorajando a busca pelos serviços de saúde.

Campanha

O INCA e o Ministério da Saúde lançaram a campanha Outubro Rosa 2019, que reforça três pilares estratégicos no controle da doença: prevenção primária, diagnóstico precoce e mamografia A campanha, que inclui cartazes, folders, banners e cards para impressão e utilização nas redes sociais, foi criada para divulgação não apenas em outubro, mas sim ao longo do ano inteiro, porque o cuidado com as mamas deve ser uma preocupação permanente. O mote da campanha é “Cada corpo tem uma história. O cuidado com as mamas faz parte dela”. Para mais informações, acesse www.inca.gov.br.

INCA

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