Desigualdades na realização do exame clínico de mama em São Leopoldo, Rio Grande do Sul, Brasil / Inequalities in clinical breast examination in São Leopoldo, Rio Grande do Sul, Brazil

RESUMO

Foi realizado um estudo transversal de base populacional com o objetivo de estabelecer o nível de cobertura de exame clínico de mamas entre as mulheres de 20 a 60 anos residentes em São Leopoldo, Rio Grande do Sul, Brasil, e descrever as características associadas à sua não-realização. O desfecho foi definido como realização de exame clínico de mamas por médico no ano que antecedeu a entrevista. Foram utilizados dois modelos de análise multivariada. Entre as 1.026 mulheres incluídas na amostra, 556 (54,2 por cento; IC95 por cento 51,1-57,2) foram submetidas ao exame clínico de mamas. A análise multivariada incluindo todas as mulheres demonstrou que somente a variável classe econômica estava associada com a não-realização de exame médico de mama. No outro modelo constatou-se associação entre classe econômica e cor da pele. Assim, classe econômica influenciou a realização de exames de mama nos modelos. Entretanto, no modelo restrito àquelas mulheres que haviam se consultado no ano, cor da pele foi determinante para a realização do exame, ou seja, superadas as diferenças de acesso, as mulheres brancas terão maior probabilidade de serem examinadas.

ABSTRACT

This cross-sectional population-based survey focused on the coverage of clinical breast examination (CBE) in women 20 to 60 years of age in São Leopoldo, Rio Grande do Sul State, Brazil, and described the factors associated with lack of CBE. The outcome was defined as having received a CBE by a physician during the year prior to the interview. Two different multivariate models were analyzed. Among the 1,026 women included in the sample, 556 (54.2 percent; 95 percentCI 51.1-57.2) had received CBEs. Multivariate analysis including the entire sample of women showed that low socioeconomic status (SES) was the only variable associated with not having a CBE. In the other multivariate model (only women who had consulted physicians in the previous year, with or without CBE), a statistically significant effect was found for both SES and skin color. Thus, low SES was significantly associated with lack of CBE in both models. However, in the model limited to women with physician consultations in the previous year, skin color was the main factor for receiving CBE, suggesting that once differences in initial access to the health service were overcome, white women had a higher probability of receiving a clinical breast examination as part of their consultation.