Analysis of screening tests coverage at private health system in Brazil: Stimulating strategies to prevent and control breast and cervical cancers

Background: National Supplementary Health Agency – ANS is a federal Brazilian agency that aims at both granting adequate and integral care to all beneficiaries of health care plans and maintaining the stability of the sector. ANS has implemented a Qualification Program for private health system. This program, through a number of indicators related to cancer, has been monitoring mammography and cervical cytology rates achieved by health care companies since 2005. Information is gathered from Product Information System, which is responsible for collecting assistance data, number of beneficiaries, events and expenses. Screening exams are the main preventive measures for detecting breast and cervical cancers at early stages. Therefore, we selected information related to these events and compared data from private system to other systems.   Objective: We aimed at analyzing the coverage of mammography and cervical cytology at the private health systems in order to support the policy of stimulating prevention and control of cancer in this sector.   Methods: We analyzed the number of cytological exams performed for the first time in women aged 25 to 59; and the number of women from 50 to 69 years old submitted to mammography, in 2005 and 2006. Results were compared to those from Brazilian public health system, international data and among private health care companies.   Results: Our study showed a cytological rate in 2005 of 26,82% and 28,66% in 2006, which is in accordance to the values recommended worldwide. For mammography the rates were 11,74% in 2005 and 30,70% in 2006, below the parameters recommended by WHO.   Conclusion: The Qualification Program implemented by ANS aims at detecting problems and proposes actions to solve them. By identifying mammography rates below recommended values, we visualize two ways of intervention: improve data quality and adopt measures to increase assistance quality.