Purpose: The aim is to verify the impact of the Covid-19 pandemic on women’s healthcare and medical assistance in Brazil. Patients and Methods: This exploratory cross-sectional study evaluated a non-probabilistic sample of women above 20 years old, carried out between August and September of 2020, through a snowball sampling using a Google Forms application. Results: From a total of 2495 women, more than 70% have not been screened for cervical cancer (77.8% of 2244 women aged for screening), and more than 80% have not been screened for breast cancer (80.2% from 1325 women aged for mammography) during the pandemic. Also, 55.2% of the women did not undergo routine blood tests during the same period. The most frequent reasons for not performing screening and routine tests were: they were up to date; fear of contracting Covid-19; they decided to postpone it until after the end of the pandemic; they were unable to schedule the appointment at the healthcare center for whatever reason; and the healthcare center was only attending Covid-19 patients. Women with no comorbidities have performed significantly more mammograms and routine blood tests than women with comorbidities. In addition, women with comorbidities who were used to perform periodic medical follow-up have done it substantially more than women with no comorbidities during the pandemic. Conclusion: As observed, there was a significant decrease in women’s access to the healthcare system during this pandemic. Many participants reported that they had not attended any screening tests, and some reasons included fear of getting infected and due to the public measures of social distancing. The consequences are late diagnoses and a worse prognosis. It might impact the healthcare systems around the world in the next few years. Further studies should be done to follow these consequences.

Background: This study aimed to analyze maternal risk factors associated with negative outcomes of COVID-19 and association with socioeconomic indicators in Brazil. Methods: A cross-sectional study, with data from the Influenza Epidemiological Surveillance Information System (SIVEP-Flu) of pregnant women with COVID-19 and cases of hospitalization and death. For the analysis of risk factors and outcomes, the multiple logistic regression method was used. Results: Pregnant women who had some risk factor represented 47.04%. The chance of death was 2.48 times greater when there was a risk factor, 1.55 for ICU admission and 1.43 for use of ventilatory support. The percentage of cure was 79.64%, 15.46% without any negative outcome, 4.65% death and 0.26% death from other causes. Pregnant women who did not take the vaccine represented 30.08%, 16.74% took it and 53.18% were not specified. The variables HDI, illiteracy, per capita income and urbanization did not influence the cases of COVID-19. Conclusions: Factors such as age, obesity, asthma and pregnancy were responsible for the increase in hospitalizations, respiratory complications and death. Vaccination reduced the risk of negative outcomes by 50%. There were no correlations between socioeconomic indicators and the negative outcomes of COVID-19 in pregnant women.

Lung cancer (LC) is one of the main causes of mortality in Brazil; geographic, cultural, socioeconomic and health access factors can affect the development of the disease. We explored the geospatial distribution of LC mortality, and associated factors, between 2015 and 2019, in Parana state, Brazil. We obtained mortality (from the Brazilian Health Informatics Department) and population rates (from the Brazilian Institute of Geography and Statistics [IBGE]) in people over 40 years old, accessibility of oncology centers by municipality, disease diagnosis rate (from Brazilian Ministry of Health), the tobacco production rate (IBGE) and Parana Municipal Performance Index (IPDM) (from Parana Institute for Economic and Social Development). Global Moran’s Index and Local Indicators of Spatial Association were performed to evaluate the spatial distribution of LC mortality in Parana state. Ordinary Least Squares Regression and Geographically Weighted Regression were used to verify spatial association between LC mortality and socioeconomic indicators and health service coverage. A strong spatial autocorrelation of LC mortality was observed, with the detection of a large cluster of high LC mortality in the South of Parana state. Spatial regression analysis showed that all independent variables analyzed were directly related to LC mortality by municipality in Paraná. There is a disparity in the LC mortality in Parana state, and inequality of socioeconomic and accessibility to health care services could be associated with it. Our findings may help health managers to intensify actions in regions with vulnerability in the detection and treatment of LC.

Pacientes oncológicos possuem riscos mais elevados para o desenvolvimento da doença por COVID-19 em sua forma mais severa. Objetivo: analisar a mortalidade por câncer de mama associada a COVID-19 em mulheres brasileiras. Metodologia: Trata-se de um estudo quantitativo. Os dados foram coletados no site do Open Data SUS, no período de janeiro a agosto de 2020. Utilizou-se estatística descritiva para análise dos dados. Resultados: o câncer de mama associado ao COVID-19 causou 69 óbitos nesse período, as idades que tiveram maior número de óbitos foram nos intervalos de idade 45-49 (14.5%), 60-64 (14.5%) e 65-69 anos (14.5%). Sobre a raça, (56,52%) eram brancos, seguida da cor parda (31,88%). Apenas (31,88%) apresentaram 8 anos ou mais de estudos e (49.27%) eram casadas. Em relação a causa básica da morte, o CID B34.2 (Infecção pelo Coronavírus de localização não especificada) se apresentou em maior número, com uma frequência de 52 (75.36%) e o CID C50.9 (Neoplasia maligna de mama, não especificada) teve uma frequência de 17 (24.64%). A cidade com maior número de óbitos por câncer de mama associada a COVID-19 no qual atingiu (20,29%) dos casos foi o Rio de Janeiro (RJ), seguida pela cidade de São Bernardo do Campo (SP) com (7.25%). Conclusão: O aumento da mortalidade por câncer de mama no período da pandemia do COVID-19 no Brasil pode estar atribuído à imunossupressão dessas mulheres e as medidas de enfrentamento ao COVID-19, no qual reduziu a procura por cuidados de saúde, acesso e disponibilidade de serviços de diagnóstico.

Ovarian cancer is the eighth cause of death by cancer in women worldwide. The objective of this study was to analyze trends in the Brazilian ovarian cancer mortality and the relation to age, schooling, and race. Data was collected in the Brazilian Mortality Information System (SIM), from 2006 to 2016. The polynomial regression model was used for the trends analysis, a significant trend was considered when the estimated model obtained a p-value <0.05. Ovarian Cancer caused 34,003 deaths in Brazilian women in this period, the mortality rate (MR) was 0.46 per 100.000 women aged less than 40; 4.2 in women aged between 40 – 59; 12.2 in women aged between 60 – 79 and 19.4 in women 80 years old or more. About Race, 65% were White, others were declared as Black, Asian, Mixed-race, or Indigenous. Only 26% had 8 years or more of schooling. Mortality rates from ovarian cancer seemed to be rising in Brazil, the major increase happened in the South, the Southeast, and the Middle-West Regions. Women aged between 40 to 59 had the most significant increase. Politics are needed to facilitate the Brazilian population's access to health services, consequently minimizing the time to diagnose and start the treatment. Research about mortality rates could help health workers identify gaps in knowledge and consequently decrease the magnitude of the disease.

Background: Breast cancer is the most common type of cancer worldwide. If diagnosed and treated early, it has a high chance of cure, and for this, screening tests are necessary, namely mammograms, which are the most commonly used. The objective of this study was to analyze the association between the number of screening and diagnostic mammograms and the number of hospitalizations and deaths from breast cancer. Methods: This is a cross-sectional, analytical, retrospective study with secondary data made available by the Ministry of Health. Pearson correlation analysis was employed to assess whether the number of mammograms is associated with the number of deaths and hospitalizations, Poisson regression was used to assess whether an increase in the number of mammograms and hospitalizations is related to the number of deaths, and the Cox–Stuart test was used to analyze the temporal trend of the variables under study and the projection of time series. Results: There was a strong positive correlation for all age groups when relating the variables hospitalizations and deaths, a moderate-to-strong correlation for the variables mammography and hospitalization, and a weak correlation for the variables mammography and death. There was no statistical significance in the relationship between the number of mammograms and deaths, whereas the hospitalization variable had a significant impact in relation to death, increasing the chance by 0.015%. There has also been a significant growth trend in the variables deaths and hospitalizations in Brazil over the years. Conclusions: A growing trend was identified from 2013 to 2021, both in hospitalizations and deaths, thus suggesting that strategies aimed at reformulating public health policies are necessary for earlier diagnosis in order to improve the treatment of breast cancer and the prognosis of the disease.