Socioeconomic disparities in epidemiological profiles of cervical cancer in Brazil: a systematic review of variations in diagnosis and survival

Introduction: Cervical cancer, primarily caused by the human papillomavirus (HPV), is marked by the abnormal growth of cells in the cervical-vaginal transition zone. This neoplasm is easily detectable through preventive screenings and remains one of the most common cancers affecting women in Brazil, following only skin and breast cancers. Despite advancements in prevention and treatment, noticeable differences in diagnosis and survival rates among patients persist.

Objective: This study aims to analyze the impact of socioeconomic disparities on the diagnosis and survival of cervical cancer patients in Brazil through a systematic review.

Methods: This systematic literature review was conducted using the MedLine and ScieLo database, focusing on the keywords “Cervical Cancer,” “Social Disparities,” and “Brazil,” along with their variations from Medical Subject Headings (MeSH). Inclusion criteria encompassed studies conducted in the last 10 years, within Brazil, in English, that compared epidemiological profiles of cervical cancer among different socioeconomic groups. Studies that did not provide comparative data or focus on socioeconomic differences were excluded. The PRISMA scale was used to systematize the reporting of this review.

Results: Initially, 32 articles were identified; 26 met the criteria. After a complete reading, 8 articles were selected for final analysis. The studies demonstrated a significant correlation between high mortality rates from the neoplasm and socioeconomic indicators, such as the Gini Index (p = 0.000) and the Human Development Index (HDI) (p = 0.03). Regions with higher HDI showed a decline in the mortality of this cancer between 2003 and 2012 (p < 0.001), as well as a higher rate of early diagnosis compared to the rest of the country. Furthermore, less advantaged regions, such as rural areas in the North and Northeast, presented a higher incidence of cervical cancer (p<0.005), primarily due to factors contributing to inequality in combating the disease, such as a lower number of doctors per 1,000 inhabitants (p < 0.008) and lower education levels (p<0.0018).

Conclusion: While there has been a noticeable reduction in cervical cancer mortality in Brazil, socioeconomic disparities across regions continue to significantly affect the early detection of this disease. Therefore, it is crucial to address these inequalities and ensure that all Brazilian women have equitable access to information and proper medical care.

Corresponding author: Giovanna Lima Emerick (e-mail: giovanna.emerick@gmail.com).