Padrões espaciais do câncer de mama no município de São Paulo (2023)desigualdades socioespaciais e determinantes sociais de saúde

Resumo

BACKGROUND: Breast cancer is the most incident neoplasm among women and represents a major challenge for health systems due to its epidemiological magnitude and inequalities in access to diagnosis and treatment. In 2022, an estimated 2.3 million new cases and more than 660,000 deaths were reported worldwide. In Brazil, for the 2023–2025 triennium, approximately 73,610 new cases are expected annually. In this context, spatial analysis emerges as a strategic tool to identify territorial patterns and support more equitable public policies. OBJECTIVES: To analyze the spatial distribution of breast cancer cases in the city of São Paulo in 2023 and its relationship with the social determinants of health. METHODS: Ecological study using data from the Hospital-Based Cancer Registry of the Fundação Oncocentro de São Paulo (RHC FOSP) (n = 1,732), georeferenced with high precision. Global spatial autocorrelation was assessed using Moran’s I, with statistical significance tested through Monte Carlo simulations (999 permutations). RESULTS: A positive and statistically significant spatial autocorrelation was observed (I = 0.4447; p < 0.001), indicating a non-random distribution pattern. LISA analysis identified 10 hotspot districts (15.89% of cases), concentrated in the Central and Eastern regions, and 13 coldspots in the Northern and Southern regions. In hotspots, 75% of cases occurred in women aged over 50 years, with high female aging indices. Although located in areas with higher HDI, these districts showed socioeconomic heterogeneity and variability in access to health services, with a substantial proportion initiating treatment more than 90 days after diagnosis. Coldspots were concentrated in more vulnerable areas, with lower average income and greater distances to health services, suggesting access barriers and possible underreporting. These findings highlight the influence of territorial inequalities on disease distribution. CONCLUSIONS: High-incidence clusters of breast cancer constitute territories of persistent risk in the municipality of São Paulo, characterized by pronounced female aging, socioeconomic inequalities, and barriers to timely diagnosis and treatment. The spatial distribution of the disease reflects structural territorial inequalities associated with the social determinants of health, underscoring the need for territorially targeted public policies and integrated strategies focused on prevention, early detection, and the organization of oncological care networks.

Ficha do documento

Tipo

Dissertação

Ano

2026

Instituição

Fundação Getulio Vargas

Fonte

Repositório da FGV

Idioma

Português

Acesso

Acesso aberto

Identificador

oai:repositorio.fgv.br:10438/41415

Temas

Políticas PúblicasDadosSaúdeGestão Municipal

Palavras-chave

GeoanalíticaAnálise espacialEpidemiologiaCâncer de mamaDeterminantes sociais de saúdeGeoanalyticsSpatial analysisEpidemiologyBreast cancerSocial determinants of healthAdministração de empresasMamas - CâncerAcesso aos serviços de saúde - São PauloBanco de dados geográficosAvaliação de resultados (Cuidados médicos)ODS 3: Saúde e bem-estarODS 5: Igualdade de gêneroODS 10: Redução das desigualdades