How are we allocating physicians to deal with breast cancer in men and women in Brazil?

Abstract

Background: Female breast cancer (FBC) is a well-known public health issue worldwide. However, male breast cancer (MBC), though rare, may be overlooked by both public health authorities and clinicians. Both diseases exhibit similarities, and understanding their behavior over time is crucial to grasping their annual impact on many citizens. Furthermore, analyzing if medical personnel are well allocated and influence disease outcomes in a limited setting such as the Public Health System (PHS) is of utmost importance.

Methods: This ecological study utilized secondary data from 2008 to 2020 to explore the relationship between the number of doctors per 100,000 inhabitants and mortality from FBC and MBC in Brazil. All data were sourced from Brazil's PHS. Mortality rates were analyzed by age and standardized according to the World Health Organization's population figures. The number of physicians was calculated per 100,000 inhabitants. A linear regression analysis was performed using a stepwise selection/backward elimination approach.

Results: Between 2008 and 2020, Brazil recorded 195,969 breast cancer-related deaths among adults, including 2,220 male victims. The majority of these deaths occurred in the Southeast region among patients older than 50 years. Although both MBC and FBC demonstrated increasing trends over the study period, no correlation was found between the number of physicians and mortality rates for MBC. Conversely, an increase in primary care physicians over the years was positively correlated with mortality rates for FBC (p < 0.05). In addition, the number of physicians in the PHS (β = -0.163; 95% CI: -0.240 to -0.085; p = 0.002), oncologists (β = -0.507; 95% CI: -0.881 to -0.134; p = 0.015), and radiotherapists (β = -6.402; 95% CI: -12.357 to -0.446; p = 0.039) all showed an inverse association with FBC mortality.

Conclusions: The increasing trends in FBC and MBC underscore the need for urgent monitoring. Lower FBC mortality correlates with higher numbers of physicians and specialized care, highlighting the critical role of healthcare workforce capacity and the strategic allocation of specialized personnel in enhancing patient outcomes.