THE IMPACT OF LATE SCREENING FOR FEMALE NEOPLASMS IN PRIMARY HEALTH CARE (APS): ANALYSIS BASED ON THE MINISTRY OF HEALTH PROTOCOL

Resumen

Timely screening for female neoplasms is one of the essential pillars of Primary Health Care (APS), particularly in view of the high burden of morbidity and mortality associated with cervical cancer and breast cancer in Brazil. Despite the existence of consolidated guidelines issued by the Ministry of Health, which establish clear criteria for periodicity, risk groups, and clinical approach, a significant gap remains between formal recommendations and the reality of care delivery. Late screening often results in diagnoses at advanced stages, greater therapeutic complexity, high costs, and unfavorable outcomes, highlighting the need for continuous improvement in health prevention and surveillance strategies. Among the factors contributing to the late performance of examinations, structural barriers stand out, such as insufficient human resources, care demands that overload teams, weaknesses in scheduling appointments and tests, and technological limitations related to the registration and follow‑up of users. Added to this are sociocultural aspects that directly influence the pursuit of care, including low risk perception, fear of diagnosis, misinformation, gender inequalities, and socioeconomic vulnerabilities that restrict ongoing and organized access to services. Inadequate coordination among different points of the network also undermines the diagnostic flow, prolonging the time between screening, case confirmation, and the start of treatment. From a clinical and epidemiological standpoint, the impact of late screening manifests in increased incidence of advanced cases, reduced cure rates, and a higher occurrence of physical and psychosocial sequelae. In APS, this scenario reinforces the importance of proactive team performance, strengthening health education actions, active outreach to women who are overdue, qualified listening, and effective integration with medium‑ and high‑complexity services. The consistent adoption of Ministry of Health recommendations—especially regarding the periodicity of the cytopathological examination and the performance of mammography for the indicated age groups—proves crucial to reverse this picture. In summary, addressing the late screening of female neoplasms requires coordinated actions sensitive to territorial vulnerabilities and a continuous institutional commitment to comprehensive, resolutive, and equitable care.