Integrated health system for resolving breast cancer screening actions: Multicenter randomized clinical study—Itaberaí randomized trial, ReBEC, RBR-39vm2nd.

Abstract

1511 Background: The ITABERAÍ Project involves an intervention through training of Community Health Workers (CHW), based on evidence from clinical breast examinations (CBE) screening. It is a randomized, prospective, phase III, multicenter clinical study. The target population is divided into a Control Group (CG) and an Intervention Group (IG), where the CG receives the Brazilian Ministry of Health’s (MS) recommendations for breast cancer screening, The IG, in addition to the MS recommendations, receives the CBE. Among the stages of the project are the training of CHW and the development of tools for data collection. Objective: This study aims to evaluate the functioning of the integrated system as a tool for the resolution of breast cancer screening actions, according to the ITABERAÍ Project. Methods: Information stored in the integrated system database developed for the project, from 2022 to 2024, was analyzed. The system comprises a set of services and applications that integrates actions from the registration of participants to the diagnosis and treatment of altered cases. It involves the integration of the App Rosa with the Web System (RosaWatch). The App Rosa was created for exclusive use by the CHW to collect data from participants who agree to participate in the study, while RosaWatch is for use by the Family Health Team (FHT), specialist doctors, nurse navigators, and researchers, and was created to collect information on the follow-up of altered cases. To evaluate the functioning of the system, data on the completeness of the information stored according to the Study Group and the follow-up of cancer cases were checked. Results: At the end of 3 years of project implementation, data from 3,670 randomized women were reported, of which 92% (3,359) were active in the project, out of this 1,780 (53%) in the CG and 1,579 (47%) in the IG (p < 0.05). Regarding the completeness of the information, by the end of 2024, it was found that 2,984 (88.8%) had consistent data. Stratifying by year of data collection, a significant increase in completeness was observed: in 2022, of the 425 records, 278 (65%) were compliant; in 2023, of the 2,255 records, 2,117 (94%) were compliant; and in 2024, of the 679 records, 654 (96%) were compliant. During the study period, 3,143 breast exams were performed by the CHW of the IG, with 594 (19%) altered cases. Of these, after screening at the Family Health Units (ESF), 90 (15%) participants received care from a specialist doctor (mastologist), and 10 had a confirmed breast cancer. In the CG, ESF doctors referred 33 women for specialist consultations, and six diagnoses were confirmed. Conclusion: The integrated system proved to be effective in monitoring the actions of the ITABERAÍ Project. Additionally, it contributed to the adherence of the CHW and the quality standard of the information, facilitating better data monitoring. Clinical trial information: RBR-39vm2nd .