Deputada cobra ANS e Ministério da Saúde sobre possível recusa de mamografia para mulheres 40+

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Rosana Valle (PL-SP) oficiou o presidente da agência reguladora e a União, alertando sobre Consulta Pública que indica este tipo de exame apenas para quem tem a partir de 50 anos; segundo Sociedade Brasileira de Mastologia (SBM), 40% dos casos de câncer de mama são identificados antes dos 50 anos

A deputada federal Rosana Valle (PL-SP) protocolou um ofício na Agência Nacional de Saúde Suplementar (ANS) e no Ministério da Saúde cobrando explicações “e clareza” quanto à Consulta Pública 144.

Lançada recentemente pela entidade reguladora, a medida, na análise da liberal, “confusa e com ares de obstrução”, pode impedir o acesso de brasileiras de 40 a 50 anos a mamografias viabilizadas por planos de saúde.

A ANS avalia a criação de uma “Certificação de Boas Práticas em Atenção Oncológica”, que tem como critério a indicação do exame de rastreio na rede privada apenas a partir dos 50 anos, e a cada dois anos – e não mais anualmente.

Na prática, a partir desta Consulta Pública em aberto, existe o risco de médicos da rede privada começarem a recomendar mamografia apenas para pacientes com mais de 50 anos, uma vez que a decisão estará, em tese, condicionada ao “padrão de qualidade” a ser considerado pelos convênios na liberação da tal certificação.

No ofício endereçado ao diretor-presidente da ANS, Paulo Roberto Rebello Filho, e à ministra da Saúde, Nísia Trindade, na sexta-feira (24/1), Rosana justifica que, diminuir a periodicidade deste tipo de análise para dois anos e aumentar a idade recomendada faz com que menos mamografias sejam autorizadas pelos convênios – o que, aparentemente, vai ao encontro “de interesses econômicos” dos planos de saúde.

“A criação de um selo de qualidade é positiva, mas condicionar sua outorga ao pedido de mamografia só a partir dos 50 anos, e ainda a cada dois anos, vai na direção contrária da recomendação da maior parte das entidades médicas.

Isso é lamentável; parece até mentira! Cerca de 40% dos diagnósticos de câncer de mama são abaixo dos 50 anos. Isso é um retrocesso!”, reforça a congressista.

Rosana se refere a práticas de Medicina do País que preconizam este tipo de exame a partir dos 40 anos, e com indicação anual, como é o caso da Federação Brasileira de Instituições Filantrópicas de Apoio à Saúde da Mama (Femama) e a Sociedade Brasileira de Mastologia (SBM).

A liberal também alerta que, o número de jovens diagnosticadas com câncer de mama tem crescido no Brasil.

Segundo dados de 2009 do Instituto Nacional de Câncer (Inca), do total de pacientes com a doença, a faixa etária até 40 anos representava 7,9% do total de acometidas. Já em 2020, o percentual chegou a 21,8%.

De acordo com a parlamentar do PL-SP, outro fator importante que justifica o pedido de mudança na Consulta Pública da ANS é o fato de o câncer de mama em jovens ter a tendência de ser mais agressivo, o que demanda, consequentemente, diagnóstico precoce:

“Isto tudo está me parecendo uma grande trapalhada da ANS ou, de maneira consciente, um plano para que os convênios tenham mais lucro e menos gastos – sendo que as duas opções são absurdas. Na prática, os médicos da rede privada vão recomendar que a mamografia seja feita a partir dos 50 anos, possivelmente pressionados pelas operadoras, que vão condicionar a decisão a tal ‘Certificação de Boas Práticas em Oncologia’”, teme a liberal, que está no segundo mandato no Congresso Nacional e, também, é presidente da Executiva Estadual do PL Mulher de São Paulo.  

Na qualidade de cidadã, Rosana acessou a Consulta Pública 144 e deu parecer contrário à ideia de baixar a indicação de mamografia para cobertura dos planos de saúde de 40 para 50 anos:

“E, na qualidade de deputada federal, estou cobrando explicações e clareza da ANS e do Ministério da Saúde neste processo. A falta de credibilidade do governo federal cresce, a cada dia.

A União precisa, com urgência, melhorar sua Comunicação e parar de brincar com a vida dos brasileiros. Quando questionada sobre o assunto, a ANS diz que não muda nada. Então, pergunto: para que a tal Consulta Pública? Está parecendo a história do Pix – não iam taxar, mas iam monitorar.

E monitorar para que? Por fim, derrubaram tudo”, relembra a política.

Vídeo e foto em alta resolução para download

ROSANA VALLE (PL-SP) | ANS | MAMOGRAFIA

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Fiamini – Soluções Integradas em Comunicação – A serviço do Gabinete da Deputada Federal Rosana Valle (PL-SP)

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Câmara dos Deputados, Anexo IV, Gabinete 529, Praça dos Três Poderes, Brasília/DF – CEP: 70160-900
Tel.: (61) 3215-5529 | dep.rosanavalle@camara.leg.br
CÂMARA DOS DEPUTADOS
GABINETE DA DEPUTADA ROSANA VALLE – PL/SP
Ofício N. 08/2025 /GAB-SSZ
Brasília, 24 de janeiro de 2025.
Ao Senhor
Paulo Rebello
Diretor-Presidente da Agencia Nacional de Saúde Suplementar
Assunto: Consulta Pública ANS 144.
Senhor Presidente,
A população do Estado de São Paulo tem demonstrado uma
preocupação crescente com a possibilidade de mudança nas normas dos planos
de saúde, que pode ocorrer após a Consulta Pública 144, que inclui na Resolução
Normativa 506/2022 o anexo III, que contém o Manual de Boas Práticas em
Atenção Oncológica.
A razão da preocupação é de se diminuir a quantidade de
diagnósticos precoces de câncer de mama, visto que esse Manual prevê que para
obter a certificação a operadora de planos de saúde deve recomendar a seus
pacientes a realização de mamografias a partir dos 50 anos, com um intervalo de
dois anos entre elas, como hoje é feito no SUS.
As melhores práticas de medicina preconizam a mamografia a partir
dos 40 anos, a ser realizada anualmente, como é o caso da recomendação da
Federação Brasileira de Instituições Filantrópicas de Apoio à Saúde da Mama
(Femama) e a Sociedade Brasileira de Mastologia (SBM).
Entendemos que a própria mamografia tem seus riscos, mas o
número de mulheres jovens diagnosticadas com câncer de mama tem crescido,
segundo o próprio INCA, em 2009 do total de pacientes com a doença a faixa
Câmara dos Deputados, Anexo IV, Gabinete 529, Praça dos Três Poderes, Brasília/DF – CEP: 70160-900
Tel.: (61) 3215-5529 | dep.rosanavalle@camara.leg.br
CÂMARA DOS DEPUTADOS
GABINETE DA DEPUTADA ROSANA VALLE – PL/SP
etária até os 40 anos representava 7,9% do total, em 2020 esse percentual já era
de 21,8%, o que nos leva a acreditar que há uma mudança de perfil nos pacientes.
Outra questão importante é que o câncer de mama em mulheres
mais jovens tende a ser mais agressivo, o que demanda um diagnóstico num
momento anterior aos seus 50 anos.
Importante destacar também que diminuir a periodicidade dos
exames e aumentar a idade recomendada para a mamografia faz com que menos
desses procedimentos sejam realizados nos planos de saúde, então, afeta os
interesses econômicos dessas instituições, se menos procedimentos são
realizados o plano de saúde é menos utilizado.
Representando a população do Estado de São Paulo, venho,
portanto, me posicionar contra essa possível regulamentação, por considerar que
esse tipo de certificação é importante, mas deveria ser dada aos planos de saúde
que recomendarem a mamografia a partir dos 40 anos e anualmente, e não dos
50, a cada dois anos.
Em último lugar, venho recomendar à ANS que mude a dinâmica de
descrição das suas Consultas Públicas, a falta de clareza sobre o real conteúdo da
norma a ser modificada e os seus efeitos práticos deve ser de fácil entendimento
pela população afetada.
Pela falta de clareza da Consulta Pública, o entendimento geral é de
que os exames seriam negados pelos planos de saúde caso fossem feitos por
mulheres abaixo dos 50 anos, isso porque a sugestão é de uma mudança feita
pela inclusão de um anexo ao art. 27 da resolução, que introduz um documento
de 304 páginas.
Documentos como este são de difícil entendimento pelo cidadão
comum. Não basta a informação estar disponível, ela deve estar exposta de uma
maneira que facilite o entendimento, e esse veio por meio das reportagens, o que
Câmara dos Deputados, Anexo IV, Gabinete 529, Praça dos Três Poderes, Brasília/DF – CEP: 70160-900
Tel.: (61) 3215-5529 | dep.rosanavalle@camara.leg.br
CÂMARA DOS DEPUTADOS
GABINETE DA DEPUTADA ROSANA VALLE – PL/SP
criou uma infinidade de interpretações, que poderiam ter sido evitadas se a
informação estivesse exposta de maneira clara e resumida, logo na descrição, ou
em uma nova aba no site da Consulta Pública, por exemplo.
Pelos fatos acima relatados, certa de poder contar com o apoio da
Agencia Nacional de Saúde Suplementar, desde já agradeço a atenção e
aproveito a oportunidade para enviar votos de estima e elevada consideração.
Atenciosamente,
Rosana Valle
Deputada Federal
PL/SP
Câmara dos Deputados, Anexo IV, Gabinete 529, Praça dos Três Poderes, Brasília/DF – CEP: 70160-900
Tel.: (61) 3215-5529 | dep.rosanavalle@camara.leg.br
CÂMARA DOS DEPUTADOS
GABINETE DA DEPUTADA ROSANA VALLE – PL/SP
Ofício N. 09/2025 /GAB-SSZ
Brasília, 24 de janeiro de 2025.
À Senhora
Nísia Trindade
Ministra da Saúde
Assunto: Consulta Pública ANS 144.
Senhora Ministra,
A população do Estado de São Paulo tem demonstrado uma
preocupação crescente com a possibilidade de mudança nas normas dos planos
de saúde, que pode ocorrer após a Consulta Pública 144, que inclui na Resolução
Normativa 506/2022 o anexo III, que contém o Manual de Boas Práticas em
Atenção Oncológica.
A razão da preocupação é de se diminuir a quantidade de
diagnósticos precoces de câncer de mama, visto que esse Manual prevê que para
obter a certificação a operadora de planos de saúde deve recomendar a seus
pacientes a realização de mamografias a partir dos 50 anos, com um intervalo de
dois anos entre elas, como hoje é feito no SUS.
As melhores práticas de medicina preconizam a mamografia a partir
dos 40 anos, a ser realizada anualmente, como é o caso da recomendação da
Federação Brasileira de Instituições Filantrópicas de Apoio à Saúde da Mama
(Femama) e a Sociedade Brasileira de Mastologia (SBM).
Entendemos que a própria mamografia tem seus riscos, mas o
número de mulheres jovens diagnosticadas com câncer de mama tem crescido,
segundo o próprio INCA, em 2009 do total de pacientes com a doença a faixa
Câmara dos Deputados, Anexo IV, Gabinete 529, Praça dos Três Poderes, Brasília/DF – CEP: 70160-900
Tel.: (61) 3215-5529 | dep.rosanavalle@camara.leg.br
CÂMARA DOS DEPUTADOS
GABINETE DA DEPUTADA ROSANA VALLE – PL/SP
etária até os 40 anos representava 7,9% do total, em 2020 esse percentual já era
de 21,8%, o que nos leva a acreditar que há uma mudança de perfil nos pacientes.
Outra questão importante é que o câncer de mama em mulheres
mais jovens tende a ser mais agressivo, o que demanda um diagnóstico num
momento anterior aos seus 50 anos.
Importante destacar também que diminuir a periodicidade dos
exames e aumentar a idade recomendada para a mamografia faz com que menos
desses procedimentos sejam realizados nos planos de saúde, então, afeta os
interesses econômicos dessas instituições, se menos procedimentos são
realizados o plano de saúde é menos utilizado.
Representando a população do Estado de São Paulo, venho,
portanto, me posicionar contra essa possível regulamentação, por considerar que
esse tipo de certificação é importante, mas deveria ser dada aos planos de saúde
que recomendarem a mamografia a partir dos 40 anos e anualmente, e não dos
50, a cada dois anos.
Em último lugar, venho recomendar ao Ministério junto com a ANS
que mude a dinâmica de descrição das suas Consultas Públicas, a falta de clareza
sobre o real conteúdo da norma a ser modificada e os seus efeitos práticos deve
ser de fácil entendimento pela população afetada.
Pela falta de clareza da Consulta Pública, o entendimento geral é de
que os exames seriam negados pelos planos de saúde caso fossem feitos por
mulheres abaixo dos 50 anos, isso porque a sugestão é de uma mudança feita
pela inclusão de um anexo ao art. 27 da resolução, que introduz um documento
de 304 páginas.
Documentos como este são de difícil entendimento pelo cidadão
comum. Não basta a informação estar disponível, ela deve estar exposta de uma
maneira que facilite o entendimento, e esse veio por meio das reportagens, o que
Câmara dos Deputados, Anexo IV, Gabinete 529, Praça dos Três Poderes, Brasília/DF – CEP: 70160-900
Tel.: (61) 3215-5529 | dep.rosanavalle@camara.leg.br
CÂMARA DOS DEPUTADOS
GABINETE DA DEPUTADA ROSANA VALLE – PL/SP
criou uma infinidade de interpretações, que poderiam ter sido evitadas se a
informação estivesse exposta de maneira clara e resumida, logo na descrição, ou
em uma nova aba no site da Consulta Pública, por exemplo.
Pelos fatos acima relatados, certa de poder contar com o apoio do
Ministério da Saúde em sua supervisão da ANS, desde já agradeço a atenção e
aproveito a oportunidade para enviar votos de estima e elevada consideração.
Atenciosamente,
Rosana Valle
Deputada Federal
PL/SP
Contribuições em consulta pública
Protocolo: 282657
Nome do contato E-mail Data
Rosana de Oliveira Valle contato@rosanavalle.com.br 24/01/2025
Assunto
Consulta Pública – CP nº 144, que tem como objetivo receber contribuições para a alteração
da Resolução Normativa – RN nº 506, de 30 de março de 2022, que institui o Programa de Certificação
de Boas Práticas em Atenção à Saúde das Operadoras de Planos Privados de Assistência à Saúde, bem
como para as propostas de inclusão de anexo à referida norma, contendo o Manual de Certificação de
Boas Práticas em Atenção Oncológica – OncoRede.
Contribuição:
Item de contribuição
ANEXO III: CAPÍTULO II
Opinião
Justificativa
Discordo da recomendação da Agência Nacional de Saúde Suplementar (ANS) que sugere o rastreamento
bienal para mulheres na faixa etária de 50 a 69 anos. Essa orientação ignora importantes dados
epidemiológicos e vai de encontro ao que é preconizado por sociedades médicas respeitadas, como
o Colégio Brasileiro de Radiologia (CBR), a Sociedade Brasileira de Mastologia (SBM) e a Federação
Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO).
Essas instituições defendem o rastreamento anual por meio da mamografia a partir dos 40 anos, e há
razões fundamentadas para isso:

  1. Prevalência da Doença em Mulheres Jovens:
    Estudos mostram que cerca de 40% dos casos de câncer de mama no Brasil são diagnosticados em
    mulheres com menos de 50 anos. Isso indica que a faixa etária entre 40 e 49 anos é um grupo significativo
    que precisa de atenção para o rastreamento precoce.
  2. Impacto nas Taxas de Mortalidade:
    Dados revelam que 22% das mortes por câncer de mama ocorrem em mulheres com menos de 50 anos.
    Esse é um número alarmante e que evidencia como o diagnóstico precoce é crucial para aumentar as
    chances de sobrevida e reduzir a mortalidade nesse grupo.
  3. Benefício do Rastreamento Anual:
    O rastreamento anual permite a detecção precoce de tumores, que, quando identificados em estágios
    iniciais, têm maior probabilidade de cura e menor necessidade de tratamentos mais agressivos.
    Ao restringir o rastreamento a intervalos bienais e limitar a recomendação à faixa etária de 50 a 69 anos, a
    ANS desconsidera a realidade brasileira e expõe um grande número de mulheres ao risco de diagnósticos
    tardios. Essa abordagem pode ter um impacto negativo direto na sobrevida e na qualidade de vida dessas
    pacientes.
    Portanto, é essencial que as políticas públicas de saúde sejam alinhadas às evidências científicas e
    adaptadas ao contexto nacional. Adotar a recomendação de rastreamento anual a partir dos 40 anos,
    como defendem as principais sociedades médicas do Brasil, é uma medida mais adequada para proteger
    a saúde das mulheres e reduzir a mortalidade pelo câncer de mama.

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