Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil.
Rio de Janeiro State Federal University (UNIRIO), Rio de Janeiro, Brazil.
Health Soc Care Community. 2021 Nov;29(6):1769-1778. doi: 10.1111/hsc.13284. Epub 2021 Jan 13.
This objective this study was to identify the time interval between breast cancer (BC) diagnosis and treatment initiation and delay-associated factors. This is a prospective cohort study that followed breast cancer patients, enrolled and treated at the cancer center in Rio de Janeiro (RJ) - Brazil, from October 02, 2014 to April 30, 2015. Participants were interviewed at the first consultation. Treatment-related information was collected six months after recruitment. The median and interquartile range (IQR) were calculated. The interval between breast cancer diagnosis and treatment initiation of more than 60 days was considered the delay, according to the maximum term determined by Brazilian law. The association between independent variables and the outcome was performed using the crude odds ratios (OR). Variables presenting p < .20 in the univariate analysis were included in the multiple logistic regression model by the stepwise forward method, and those with p < .05 were retained in the final model. A total of 470 patients were included in the study. The median time was of 127 days (IQR: 85- 174). Delay was observed in 89.1% of the cases. After adjustment, the variables associated with delay were age ≥ 60 years (OR: 2.48; 95% CI 1.22-5.06), initial clinical staging (<2B) (OR: 2.01; 95% CI 1.05-3.86) and residence outside the city of Rio de Janeiro (OR: 2.75; 95% CI 1.38-5.51). Delays in starting treatment were associated with sociodemographic and clinical factors. Improving patient quality of care and restructuring the health service can minimise delays.
本研究旨在确定乳腺癌（BC）诊断与治疗开始之间的时间间隔以及与延迟相关的因素。这是一项前瞻性队列研究，对 2014 年 10 月 2 日至 2015 年 4 月 30 日在巴西里约热内卢癌症中心招募和治疗的乳腺癌患者进行了随访。参与者在首次就诊时接受了访谈。在招募后六个月收集与治疗相关的信息。计算了中位数和四分位距（IQR）。根据巴西法律规定的最长期限，将乳腺癌诊断与治疗开始之间超过 60 天的时间间隔定义为延迟。使用未经调整的优势比（OR）对独立变量与结局之间的关联进行了分析。在单因素分析中 p 值<0.20 的变量被纳入逐步向前的多因素逻辑回归模型，p 值<0.05 的变量被保留在最终模型中。共纳入 470 例患者。中位时间为 127 天（IQR：85-174）。89.1%的病例存在延迟。调整后，与延迟相关的变量为年龄≥60 岁（OR：2.48；95%CI 1.22-5.06）、初始临床分期（<2B）（OR：2.01；95%CI 1.05-3.86）和居住地不在里约热内卢市（OR：2.75；95%CI 1.38-5.51）。开始治疗的延迟与社会人口学和临床因素有关。改善患者的护理质量和重构卫生服务可以将延迟降到最低。
