Lima Mariana Araujo Neves, Villela Daniel Antunes Maciel
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Programa de Computação Científica, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2021 May 28;37(5):e00214919. doi: 10.1590/0102-311X00214919. eCollection 2021.
Colorectal cancer presents high incidence worldwide, but case-fatality is higher in developing countries. The study's objective was to analyze sociodemographic and clinical factors associated with delay in the initiation of treatment for colorectal cancer in hospitals in Brazil. This is a retrospective study of data from hospital cancer registries in Brazil from 2006 to 2015. The target variable is time to initiation of treatment for colorectal cancer and possible associations between sociodemographic variables and clinical factors. The analysis revealed disparities in time to treatment according to sociodemographic strata and geographic regions. Higher odds of treatment delay were associated with age over 50 years, black race/color (OR = 1.50; 95%CI: 1.21-1.84) and brown race/color (OR = 1.28; 95%CI: 1.17-1.42), illiteracy or low schooling (OR = 1.50; 95%CI: 1.19-1.90), and treatment in a city far from the patient's residence (OR = 1.25; 95%CI: 1.14-1.38). For rectal cancer, higher odds of treatment delay were associated with age over 50 years, black (OR = 1.44; 95%CI: 1.20-1.72) or brown race/color (OR = 1.29; 95%CI: 1.19-1.39), illiteracy or low schooling (OR = 1.71; 95%CI: 1.40-2.09), and treatment in a city far from the patient's residence (OR = 1.35; 95%CI: 1.25-1.47). In conclusion, greater attention should be given to reducing the time to initiation of treatment in underprivileged regions and in social strata identified with barriers to timely treatment access.
结直肠癌在全球范围内发病率很高,但在发展中国家病死率更高。该研究的目的是分析巴西医院中与结直肠癌治疗起始延迟相关的社会人口统计学和临床因素。这是一项对巴西2006年至2015年医院癌症登记数据的回顾性研究。目标变量是结直肠癌治疗起始时间以及社会人口统计学变量与临床因素之间可能存在的关联。分析揭示了根据社会人口统计学阶层和地理区域在治疗时间上的差异。治疗延迟几率较高与50岁以上年龄、黑人种族/肤色(比值比=1.50;95%置信区间:1.21-1.84)和棕色种族/肤色(比值比=1.28;95%置信区间:1.17-1.42)、文盲或受教育程度低(比值比=1.50;95%置信区间:1.19-1.90)以及在远离患者居住地的城市接受治疗(比值比=