Associação Feminina de Prevenção e Combate ao Câncer de Juiz de Fora, Juiz de Fora, MG, Brazil.
Instituto Nacional de Câncer, Programa de Pós-Graduação em Saúde Coletiva e Controle do Câncer, Rio de Janeiro, RJ, Brazil.
Epidemiol Serv Saude. 2024 Aug 23;33:e20231177. doi: 10.1590/S2237-96222024v33e20231177.en. eCollection 2024.
To analyze factors associated with delayed initiation of breast cancer treatment at an oncology referral center in Juiz de Fora, Minas Gerais state, between 2010 and 2019.
This was a cohort study using data from the Hospital-based Cancer Registry. The probability of not starting treatment within 60 days, in accordance with Brazilian law, was estimated using Kaplan-Meier, method and its association with the factors studied was assessed using the Cox model, presenting hazard ratios (HR) and respective 95% confidence intervals (95%CI).
Among the 911 participants, the probability of delayed treatment initiation was 18.8% (95%CI 16.4;21.5). Those who underwent treatment at a health service other than the one where the cancer was diagnosed had a significantly higher risk (HR: 3.49; 95%CI 3.00;4.07).
Receiving a diagnosis and treatment at the same institution may help reduce waiting time to initiate cancer treatment.
The probability of study participants not initiating treatment within 60 days was 18.8%. Undergoing treatment at a healthcare service other than the one where the diagnosis was made was the main factor associated with delay.
Organizing healthcare services based on strategies that optimize referral flows and avoid transitions of care, can be crucial in reducing the time to initiation of breast cancer treatment.
It is essential to improve the workflows at the different stages of health care to ensure timely initiation of oncological treatment.
分析 2010 年至 2019 年米纳斯吉拉斯州茹伊斯迪福拉肿瘤转诊中心乳腺癌治疗延迟启动的相关因素。
这是一项使用医院癌症登记处数据的队列研究。使用 Kaplan-Meier 方法估计 60 天内未开始治疗的概率（符合巴西法律），并使用 Cox 模型评估其与研究因素的相关性，呈现风险比（HR）和相应的 95%置信区间（95%CI）。
在 911 名参与者中，治疗延迟启动的概率为 18.8%（95%CI 16.4；21.5）。在与诊断癌症的机构不同的医疗机构接受治疗的患者，其风险显著更高（HR：3.49；95%CI 3.00；4.07）。
在同一机构接受诊断和治疗可能有助于减少启动癌症治疗的等待时间。
研究参与者在 60 天内未开始治疗的概率为 18.8%。在与做出诊断的医疗机构不同的医疗机构接受治疗是与延迟相关的主要因素。
基于优化转诊流程和避免护理过渡的策略来组织医疗保健服务可能对减少乳腺癌治疗启动时间至关重要。
改善医疗保健各个阶段的工作流程对于确保及时开始肿瘤治疗至关重要。
