MSD Brazil, São Paulo, Brazil.
IQVIA Brazil, São Paulo, Brazil.
PLoS One. 2024 Oct 30;19(10):e0312757. doi: 10.1371/journal.pone.0312757. eCollection 2024.
The aim of the study is to evaluate the treatment patterns, time to start treatment, and healthcare resources utilization (HCRU) of cervical cancer (CC) patients within the Brazilian public health system (SUS). This is an observational retrospective study using SUS administrative database (DATASUS). Data from January-2014 to December-2020 was gathered from patients with the ICD-10 C53 codes. From 2014 to 2020, 206,861 women were included, among whom 90,073 (43.5%) had stage information. Of staged patients, 60.7% (54,719) had advanced disease (stages III and IV) and the most performed treatments were chemoradiotherapy (CRT) (41.6%), surgery + CRT (19.1%), radiotherapy (RT) only (16.8%) and chemotherapy (CT) only (13.3%). The proportion of patients submitted to CT in advanced stages was higher than in non-advanced stages (I and II), in contrast to RT, which was more frequent in stage I than stage IV. Median time to initiate treatment surpassed two months in approximately 30% of the cases, regardless of stage. Conization was the most performed surgical procedure. The hospitalization rate per patient per month for stage IV was twice as high as stage I (0.05 [95%CI 0.05-0.05] and 0.11 [0.11-0.11], respectively). The same trend was observed for outpatient visits (0.54 [95%CI 0.53-0.55] and 0.96 [0.93-0.98], respectively). This study demonstrated a high proportion of advanced CC at diagnosis in Brazil. The treatment pattern showed that chemoradiotherapy was the most frequent regimen overall and the use of chemotherapy and HCRU increased with staging. These results could provide information to improve public policies towards access to prevention, diagnosis, and treatment of CC in Brazil.
本研究旨在评估巴西公共卫生系统（SUS）中宫颈癌（CC）患者的治疗模式、开始治疗的时间和医疗保健资源利用（HCRU）。这是一项使用 SUS 管理数据库（DATASUS）的观察性回顾性研究。研究数据来自 2014 年 1 月至 2020 年 12 月，共纳入了 206861 名患有 ICD-10 C53 编码的女性患者。在这 206861 名患者中，2014 年至 2020 年期间有 90073 名（43.5%）患者有分期信息。在分期患者中，60.7%（54719 名）患有晚期疾病（III 期和 IV 期），最常见的治疗方法是放化疗（CRT）（41.6%）、手术+ CRT（19.1%）、单纯放疗（RT）（16.8%）和单纯化疗（CT）（13.3%）。在晚期患者中接受 CT 治疗的比例高于非晚期（I 期和 II 期）患者，而 RT 在 I 期患者中比 IV 期更为常见。大约 30%的患者开始治疗的时间超过两个月，与分期无关。在所有手术中，锥切术是最常见的术式。IV 期患者的月住院率是 I 期患者的两倍（分别为 0.05[95%CI 0.05-0.05]和 0.11[0.11-0.11]）。门诊就诊情况也呈现同样趋势（分别为 0.54[95%CI 0.53-0.55]和 0.96[0.93-0.98]）。本研究表明，巴西诊断出的宫颈癌患者中晚期病例比例较高。治疗模式表明，总体上放化疗是最常见的方案，随着分期的增加，化疗和 HCRU 的应用也随之增加。这些结果可以为改善巴西宫颈癌预防、诊断和治疗的公共政策提供信息。
