Factors associated with delay in specialized treatment after diagnosis of cervical cancer in Bahia State, Brazil

Dândara Santos Silva, Mônica Conceição Pinto, M. A. Figueiredo
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Abstract

This study aimed to analyze factors associated with delay in specialized treatment after diagnosis of cervical cancer in the State of Bahia, Brazil. This was a cross-sectional hospital-based study of women treated in accredited units in the Hospital-Based Cancer Registry (HBCR) system in the State of Bahia from 2008 to 2017. A descriptive analysis and logistic regression were performed with backward stepwise modeling to estimate crude and adjusted prevalence ratios (PR), defining statistical significance as p ≤ 0.05 in Pearson’s chi-square test. We analyzed 9,184 cases, and 65% had delayed treatment (time between diagnosis and first treatment > 60 days). Delayed treatment was more prevalent among women 65 years or older (PR = 1.30; 95%CI: 1.21-1.39), with no schooling (PR = 1.24; 95%CI: 1.15-1.33), and in advanced stages (PR = 1.17; 95%CI: 1.13-1.21). Most of the cases analyzed had delayed treatment, more prevalent among older women, with less schooling, and advanced tumor stages, highlighting the need to expand access to cancer treatment services in Bahia state, especially for these groups in worse conditions.
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巴西巴伊亚州宫颈癌诊断后延迟专科治疗的相关因素
本研究旨在分析巴西巴伊亚州宫颈癌诊断后延迟专科治疗的相关因素。这是一项以医院为基础的横断面研究,研究对象是2008年至2017年在巴伊亚州医院癌症登记(HBCR)系统认可的单位接受治疗的妇女。采用后向逐步模型进行描述性分析和logistic回归,估计粗患病率和校正患病率(PR), Pearson卡方检验中p≤0.05为统计学显著性。我们分析了9184例病例,65%的患者延迟治疗(从诊断到首次治疗的时间为60天)。延迟治疗在65岁及以上的妇女中更为普遍(PR = 1.30;95%CI: 1.21-1.39),未上过学(PR = 1.24;95%CI: 1.15-1.33)和晚期(PR = 1.17;95%置信区间:1.13—-1.21)。分析的大多数病例延迟了治疗,在受教育程度较低的老年妇女和肿瘤晚期中更为普遍,突出表明需要在巴伊亚州扩大获得癌症治疗服务的机会,特别是对这些条件较差的群体。
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