Factors associated with delayed initiation of breast cancer treatment at an oncology referral center in Juiz de Fora, Minas Gerais state, from 2010 to 2019: a cohort study.

IF 2.5 Q1 Multidisciplinary Epidemiologia e Servicos de Saude Pub Date : 2024-08-23 eCollection Date: 2024-01-01 DOI:10.1590/S2237-96222024v33e20231177.en
Fernanda de Paula Ciribelli da Silva, Mirian Carvalho Souza, Neilane Bertoni
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Abstract

Objectives: 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.

Methods: 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).

Results: 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).

Conclusion: Receiving a diagnosis and treatment at the same institution may help reduce waiting time to initiate cancer treatment.

Main results: 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.

Implications for services: 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.

Perspectives: It is essential to improve the workflows at the different stages of health care to ensure timely initiation of oncological treatment.

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2010 年至 2019 年米纳斯吉拉斯州胡伊斯德福拉市一家肿瘤转诊中心乳腺癌治疗延迟的相关因素:一项队列研究。
目的分析 2010 年至 2019 年期间米纳斯吉拉斯州 Juiz de Fora 一家肿瘤转诊中心乳腺癌治疗延迟的相关因素:这是一项队列研究,使用的数据来自医院癌症登记处。根据巴西法律,采用 Kaplan-Meier 方法估算了未在 60 天内开始治疗的概率,并采用 Cox 模型评估了该概率与所研究因素的关系,给出了危险比(HR)和各自的 95% 置信区间(95%CI):在 911 名参与者中,延迟开始治疗的概率为 18.8% (95%CI 16.4;21.5)。在癌症确诊地以外的医疗服务机构接受治疗的风险明显更高(HR:3.49;95%CI 3.00;4.07):结论:在同一机构接受诊断和治疗可能有助于缩短癌症治疗的等待时间:主要结果:研究参与者未在 60 天内开始治疗的概率为 18.8%。在诊断地以外的医疗机构接受治疗是导致治疗延迟的主要因素:对服务机构的启示:根据优化转诊流程和避免护理过渡的策略来组织医疗服务,对于缩短乳腺癌治疗的开始时间至关重要:展望:改善医疗保健不同阶段的工作流程对确保及时开始肿瘤治疗至关重要。
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来源期刊
Epidemiologia e Servicos de Saude
Epidemiologia e Servicos de Saude PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
4.90
自引率
0.00%
发文量
88
审稿时长
21 weeks
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