Ana Maria Valbuena-Garcia , Silvia Juliana Trujillo-Cáceres , Juliana Alexandra Hernández Vargas , Sandra Diaz , Lizbeth Acuña , Sandra Perdomo , Marion Piñeros
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引用次数: 0
Abstract
Background
Early-onset breast cancer (EOBC) refers to breast cancer diagnosed in women aged 18–45 years, being in many cases associated with hereditary breast cancer syndromes, diagnosed at more advanced stages and worse prognosis. In this paper, we sought to describe the main characteristics of EOBC and quality of care within the framework of the national health system in Colombia.
Methods
Cross-sectional study. We used a national administrative cancer registry, including women diagnosed with EOBC between 2017 and 2022. Demographic and clinical characteristics, as well as quality healthcare indicators, were compared (numbers and percentages) over two periods (2017–2019, 2020–2022), stratified by health insurance scheme.
Findings
7621 women with incident EOBC were included, constituting 19.4% (7621/39,238) of all breast cancers reported in the study period. The mean age was 39.2 (SD 5.2). Most of the cases (23% [1753/7621]) were diagnosed at stage IIA. Systemic therapy was the most frequent first treatment. When comparing both periods, the main areas of improvement were related to breast-conserving surgery for early stages (from 60.3% [459/761] to 68.3% [699/1024]), access to palliative care for metastatic cancer (from 29.5% [59/199] to 54.9% [101/184]), and reduction of waiting times. The time from collecting biopsy samples to receiving results showed the biggest improvement between periods (from a mean of 24.5 to 5.0 days). However, delays in initiating treatment persist, with an average of over two months.
Interpretation
While the quality of breast cancer care in women with EOBC has improved in recent years in Colombia, mainly due to better access to specific technologies and treatments, there are important challenges regarding early detection and health services delays that require corrective measures.
Funding
Work at the IARC/WHO was supported by regular budget funding.
期刊介绍：
The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.
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