Open AccessDelays on Treatment Initiation and Associated Factors in a Cohort of Brazilian Women Diagnosed With Cervical Cancer at the National Cancer Institute in Rio De Janeiro
Author(s) -
I.F.d. Silva,
R J Koifman
Publication year - 2018
Publication title -
journal of global oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.002
H-Index - 17
ISSN - 2378-9506
DOI - 10.1200/jgo.18.53400
Subject(s) - medicine , cancer , cervical cancer , stage (stratigraphy) , cohort , retrospective cohort study , logistic regression , gynecology , paleontology , biology
Background: Cervical cancer is still a major public health problem in developing countries, where are observed high mortality rates and poor survival rates. Treatment delays may influence survival and have been associated to poor health care access and quality of care. Aim: To estimate treatment delays, and associated factors among women diagnosed with cervical cancer, treated on the main cancer center in Rio de Janeiro, Brazil. Methods: A retrospective cohort study comprising 865 women newly diagnosed with cervical cancer between 2012 and 2014 was accomplished. Times from diagnose to treatment initiation (≤ 60 > days), and from diagnose to treatment ending ( 120 days) of 92.6%. Median time interval from diagnosis to 1st visit at cancer center was 28 days, with a delay over 30 days of 46.6%. Age (OR=1.05; 95% CI:1.02-1.08), stage IIIB-IVA (OR=0.38; 95% CI: 0.16-0.90), time to first visit at cancer center (OR=11.52; 95% CI: 4.32-30.66), chemo radiation treatment (OR=4.56; 95% CI: 1.81-11.47) and adequate treatment (OR=2.57; 95% CI: 1.26-5.40) were independently associated with delay on treatment initiation. Conclusion: Increased treatment initiation and ending delays were observed in this studied population. Delay on treatment initiation was positively associated with age, time interval over 30 days from diagnosis to 1st visit at the cancer, treatment with chemo radiation, and adequate treatment.