Epidemiological Characteristics of Families and Patients with Cancer in the State of São Paulo, their Difficulties and Challenges in Accessing the Barretos Children's Cancer Hospital

ABSTRACT

Introduction:  Cancer corresponds to abnormal proliferation of cells and, although it can be considered rare in children, adolescents and young adults, is the leading cause of death from disease up to the age of 29.

Objective:  To investigate the epidemiological characteristics of patients and families, by region of the State of São Paulo, with a contextual analysis of the first care and the difficulties in arriving at the Barretos Children's Cancer Hospital.

Method:  Cross-sectional, ambispective study, from January 2015 to January 2023, using questionnaires and descriptive analysis of data with quantitative variables median (variation in days) and qualitative variables (absolute and/or relative frequency), using Student's t, Kruskal-Wallis and ANOVA or Bonferroni variance tests and chi-square or Fisher's exact.

Results:  650 patients were analyzed, most of whom were male (54%), white (68.1%), living in urban areas (95.4%) and with an average family income (67.7%). Considering all patients, the first consultation was most frequent in the public service (57.1%), in the National Health System office (30.8%) with the need for one more consultation after the first evaluation (37.2%). Residents of regions far from the oncology center had their first consultation in a private office (32.4%) and four or more consultations in more than 25% of cases. The biggest barrier was related to the health system (16.8%), with slow procedures. Hematological neoplasms were more frequent (33.7%).

Conclusion:  The health system was the greatest obstacle for patients, suggesting inequity of access related to sociodemographic and economic factors of the population.

Key words:
Neoplasms/epidemiology; Access to Primary Care; Barriers to access health services; Diagnosis