Frequency and factors associated with delay in breast cancer treatment in Brazil, according to data from the Oncology Panel, 2019-2020

Nogueira, Mário Círio; Atty, Adriana Tavares de Moraes; Tomazelli, Jeane; Jardim, Beatriz Cordeiro; Bustamante-Teixeira, Maria Teresa; Azevedo e Silva, Gulnar

doi:10.1590/S2237-96222023000300004

Mário Círio Nogueira

concept and design of the study

analysis and interpretation of the results

drafting and critically reviewing the contents of the manuscript

approved the final version of the manuscript

responsible for all aspects thereof, including the guarantee of its accuracy and integrity

Universidade Federal de Juiz de Fora, Programa de Pós-Graduação em Saúde Coletiva, Juiz de Fora, MG, Brasil.

http://orcid.org/0000-0001-9688-4557

Adriana Tavares de Moraes Atty

concept and design of the study

analysis and interpretation of the results

drafting and critically reviewing the contents of the manuscript

approved the final version of the manuscript

responsible for all aspects thereof, including the guarantee of its accuracy and integrity

Instituto Nacional de Câncer José Alencar Gomes da Silva, Divisão de Detecção Precoce e Apoio a Organização de Rede, Rio de Janeiro, RJ, Brasil.

http://orcid.org/0000-0003-2271-746X

Jeane Tomazelli

analysis and interpretation of the data

drafting and critically reviewing the contents of the manuscript

approved the final version of the manuscript

responsible for all aspects thereof, including the guarantee of its accuracy and integrity

Instituto Nacional de Câncer José Alencar Gomes da Silva, Divisão de Pesquisa Populacional, Rio de Janeiro, RJ, Brasil.

http://orcid.org/0000-0002-2472-3444

Beatriz Cordeiro Jardim

analysis and interpretation of the data

drafting and critically reviewing the contents of the manuscript

approved the final version of the manuscript

responsible for all aspects thereof, including the guarantee of its accuracy and integrity

Instituto Nacional de Câncer José Alencar Gomes da Silva, Divisão de Detecção Precoce e Apoio a Organização de Rede, Rio de Janeiro, RJ, Brasil.

http://orcid.org/0000-0002-3075-2591

Maria Teresa Bustamante-Teixeira

concept and design of the study

drafting and critically reviewing the contents of the manuscript

approved the final version of the manuscript

responsible for all aspects thereof, including the guarantee of its accuracy and integrity

Universidade Federal de Juiz de Fora, Programa de Pós-Graduação em Saúde Coletiva, Juiz de Fora, MG, Brasil.

http://orcid.org/0000-0003-0727-4170

Gulnar Azevedo e Silva

concept and design of the study

drafting and critically reviewing the contents of the manuscript

approved the final version of the manuscript

responsible for all aspects thereof, including the guarantee of its accuracy and integrity

Universidade Estadual do Rio de Janeiro, Instituto de Medicina Social Hesio Cordeiro, Rio de Janeiro, RJ, Brasil.

http://orcid.org/0000-0001-8734-2799

*Correspondence
Adriana Tavares de Moraes Atty aatty@inca.gov.br

Associate editor

Doroteia Aparecida Höfelmann

Conflicts of interest

The authors declare that they have no conflicts of interest.

Variables	Total (n = 78,527)	Time (in days)		p-value^a
	Total (n = 78,527)	≤ 60 (n = 37,849)	> 60 (n = 40,678)
	n (%)	n (%)	n (%)
Age (in years)				< 0.001
≤ 39	8,850 (100.0)	5,358 (60.5)	3,492 (39.5)
40-49	17,800 (100.0)	8,983 (50.5)	8,817 (49.5)
50-59	21,189 (100.0)	10,011 (47.2)	11,178 (52.8)
60-69	17,791 (100.0)	7,841 (44.1)	9,950 (55.9)
≥ 70	12,897 (100.0)	5,656 (43.9)	7,241 (56.1)
Year of diagnosis				< 0.001
2019	42,102 (100.0)	19,146 (45.5)	22,956 (54.5)
2020	36,425 (100.0)	18,703 (51.3)	17,722 (48.7)
Municipality where treatment was provided				< 0.001
Same municipality (of residence)	36,351 (100.0)	17,757 (48.8)	18,594 (51.2)
Another municipality, up to 200 km away	37,158 (100.0)	17,836 (48.0)	19,322 (52.0)
Another municipality, more than 200 km away	5,018 (100.0)	2,256 (45.0)	2,762 (55.0)
Treatment in other health macro-region				< 0.001
No	67,827 (100.0)	32,885 (48.5)	34,942 (51.5)
Yes	10,700 (100.0)	4,964 (46.4)	5,736 (53.6)
Licensed service in macro-region of residence				< 0.001
Yes	74,824 (100.0)	36,198 (48.4)	38,626 (51.6)
No	3,703 (100.0)	1,651 (44.6)	2,052 (55.4)
Average per capita income in macro-region of residence				< 0.001
1^st tercile	26,636 (100.0)	13,194 (49.5)	13,442 (50.5)
2^nd tercile	23,515 (100.0)	11,347 (48.3)	12,168 (51.7)
3^rd tercile	28,376 (100.0)	13,308 (46.9)	15,068 (53.1)
Region of residence in Brazil				< 0.001
North	3,162 (100.0)	1,485 (47.0)	1,677 (53.0)
Northeast	18,489 (100.0)	9,233 (49.9)	9,256 (50.1)
Southeast	35,689 (100.0)	16,217 (45.4)	19,472 (54.6)
South	16,147 (100.0)	8,577 (53.1)	7,570 (46.9)
Midwest	5,040 (100.0)	2,337 (46.4)	2,703 (53.6)

Region	Federative Unit of residence	2019		2020
		Cases	Delay	Cases	Delay
		n (%)	n (%)	n (%)	n (%)
North	Acre	64 (100.0)	36 (56.3)	64 (100.0)	31 (48.4)
	Amapá	53 (100.0)	30 (56.6)	51 (100.0)	28 (54.9)
	Amazonas	397 (100.0)	233 (58.7)	385 (100.0)	228 (59.2)
	Pará	702 (100.0)	359 (51.1)	584 (100.0)	340 (58.2)
	Rondônia	156 (100.0)	80 (51.3)	253 (100.0)	110 (43.5)
	Roraima	46 (100.0)	31 (67.4)	52 (100.0)	9 (17.3)
	Tocantins	192 (100.0)	95 (49.5)	163 (100.0)	67 (41.1)
Northeast	Alagoas	487 (100.0)	255 (52.4)	442 (100.0)	230 (52.0)
	Bahia	2,324 (100.0)	1,277 (54.9)	2,035 (100.0)	1,070 (52.6)
	Ceará	1,868 (100.0)	968 (51.8)	1,725 (100.0)	798 (46.3)
	Maranhão	637 (100.0)	369 (57.9)	652 (100.0)	322 (49.4)
	Paraíba	861 (100.0)	495 (57.5)	772 (100.0)	442 (57.3)
	Pernambuco	1,860 (100.0)	888 (47.7)	1,521 (100.0)	670 (44.0)
	Piauí	577 (100.0)	227 (39.3)	433 (100.0)	173 (40.0)
	Rio Grande do Norte	845 (100.0)	432 (51.1)	705 (100.0)	312 (44.3)
	Sergipe	404 (100.0)	192 (47.5)	341 (100.0)	136 (39.9)
Southeast	Espírito Santo	955 (100.0)	464 (48.6)	819 (100.0)	337 (41.1)
	Minas Gerais	5,021 (100.0)	2,864 (57.0)	4,199 (100.0)	2,128 (50.7)
	Rio de Janeiro	3,900 (100.0)	2,433 (62.4)	3,213 (100.0)	1,805 (56.2)
	São Paulo	9,459 (100.0)	5,485 (58.0)	8,123 (100.0)	3,956 (48.7)
South	Paraná	2,927 (100.0)	1,185 (40.5)	2,602 (100.0)	899 (34.6)
	Rio Grande do Sul	3,560 (100.0)	1,832 (51.5)	3,079 (100.0)	1,436 (46.6)
	Santa Catarina	2,058 (100.0)	1,235 (60.0)	1,921 (100.0)	983 (51.2)
Midwest	Distrito Federal	476 (100.0)	288 (60.5)	481 (100.0)	285 (59.3)
	Goiás	1,194 (100.0)	611 (51.2)	974 (100.0)	525 (53.9)
	Mato Grosso	565 (100.0)	286 (50.6)	451 (100.0)	199 (44.1)
	Mato Grosso do Sul	514 (100.0)	306 (59.5)	385 (100.0)	203 (52.7)
Brazil		42,102 (100.0)	22,956 (54.5)	36,425 (100.0)	17,722 (48.7)

Variables	Simple model			Multiple model^d
Variables	OR^b	95%CI^c	p-value	OR^b	95%CI^c	p-value
Age group (in years)
≤ 9 years	1.00		< 0.001^e	1.00		< 0.001^e
40-49	1.50	1.42;1.58		1.49	1.42;1.57
50-59	1.70	1.62;1.79		1.70	1.61;1.79
60-69	1.93	1.83;2.03		1.93	1.83;2.03
≥ 70	1.95	1.85;2.07		1.95	1.85;2.07
Year of diagnosis
2019	1.00			1.00
2020	0.79	0.76;0.81	< 0.001^f	0.79	0.77;0.81	< 0.001^f
Municipality where treatment was provided
Same municipality (of residence)	1.00		< 0.001^e	1.00		< 0.001^e
Another municipality, up to 200 km away	1.07	1.03;1.10		1.09	1.05;1.12
Another municipality, more than 200 km away	1.20	1.11;1.29		1.21	1.13;1.31
Treatment outside health macro-region of residence
No	1.00
Yes	1.03	0.97;1.09	0.299^f
Licensed service in health macro-region of residence
Yes	1.00
No	1.11	0.91;1.35	0.325^f
Region of residence in Brazil
South	1.00
North	1.05	0.80;1.39	0.729^f
Northeast	1.06	0.85;1.32	0.592^f
Southeast	1.18	0.96;1.46	0.119^f
Midwest	1.10	0.84;1.43	0.490^f

[1] *Correspondence
Adriana Tavares de Moraes Atty aatty@inca.gov.br

Brasil

Brasil

Frequency and factors associated with delay in breast cancer treatment in Brazil, according to data from the Oncology Panel, 2019-2020

Frecuencia y factores asociados al retraso en el tratamiento del cáncer de mama en Brasil, según datos del Panel de Oncología, 2019-2020

Abstract

Objective:

Method:

Results:

Conclusion: