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Time-to-treatment initiation for cutaneous melanoma reflects disparities in healthcare access in Brazil: a retrospective study.
Pereira Shimada, G D; Archanjo da Mota, A; Carvalho de Souza, M; Bernardes, S S.
Afiliação
  • Pereira Shimada GD; Faculty of Health Sciences, Federal University of Grande Dourados - UFGD, Dourados, Mato Grasso do Sul, Brazil.
  • Archanjo da Mota A; Faculty of Human Sciences, Federal University of Grande Dourados - UFGD, Dourados, Mato Grasso do Sul, Brazil.
  • Carvalho de Souza M; Population Research Division, National Institute of Cancer, Rio de Janeiro, Rio de Janeiro, Brazil.
  • Bernardes SS; Faculty of Health Sciences, Federal University of Grande Dourados - UFGD, Dourados, Mato Grasso do Sul, Brazil; General Pathology Department, Biological Sciences Institute, Federal University of Minas Gerais - UFMG, Belo Horizonte, Minas Gerais, Brazil. Electronic address: sarabernardes@ufmg.br.
Public Health ; 210: 1-7, 2022 Sep.
Article em En | MEDLINE | ID: mdl-35863157
OBJECTIVES: This study aimed at identifying the sociodemographic and first treatment characteristics affecting time-to-treatment initiation (TTI) of patients with cutaneous melanoma assisted by the Brazilian Unified Health System (SUS). STUDY DESIGN: Retrospective observational study using cutaneous melanoma cases recorded in the Brazilian Hospital-Based Cancer Registries (HBCR). METHODS: A total of 12,783 cutaneous melanoma cases were included in the analysis. Based on the legislation, TTI in Brazil is 60 days; therefore, the cohort was dichotomized into TTI within 60 days and over. The association among variables was evaluated through the Chi-squared test. Kaplan-Meier method and log-rank hypothesis test were used to determine the probability of initiating treatment within 60 days. Cox proportional hazards regression model was used for multivariate analysis. RESULTS: Median TTI was 28 days (95% CI, 25-29). First treatment in SUS provided more than 60 days after diagnosis (34.8%) was associated with females; low level of formal education; living or getting treatment in northern Brazil; being diagnosed in SUS and treated at different healthcare facilities, in addition to starting treatment with radiotherapy or systemic therapy. There were no significant differences in access to health care before and after the enactment of the 60-day law. CONCLUSION: Increased TTI for cutaneous melanoma is associated with sociodemographic and first treatment characteristics in Brazil; approximately one-third of cases did not have access to first treatment within the period established by law. Receiving the diagnosis and treatment at different healthcare facilities (transitions in care) is the main independent factor associated with TTI longer than 60 days.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Melanoma Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male País/Região como assunto: America do sul / Brasil Idioma: En Revista: Public Health Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Holanda
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Melanoma Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male País/Região como assunto: America do sul / Brasil Idioma: En Revista: Public Health Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Holanda