Factors associated with delayed initiation of breast cancer treatment at an oncology referral center in Juiz de Fora, Minas Gerais state, from 2010 to 2019: a cohort study.

Abstract

Objectives: To analyze factors associated with delayed initiation of breast cancer treatment at an oncology referral center in Juiz de Fora, Minas Gerais state, between 2010 and 2019.

Methods: This was a cohort study using data from the Hospital-based Cancer Registry. The probability of not starting treatment within 60 days, in accordance with Brazilian law, was estimated using Kaplan-Meier, method and its association with the factors studied was assessed using the Cox model, presenting hazard ratios (HR) and respective 95% confidence intervals (95%CI).

Results: Among the 911 participants, the probability of delayed treatment initiation was 18.8% (95%CI 16.4;21.5). Those who underwent treatment at a health service other than the one where the cancer was diagnosed had a significantly higher risk (HR: 3.49; 95%CI 3.00;4.07).

Conclusion: Receiving a diagnosis and treatment at the same institution may help reduce waiting time to initiate cancer treatment.

Main results: The probability of study participants not initiating treatment within 60 days was 18.8%. Undergoing treatment at a healthcare service other than the one where the diagnosis was made was the main factor associated with delay.

Implications for services: Organizing healthcare services based on strategies that optimize referral flows and avoid transitions of care, can be crucial in reducing the time to initiation of breast cancer treatment.

Perspectives: It is essential to improve the workflows at the different stages of health care to ensure timely initiation of oncological treatment.