Análise do atraso do sistema no diagnóstico e tratamento do câncer de mama

Abstract

Introduction: Breast cancer has high mortality rates, especially in developing countries, due to delays in diagnosis and initiation of treatment, which decrease women's survival. Material and Methods: 304 women were interviewed at two referral centers for the treatment of breast cancer in Paraíba. Sociodemographic data, information about disease perception and flow within the health care network were collected; Subsequently, disease data and exam dates were collected from medical records. In addition to women using public and private services, support was provided by Non-Governmental Organizations (NGOs) that helped some patients with mammogram and biopsy donations at both hospitals. Cox regression, Kaplan-Meyer and descriptive analysis were used to compare time intervals and intervals between patients who received some support from the NGO, those who used less than one private diagnostic service, and those who used public health services. Results: Women who used a private health service at the first appointment had 3.52 times lower chance (95% CI: 2.03-6.12) of delay >90 days until treatment initiation (p= 0.000). The average delay between the first visit and the diagnosis was 56 days, and between the first visit and the start of treatment was 116.5 days. The average delay between the first consultation and diagnosis of women who received help from NGOs, women who had private examinations and those who had all done by the public was 28.0, 48.5 and 77.5 days, respectively (p <0.05). For the time interval between the results of the diagnosis and the beginning of treatment, women who received support from NGOs, performed private and all public examinations, presented median delays of 69.0, 86.0 and 93.0 days (p = 0.006), respectively. Conclusions: NGO patient support has accelerated the flow. Patients using privately funded health services experienced a decrease on delay in comparison with those using exclusively public services.