Oncological treatment in Brazil: a gender and region are associated to starting the therapeutics

ABSTRACT

Introduction: Malignant neoplasms are a major public health problem, being the second leading cause of death in the world. In 2012, the Ministry of Health (BR) instituted Law No. 12,732, which grants cancer patients the right to obtain, from the anatomopathological diagnosis, access to the first treatment in the Brazilian Healthcare System - Sistema Único de Saúde (SUS), within up to sixty days. The change in the patient's prognosis is the aim of this program. Objective: To evaluate the panorama of the time to start cancer therapy in Brazil. Methods: This is a cross-sectional and analytical study on the time for the establishment of the beginning of cancer treatment in Brazil, in the period from 2013 to 2019. The data were extracted from the PANEL-Oncology of the informatics department of Unified Health System. Chi-square and Fisher's exact tests were used to analyze proportions and risk ratios, respectively. Results: The percentage of malignant neoplasms that had the longest delay in starting therapy (>60 days) in the country were prostate (59.6%) and cervix (50.9%). As for sex, the delay was present in 36.9% of men and 33.3% of women (p<0.05). Differences in the rates of cancers with and without delay for the institution of treatment are also evident in the Brazilian macroregions (p<0.05). Assessing the odds ratio for delayed cancer treatment, the male gender is shown to be a risk factor (p<0.05) in all regions, except in the North of the country. The risk for delayed treatment differs depending on the type of cancer. Conclusion: Cancers that have a longer delay in starting therapy are those that have health policies aimed at their screening.

RESUMO

Introdução: As neoplasias malignas são a segunda causa de mortes no mundo, configurando importante problema de saúde pública. Em 2012, o Ministério da Saúde (BR) instituiu a Lei nº 12.732, que concede ao paciente oncológico o direito de obter, a partir do diagnóstico anatomopatológico, o acesso ao primeiro tratamento no Sistema Único de Saúde (SUS), em até sessenta dias. A mudança no prognóstico do paciente é o objetivo deste programa. Objetivo: Avaliar o panorama do tempo para início da terapêutica oncológica no Brasil. Métodos: Trata-se de um estudo transversal e analítico sobre o tempo de implantação para o início do tratamento oncológico no Brasil, no período de 2013 a 2019. Os dados foram extraídos do PAINEL-Oncologia do departamento de informática do Sistema Único de Saúde. Os testes de qui-quadrado e exato de Fisher foram usados para analisar proporções e razões de risco, respectivamente. Resultados: As neoplasias malignas com maiores percentuais para o retardo (>60 dias) na instituição da terapêutica foram: próstata (59,6%) e colo do útero (50,9%). Quanto ao sexo, o atraso esteve presente em 36,9% dos homens e 33,3% das mulheres (p<0,05). Entre as macrorregiões brasileiras são evidenciadas diferenças relativas das taxas dos cânceres com e sem retardo no tempo para o início da terapêutica (p<0,05). Avaliando o odds ratio para retardo no tratamento do câncer, o sexo masculino se mostra como um fator de risco (p<0,05) em todas as regiões, exceto no norte do país. O risco de atraso no tratamento difere dependendo do tipo de câncer. Conclusão: Os cânceres que apresentam maior retardo no início da terapia são aqueles que possuem políticas de saúde voltadas ao seu rastreamento.

Keywords:

Oncology - Therapeutics - Risk factors.

Descritores:

Oncologia - Terapêutica - Fatores de risco.

Publikationsverlauf

Eingereicht: 07. November 2020

Angenommen: 23. November 2020

Artikel online veröffentlicht:
18. Januar 2021

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