Waiting Time between Breast Cancer Diagnosis and Treatment in Brazilian Women: An Analysis of Cases from 1998 to 2012

Abstract

Brazilian law requires that treatment for breast cancer begin within 60 days of diagnosis. This waiting time is an indicator of accessibility to health services. The aim of this study was to analyze which factors are associated with waiting times between diagnosis and treatment of breast cancer in women in Brazil between 1998 and 2012. Information from Brazilian women diagnosed with breast cancer between 1998 and 2012 was collected through the Hospital Registry of Cancer (HRC), developed by the National Cancer Institute (INCA). We performed a secondary data analysis, and found that the majority of women (81.3%) waited for <= 60 days to start treatment after being diagnosed. Those referred by the public health system, aged >= 50 years, of nonwhite race, diagnosed at stage I or II, and with low levels of education waited longer for treatment to start. We observed that only 18.7% experienced a delay in starting treatment, which is a positive reflection of the quality of the care network for the diagnosis and treatment of breast cancer. We also observed inequalities in access to health services related to age, region of residence, stage of the disease, race, and origin of referral to the health service.