Avaliação do tempo entre diagnóstico e primeiro tratamento para o câncer de ovário no Brasil e suas regiões

Abstract

Ovarian cancer is the seventh most common cancer, the most lethal among gynecological cancers and the nineth leading cause of death, by cancer, accounting for 4.4% of female deaths worldwide. Early-stage disease is usually asymptomatic, so in most cases it is diagnosed at an advanced stage, worsening its prognosis. According to Brazilian Law 12.732/2012, patients with malignant neoplasms have the right to undergo the first treatment in the Unified Health System (SUS), within 60 (sixty) days from the day the diagnosis is made in a pathology report. In order to evaluate compliance with legal deadlines, a study was carried out with secondary data from the Oncology Panel, through a time series analysis, evaluating the percentage of cases treated with more than sixty days, as well as possible factors associated with delayed treatment in women with ovarian cancer in Brazil, and major regions, in the period from 2013 to 2022. Stability was observed in the duration of treatment in the first years and a significant drop in cases with more than 60 (sixty) days from 2017 onwards, with an annual percentage variation (APC) of 18.8% for the whole of Brazil and a highlight for the North (APC of 23.2%), Southeast and Midwest (APC of 20.0%). Regarding the possible associated factors, the region of residence, age group, type of treatment and staging were analyzed by univariate and multivariate logistic regression. The variables region of residence and type of treatment showed the highest chances of delay, with the North region having a risk of 2.4 times higher than the South region, and chemotherapy, as the first treatment, a 33.4 times higher risk of delay than surgery. Therefore, it is concluded that from 2017 onwards more patients were treated within the deadline stipulated by Law 12.732/2012, with regional differences, with a higher risk of delay for the North and Northeast regions, and a lower risk for patients initially treated by surgery. Continuity of monitoring is necessary so that there is more regional equity and availability, in time, of any type of treatment that is necessary.