Background: Breast cancer is the primary cause of cancer-related deaths among women globally, with a particularly high incidence in low- and middle-income nations. In Brazil, disparities in access to diagnosis and treatment contribute to worse clinical outcomes, particularly in regions with a lower Human Development Index (HDI). This study evaluated the association between the delay between diagnosis and treatment initiation, and clinical outcomes of breast cancer across various Brazilian regions.Methods: This observational study utilized publicly available secondary data from the Department of Informatics of the Unified Health System (DATASUS), collected between 2013 and 2023. Data included age group, treatment type (surgery, chemotherapy, radiotherapy), and delay between diagnosis and treatment initiation (≤30 days, 31–60 days, >60 days). Regional disparities were analyzed according to the HDI. Statistical analyses were performed using GraphPad Prism 8.0.1, applying Pearson’s correlation coefficient (r) and linear regression (R2) to assess associations between treatment delay and the number of cases or deaths.Results: Radiotherapy demonstrated the most significant negative correlation (r = −0.6624), and delays exceeding 60 days were consistently linked to poorer outcomes. In regions with lower Human Development Index (HDI), specifically the North and Northeast, longer treatment delays were observed, alongside a stronger correlation between delayed initiation of treatment and increased mortality. Conversely, shorter delays (30 days or less) demonstrated a weaker or absent correlation with improved outcomes. This suggests that other critical factors, such as the stage of cancer at diagnosis, the quality of care provided, and the consistency of treatment, are also significant determinants.Conclusions: Delays in treatment, particularly for radiotherapy and surgery, adversely affect breast cancer outcomes in Brazil. This impact is more pronounced in areas with lower Human Development Index (HDI), underscoring the critical need for targeted regional public policies. Such policies are essential to guarantee prompt diagnosis and treatment, thereby mitigating inequalities and enhancing survival rates.
背景：乳腺癌是全球女性癌症相关死亡的主要原因，在中低收入国家发病率尤为突出。在巴西，诊断与治疗可及性的差异导致临床结局恶化，这在人类发展指数（HDI）较低的地区尤为明显。本研究评估了巴西不同地区乳腺癌确诊至治疗开始的时间延迟与临床结局之间的关联。 方法：本观察性研究利用巴西统一卫生系统信息部（DATASUS）2013年至2023年公开的二手数据，包括年龄组、治疗类型（手术、化疗、放疗）以及确诊至治疗开始的延迟时间（≤30天、31–60天、>60天）。根据人类发展指数分析地区差异。使用GraphPad Prism 8.0.1进行统计分析，采用皮尔逊相关系数（r）和线性回归（R²）评估治疗延迟与病例数或死亡数之间的关联。 结果：放疗显示出最显著的负相关性（r = −0.6624），超过60天的延迟始终与较差的结局相关。在人类发展指数较低的地区（特别是北部和东北部），观察到更长的治疗延迟，且治疗延迟与死亡率增加之间的相关性更强。相反，较短延迟（30天或更短）与改善结局的相关性较弱或不存在。这表明其他关键因素，如确诊时的癌症分期、提供的护理质量以及治疗连续性，同样是重要的决定因素。 结论：治疗延迟（尤其是放疗和手术）对巴西乳腺癌结局产生不利影响。这种影响在人类发展指数较低的地区更为显著，凸显了制定针对性区域公共政策的迫切需求。此类政策对于确保及时诊断和治疗、从而减少不平等并提高生存率至关重要。
Delay in Diagnosis and Treatment of Breast Cancer: Regional Disparities
肿瘤(癌症)患者之家