Banca de DEFESA: PAULO VITOR DE SOUZA SILVA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : PAULO VITOR DE SOUZA SILVA
DATE: 28/07/2025
TIME: 08:30
LOCAL: Remoto
TITLE:

Waiting time between diagnosis and treatment in women with breast cancer in Brazil

KEY WORDS:

Breast Neoplasms. Hospital Records. Time-to-Treatment. Treatment Delay.

PAGES: 70
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUBÁREA: Epidemiologia
SUMMARY:

Introduction: Cancer is one of the greatest contemporary challenges in the social, economic, and public health spheres. Among women, the most common malignant neoplasm is breast cancer, which is also the leading cause of cancer mortality. Delays in starting cancer treatment are recurrent, multifactorial, and associated with reduced survival in women. Objective: To analyze the temporal trend and spatial distribution pattern of compliance with Law No. 12,732/2012, known as the “60-day law,” in Brazil for cases of female breast cancer. Methodology: Two methodological designs were developed. (1) Ecological time series study covering the period from 2006 to 2019, with analysis by state, for cases with and without prior diagnosis. Data were obtained from the Integrated Hospital Cancer Registry (IRHC) and the temporal trend was estimated using a Joinpoint regression model. (2) Ecological spatial analysis study, conducted in the 163 Intermediate Urban Articulation Regions (RIAU), focusing on the period after the law (2013-2019). The dependent variable (start of treatment within 60 days) was extracted from the IRHC, while the independent contextual variables were obtained from the Atlas of Human Development in Brazil and the SUS Department of Informatics (DATASUS) system. The detection of territorial clusters was verified by the Global Moran Index and the Local Spatial Association Indicator (LISA). In the multivariate analysis, we chose to use a model with a global spatial effect. Results: (1) Cases without a previous diagnosis of breast cancer showed a greater tendency to start cancer treatment within the legal deadline of 60 days, compared to those with a previous diagnosis. This pattern was observed both before and after the enactment of the law. (2) The percentage of treatment initiation within 60 days showed a positive spatial correlation with the density of Family and Community Physicians (p=0.007) and with the Proportion of Surgical Procedures (p=0.001). Final considerations: At the end of the study, the results are expected to provide evidence on the temporal trend and spatial distribution of compliance with the legal deadline for starting breast cancer treatment, contributing to the identification of regional inequalities and patterns of non-compliance in Brazil.

COMMITTEE MEMBERS:
Presidente - 3926907 - DYEGO LEANDRO BEZERRA DE SOUZA
Interna - 2305247 - ISABELLE RIBEIRO BARBOSA MIRABAL
Externo à Instituição - YAN NOGUEIRA LEITE DE FREITAS - UFAM