Determinants of Lack of Access to Treatment for Women Diagnosed with Breast Cancer in Brazil

Abstract

Access to timely treatment is essential for the probability of the cure and reduction of severe breast cancer cases. In Brazil, legislation states that cancer treatment must start within 60 days of diagnosis. This study analyzed the factors associated with lack of access to breast cancer treatment in women with a confirmed diagnosis inserted in the health system. We collected secondary data from Brazilian women with a diagnosis and without treatment from January to December 2019 through the Cancer Hospital Registers developed by the National Cancer Institute. Our findings indicate that most women (60.11%) are diagnosed with stage II cancer but are without treatment. Most of them are aged 18–70 years, non-white race/color, have a low educational level and are from the Southeast Brazilian region. In addition, social inequalities are determinant in women’s lack of access to breast cancer treatment.

Geographic and sociodemographic access to systemic anticancer therapies for secondary breast cancer: a systematic review

“…Eight ( n = 8) studies included women with secondary breast cancer exclusively [ 8 , 29 – 35 ]. The remaining eleven studies ( n = 11) included subgroups and cohorts of women with a secondary diagnosis [ 36 – 42 , 42 , 44 – 46 ]. These ranged from 3 to 21% of the overall sample.…”

“…Six studies reported treatment receipt with SACT which was unspecified. Two studies reported receipt of no-treatment women who did not receive a first course of treatment; this ranged from 11.1 to 25.5% with 12.8% of women with a breast cancer diagnosis who did not receive a first course of treatment [ 36 , 44 ] (Table 3 ).…”

Women with breast cancer: social issue and chemotherapy treatment in an oncological unit in the agreste Pernambuco, Brazil

“…When a woman is diagnosed with cancer, she faces several conflicts, which are often not clarified by the multidisciplinary team, such as the fear of not being able to get pregnant, the adverse reactions of chemotherapy that will prevent her from carrying out her work activities and that will impact in their monthly family budget, in addition to the emotional damage, due to the loss of hair and breasts, which directly impact on female high spirits (Medeiros et al, 2019;Taberna et al, 2020;Facchin et al, 2021;Vanstone et al, 2021). In addition to these internal conflicts, there are those related to the health service, with continuous trips to the oncological treatment environment, changes in the daily routine and difficulty in accessing the necessary tests and treatment, often having to take the tests and buy medicines privately , compromising even more the monthly budget of the family (Luiza et al, 2016;Cabral et al, 2019;Alves et al, 2022;Ivama-Brummell et al, 2022). According to the study by Alves et al (2022), more than 60% of women diagnosed with stage II breast cancer were not undergoing treatment, contrary to Brazilian legislation that establishes that cancer treatment must be started within 60 days of diagnosis.…”

“…In addition to these internal conflicts, there are those related to the health service, with continuous trips to the oncological treatment environment, changes in the daily routine and difficulty in accessing the necessary tests and treatment, often having to take the tests and buy medicines privately , compromising even more the monthly budget of the family (Luiza et al, 2016;Cabral et al, 2019;Alves et al, 2022;Ivama-Brummell et al, 2022). According to the study by Alves et al (2022), more than 60% of women diagnosed with stage II breast cancer were not undergoing treatment, contrary to Brazilian legislation that establishes that cancer treatment must be started within 60 days of diagnosis.…”