Waiting time for radiotherapy in women with cervical cancer

Abstract

OBJECTIVE To describe the waiting time for radiotherapy for patients with cervical cancer.METHODS This descriptive study was conducted with 342 cervical cancer cases that were referred to primary radiotherapy, in the Baixada Fluminense region, RJ, Southeastern Brazil, from October 1995 to August 2010. The waiting time was calculated using the recommended 60-day deadline as a parameter to obtaining the first cancer treatment and considering the date at which the diagnosis was confirmed, the date of first oncological consultation and date when the radiotherapy began. Median and proportional comparisons were made using the Kruskal Wallis and Chi-square tests.RESULTS Most of the women (72.2%) began their radiotherapy within 60 days from the diagnostic confirmation date. The median of this total waiting time was 41 days. This median worsened over the time period, going from 11 days (1995-1996) to 64 days (2009-2010). The median interval between the diagnostic confirmation and the first oncological consultation was 33 days, and between the first oncological consultation and the first radiotherapy session was four days. The median waiting time differed significantly (p = 0.003) according to different stages of the tumor, reaching 56 days, 35 days and 30 days for women whose cancers were classified up to IIA; from IIB to IIIB, and IVA-IVB, respectively.CONCLUSIONS Despite most of the women having had access to radiotherapy within the recommended 60 days, the implementation of procedures to define the stage of the tumor and to reestablish clinical conditions took a large part of this time, showing that at least one of these intervals needs to be improved. Even though the waiting times were ideal for all patients, the most advanced cases were quickly treated, which suggests that access to radiotherapy by women with cervical cancer has been reached with equity.

Analysis of the effects of the age-period-birth cohort on cervical cancer mortality in the Brazilian Northeast

“…Having a prevention and treatment program for over a decade was not enough to reduce the risk of death in the last five years of the 2000s or to reduce cervical cancer mortality rates. This reality points to problems in the PNCC that include low coverage of women aged 25-64 [14,[16][17], limited quality of collection, storage, and reading of slides [52,54], as well as difficulties in referral to the specialized care network in cases of precursor injury or cervical cancer [53][54]60].…”

“…It is suggested that the PNCC be revised in order to reorient the practice of screening, moving to organized screening, especially in places with low spontaneous adherence and high coverage by primary health care. In addition, primary care physicians and nurses need to be trained in relation to PNCC guidelines regarding collection, storage, followup, and referral to the specialist network in situations where Pap tests show changes [53][54]60]. Associated with the measures described above, it is necessary that the states of Northeastern Brazil evaluate the referral and counter-referral process for the specialized cancer network, especially regarding: (i) time between referral and colposcopy;(ii) time between referral and biopsy; and (iii) the time between diagnosis of cervical cancer and initiation of treatment [66,67].…”

“…Southeast Brazil is a region with great socioeconomic development and the highest concentration of the Brazilian cancer care network [45], while the North and Northeast are the Brazilian regions with the smallest cancer care network and the largest deficits in radiotherapy devices [54] and chemotherapy, services widely used in the treatment of advanced cervical cancer [11,45,55,60].…”

Tendências temporais e fatores associados ao diagnóstico em estágio avançado de câncer do colo uterino: análise dos dados dos registros hospitalares de câncer no Brasil, 2000-2012*

“…3 In middle and low income countries, the results are less expressive due to limitations of access to health services, low coverage of screening programs and delays in the implementation of diagnostic and therapeutic procedures. 4,5 With the objective of guaranteeing comprehensive care to individuals with a diagnosis of cancer, the Ministry of Health of Brazil, by means of decree GM/ MS No. 2,439, of 8 December 2005, established the National Policy of Oncology Care, emphasizing the importance of prevention, early diagnosis and timely treatment as measures to reduce the incidence and mortality from the disease.…”

Fatores associados à sobrecarga em cuidadores familiares na radioterapia

“…Among its therapeutic modalities, radiotherapy stands out, characterized by the emission of ionizing radiation aiming at curing, remission or control of physical symptoms and which can lead to adverse events that negatively impact the quality of life, increasing the care demand. [1][2] In this context, prolonged hospitalizations, interruption of treatment, clinical complications and dependence on care are common and affect both patients and family members who assume responsibilities as caregivers even without or with little technical-scientific preparation, representing a source support that seeks to promote health, prevent complications and provide rehabilitation. 3 Within this segment, family caregivers are considered to take care that requires availability and dedication without remuneration or professional training, such as the monitoring of disabilities and the management of physical symptoms and side effects resulting from treatment.…”