Abstract

ABSTRACTOBJECTIVE 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.

Highlights

  • Radiotherapy is used to cure and provide palliative treatment for almost all types of cancer

  • 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

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Summary

Introduction

Radiotherapy is used to cure and provide palliative treatment for almost all types of cancer. Around 58.0% of all cervical-type cancer cases receive this treatment.[8] The time spent waiting to begin radiotherapy is considered to be an indicator for quality of carea and seems to have an influence on cancer treatment results.[16] An audit performed by the Tribunal de Contas da União (Federal Court of Accounts) in Brazil showed that 65.9% of the demand for radiotherapy, in 2010, was met and that the average waiting time for the beginning the first session of treatment was 113.4 days.b important as this legislation It is worth knowing: (i) the total waiting time and the component time intervals imposed on women up to when they begin radiotherapy for cervical cancer; (ii) if any component has a greater impact on the expected waiting time before beginning radiotherapy; and (iii) if the waiting time for tumors referred to potentially curative and palliative radiotherapy is the same.

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