Title
Author
DOI
Article Type
Special Issue
Volume
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Symptomatic women experience long waits for endometrial cancer diagnosis and treatment in Brazil
1Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), 13083-881 Campinas, SP, Brazil
2Department of Pathology, Faculty of Medical Sciences, University of Campinas (UNICAMP), 13083-881 Campinas, SP, Brazil
DOI: 10.22514/ejgo.2023.063 Vol.44,Issue 4,August 2023 pp.110-117
Submitted: 06 March 2023 Accepted: 10 April 2023
Published: 15 August 2023
*Corresponding Author(s): Julio Teixeira E-mail: juliotex@unicamp.br
The aim of this study was to assess the elapsed time for symptomatic women with endometrial carcinoma to achieve diagnosis and treatment and its impact on staging and survival. A cohort study was carried out with 430 women divided into in two groups: “Type I” (n = 289, endometrioid carcinoma grade 1 or 2); “Type II” (n = 141, nonendometrioid, endometrioid carcinoma grade 3, or carcinosarcoma). Clinical information, diagnostic methods, histology, staging, and time elapsed between symptoms-diagnosis-treatment were considered. Descriptive, survival, and regression analyses were performed. The symptom-to-diagnosis interval was 284 and 249 days in Types I and II (p = 0.014), with only 30% getting a diagnosis within 90 days. The diagnosis-to-treatment interval was shorter for Type II (100 vs. 123 days for Type I; p = 0.001). Only 12.5% of Type I and 22.7% of Type II started treatment within 60 days after diagnosis. There was no association between symptom-to-diagnosis interval and staging (p = 0.377). The symptom-to-treatment interval did not change the overall survival for Type I and had a paradoxical effect for Type II, with greater overall survival associated with a longer elapsed time (p = 0.003). Symptomatic Brazilian women with endometrial carcinomas showed very long wait times for diagnosis and treatment, and less than 23% started treatment within the regulatory period of 60 days. This critical situation does not exhibit any clear effect on cancer staging or overall survival, possibly counterbalanced by the faster care of patients with a poor prognosis, such as those with Type II endometrial carcinomas.
Endometrial carcinoma; Staging; Services accessibility; Time-to-treat; Survival
Elaine Candido,Jose Torres,Daniela Yela,Caroline Pedro,Larissa Costa,Julio Teixeira. Symptomatic women experience long waits for endometrial cancer diagnosis and treatment in Brazil. European Journal of Gynaecological Oncology. 2023. 44(4);110-117.
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