RT - European Journal of Gynaecological Oncology ID - 10.22514/ejgo.2023.063 T1 - Symptomatic women experience long waits for endometrial cancer diagnosis and treatment in Brazil A1 - Elaine Candido A1 - Jose Torres A1 - Daniela Yela A1 - Caroline Pedro A1 - Larissa Costa A1 - Julio Teixeira K1 - Endometrial carcinoma; Staging; Services accessibility; Time-to-treat; Survival YR - 2023 SP - 110 AB -
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.