How long does it take to start breast cancer treatment in Brazil? Is the 60-day law fulfilled?

Abstract

Objective: The aim of this study was to evaluate compliance with the law of 60 days to start breast cancer (BC) treatment
in Brazil. Methodology: This is an ecological observational study, based on retrospective data from a National Oncology
Database (DATASUS – SISCAN/Cancer Information System) that is publicly available for download. Oncological treatment
data from 2017 to 2021 were selected, referring to the time from the diagnosis of BC to the beginning of the first oncological treatment. Only data with all available variables were considered, and an analysis was performed by federative unit
and by region of Brazil. Results: In the 5-year study period, 202,371 patients with BC treatment in Brazil were included
in the SUS, being in the north region 11,198 (5.5%), northeast region 46,775 (23.1%), southeast region 90,151 (44.6%), south
region 41,288 (20.4%), and midwest region 12,959 (6.4%). BC treatment in Brazil begins in 50% of patients within 60 days
of diagnosis; however, 16.3% take up to 90 days, 11.3% take up to 120 days, 19.8% take up to 300 days, and 2.6% take longer
than 301 days. With regard to the regions that comply with the 60-day law, it is the north region with 65% of treatments
initiated within 60 days and the one that least complies is the southeast with 45.7%, with a significant difference between
the regions (p=0.0363). Likewise, the state that best complies is Rondônia with 84.5% and the one that least complies is
Rio de Janeiro with 39.1%, with a significant difference in all states in relation to their region (p>0.0001). Conclusion: It
is observed that compliance with the 60-day law is much lower than expected, where only 50% of patients in Brazil start
their treatment within 60 days, and in many states, more than 1/4 of patients take more than 120 days to start, with an
impact on prognosis.