Determinants of the time between breast cancer diagnosis and initiation of treatment in Brazilian women

This study aimed to analyze the time elapsed between breast cancer diagnosis and initiation of treatment in woman treated from 2000 to 2011 in the Brazilian public health system and to identify factors associated with delayed onset of treatment. This retrospective cohort study included 137,593 women diagnosed in 239 hospitals in Brazil from 2000 to 2011. In 63.1% of cases the time between diagnosis and treatment was 60 days. Delayed treatment was associated with nonwhite skin color (OR = 1.18; 95% CI: 1.13-1.23), single marital status (OR = 1.05; 95% CI: 1.01-1.09), less than eight years of schooling (OR = 1.13; 95% CI: 1.08-1.18), early-stage disease (OR = 1.27; 95% CI: 1.22-1.32), treatment from 2006 to 2011 (OR = 1.54; 95% CI: 1.47-1.60), and patients in the public health system (OR = 1.19; 95% CI: 1.13-1.25). Stratified analysis showed variability of factors between regions of Brazil. The identification of factors associated with delayed initiation of breast cancer treatment can support the development of interventions targeted to specific population groups.