Delays in Cervical Cancer Treatment Initiation and Associated Factors in a Hospital- Based Cohort in the Brazilian Western Amazon

Introduction: Early diagnosis followed by timely treatment of cervical cancer are essential for better prognosis and survival. Objective: To estimate the prevalence of delay in cervical cancer treatment initiation and associated factors in women diagnosed and treated in Rio Branco-Acre between 2012 and 2017. Method: Cross-sectional study of a hospital cohort involved women with cervical cancer treated between 2012 and 2017 in Rio Branco, Acre. The time in days from diagnosis to the first treatment was categorized according to the Brazilian law. Student’s t and Kruskal-Wallis tests analyzed continuous variables, while categorical variables were evaluated using X2- Pearson and Fisher tests, with a 5% significance level. Crude and adjusted prevalence ratios (OR) were estimated by Poisson regression with robust variance, with 95% CI. Results: The median time between diagnosis and first treatment was 39 days, ranging from 81 days for surgical treatment to 29 days for isolated radiotherapy. The prevalence of delay in treatment initiation was 34%, and the factors associated with the delay included being aged >40 years, waiting >30 days for specialist consultation, and first surgical treatment. The radiotherapy with/without brachytherapy treatment protocol and stages IIIB-IVA were inversely associated with delay. Conclusion: Delay in cervical cancer treatment initiation in Acre was shorter than in other regions of the country. Age >40 years, waiting >30 days for a specialist consultation were positively associated with delay, while advanced stages were inversely associated.