Estudo do tempo entre o diagnóstico e tratamento do câncer de próstata em uma instituição de referência do Espírito Santo

Abstract

Introduction: The prostate cancer is the second most incident cancer in men and the sixth leading cause of death among men in the world. In Brazil, it is the second type of cancer that more affects men. Therefore, it is essential to expand access and increase the flexibility in attention to this kind of cancer. Objective: To analyze the wait time to treatment of men diagnosed with prostate cancer before and after the Law 12.732/2012; and to evaluate the association of sociodemographic and clinical variables with the wait times to treatment of men attended in a referral hospital in oncology of Espírito Santo. Methods: A retrospective cohort study of secondary data, which comprises men with prostate cancer attended at the Hospital Santa Rita de Cássia (HSRC-AFECC) between 2010 to 2011 and 2013 to 2014, before and after the Law 12.732/2012. The data were collected from the tumor registry sheet and records of men with diagnostic confirmation. Data were tabulated in Microsoft Office Excel 2007 program, and then analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Results: Of the 1388 men with prostate cancer, 306 (22%) had between 65 to 69 years old, 1021 (78%) were non white, 1035 (88%) had less than 8 years of study and 729 came from cities of Espírito Santo outside Vitória metropolitan area. The average waiting time between diagnosis and the treatment was 148 days (SD= 108) while the mean waiting time between the first consultation in HSRC-AFECC and the start of treatment was 84 days (SD= 77). The factors identified as determinants to the delay in the treatment were to be a men less than 70 years old anos (OR= 1,85; CI= 1,49- 2,31), to be non white (OR= 1,30; CI= 1,00-1,70), with diagnostic and without treatment (OR= 0,10; CI= 0,06-0,16), have less than 8 years of study (OR= 1,52; CI= 1,06-2,17) and be referred by the public health services (OR= 2,52; CI= 1,84-3,46). Conclusion: Unfortunately, the Law 12,732 / 2012 did not exert impact on attention to prostate cancer in the institution, which demonstrates the fragility of health services in to adequate the rules to the Law. Therefore, a reorganization of the network of care becomes necessary, looking for achieve an effective integration of care levels, which should reflect on satisfaction of people's demands.