Impact of Sociodemographic Factors on the Time to Initiate Breast Cancer Treatment at a High-Complexity Hospital in Porto Alegre, Brazil

Time between cancer diagnosis and the start of treatment is crucial for patient prognosis. In the Brazilian public health system, this interval varies significantly. Access to timely care is shaped by multiple interconnected factors, including service organization, diagnostic processes, and follow-up care. Social aspects, such as ethnicity, level of schooling, and knowledge of disease symptoms, also influence these outcomes.

To identify the association between the level of schooling and delays in the initiation of oncological treatment.

A cross-sectional study was conducted evaluating all female patients with breast tumor registered in the Cancer Registry of Hospital de Clínicas de Porto Alegre, between January 2022 and December 2023. Data collection of the sample was made through electronic medical record review and telephone questionnaires. Descriptive, univariable, and multivariable analyses were performed to assess factors associated with the prevalence of delayed treatment initiation.

A total of 307 participants had their data collected between June 1st, 2023, and February 1st, 2024. In the multivariable analysis, initiation of treatment > 60 days after diagnosis was significantly associated with lower level of schooling, with an estimated relative risk of 1.48 (95%CI = 1.064–2.062). Pardo ethnicity, which refers to mixed-race individuals, was correlated with a longer time to treatment when compared to white patients (relative risk [RR] = 1.63; 95%CI = 1.038–2.579).

The current cross-sectional study shows that the level of schooling significantly influenced time to oncological treatment, as confirmed by multivariable analysis as well as self-reported mixed-race ethnicity. Although most participants began treatment within 60 days, the interval between cancer suspicion and diagnosis exceeded the period established by law.