Delay to Curative Surgery Greater than 12 Weeks Is Associated with Increased Mortality in Patients with Colorectal and Breast Cancer but Not Lung or Thyroid Cancer

Shin, Dong Wook; Cho, Juhee; Kim, So Young; Güallar, Eliseo; Hwang, Seung Sik; Cho, Belong; Oh, Jae Hwan; Jung, Kwonil; Seo, Hong Gwan; Park, Jong Hyock

doi:10.1245/s10434-013-2957-y

Cited by 167 publications

(163 citation statements)

References 33 publications

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“…Estudo que avaliou o impacto da demora da realização de cirurgia com finalidade curativa na sobrevida concluiu que, no câncer de mama, intervalos superiores a 12 semanas estão associados ao aumento da mortalidade pela doença 13 . Em contrapartida, análise retrospectiva realizada no Reino Unido obteve resultado diferente dos demais estudos ao sugerir que atrasos superiores a 60 dias não prejudicam significativamente a sobrevivência e que os pacientes que receberam tratamento dentro de um período de 30 dias apresentaram piores resultados do que os que foram tratados em períodos mais tardios 7 .…”

Section: This Study Aimed To Analyze the Time Elapsed Between Breast unclassified

Análise dos determinantes que influenciam o tempo para o início do tratamento de mulheres com câncer de mama no Brasil

et al. 2015

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Section: This Study Aimed To Analyze the Time Elapsed Between Breast unclassified

Análise dos determinantes que influenciam o tempo para o início do tratamento de mulheres com câncer de mama no Brasil

et al. 2015

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“…O atraso no diagnóstico e no tratamento do câncer de mama pode propiciar estágio mais avançado da doença, resultando em tratamento mais agressivo, com pior prognóstico e consequente aumento da mortalidade 4,5 O principal intervalo de tempo estudado foi definido como tempo total, que compreende o período entre a data da primeira detecção da alteração na mama sugestiva de neoplasia e o início do tratamento específico (cirurgia ou quimioterapia neoadjuvante). Esse intervalo foi subdividido em dois: tempo atribuído à paciente, que abrange o intervalo entre a detecção do primeiro sintoma e a primeira consulta motivada pela anormalidade na mama; tempo atribuído ao serviço, que compreende o período entre a primeira consulta e o início do tratamento.…”

Section: Introductionunclassified

Tempo para acesso ao tratamento do câncer de mama no Distrito Federal, Brasil Central

Barros¹,

Uemura²,

Macedo³

2013

Rev. Bras. Ginecol. Obstet.

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“…A delay in CRC surgery of >12 weeks is associated with an adjusted hazard ratio (HR) of 2.65 for all-cause mortality. 54 Halpern et al noted that black and Hispanic patients were less likely to receive treatments on time, across several tumor types, and suggested that Original Article such delays may account for suboptimal outcomes in the minorities studied. 55 In a cohort of 12,181 patients with a diagnosis of CRC who were followed between 1995 and 2007, Wassira et al observed a higher incidence of advanced disease in black and Hispanic individuals compared with white patients, as well as higher mortality in the same subgroups.…”

Section: Delays In Diagnosismentioning

confidence: 99%

Counties eliminating racial disparities in colorectal cancer mortality

Rust

Zhang

et al. 2016

Cancer

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BACKGROUND: Although colorectal cancer (CRC) mortality rates are declining, racial-ethnic disparities in CRC mortality nationally are widening. Herein, the authors attempted to identify county-level variations in this pattern, and to characterize counties with improving disparity trends. METHODS: The authors examined 20-year trends in US county-level black-white disparities in CRC ageadjusted mortality rates during the study period between 1989 and 2010. Using a mixed linear model, counties were grouped into mutually exclusive patterns of black-white racial disparity trends in age-adjusted CRC mortality across 20 three-year rolling average data points. County-level characteristics from census data and from the Area Health Resources File were normalized and entered into a principal component analysis. Multinomial logistic regression models were used to test the relation between these factors (clusters of related contextual variables) and the disparity trend pattern group for each county. RESULTS: Counties were grouped into 4 disparity trend pattern groups: 1) persistent disparity (parallel black and white trend lines); 2) diverging (widening disparity); 3) sustained equality; and 4) converging (moving from disparate outcomes toward equality). The initial principal component analysis clustered the 82 independent variables into a smaller number of components, 6 of which explained 47% of the county-level variation in disparity trend patterns. CONCLUSIONS: County-level variation in social determinants, health care workforce, and health systems all were found to contribute to variations in cancer mortality disparity trend patterns from 1990 through 2010. Counties sustaining equality over time or moving from disparities to equality in cancer mortality suggest that disparities are not inevitable, and provide hope that more communities can achieve optimal and equitable cancer outcomes for all. Cancer 2016;122:1735-48. V C 2016 American Cancer Society.KEYWORDS: African American, black, cancer mortality, colorectal cancer, disparities, geographic variation, health equity, local-area variation, race, trends. INTRODUCTIONColorectal cancer (CRC) is the third most common cancer and the third leading cause of cancer death in the United States, 1 and is expected to account for >8% of US cancer deaths in men and women in 2015, although death rates are on the decline. 1-4 On average, since 1990 there has been an annual average percentage decrease in CRC mortality of 2.6% for men and 3.0% for women. 5 Unfortunately, the benefits of decreasing mortality have not accrued equally to all segments of the population. Indeed, the racial (black-white) gap in CRC mortality has been increasing since the 1990s. 6,7 Black or African American individuals have higher CRC mortality rates than whites, with sex-specific black mortality rates from 2007 to 2011 of 28.4 (male) and 18.9 (female) per 100,000 individuals, compared with white rates of 18.7 and 13.2 per 100,000 men and women, respectively. 1,2 As with other conditions for which lifesaving ...

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Delay to Curative Surgery Greater than 12 Weeks Is Associated with Increased Mortality in Patients with Colorectal and Breast Cancer but Not Lung or Thyroid Cancer

Cited by 167 publications

References 33 publications

Análise dos determinantes que influenciam o tempo para o início do tratamento de mulheres com câncer de mama no Brasil

Análise dos determinantes que influenciam o tempo para o início do tratamento de mulheres com câncer de mama no Brasil

Tempo para acesso ao tratamento do câncer de mama no Distrito Federal, Brasil Central

Counties eliminating racial disparities in colorectal cancer mortality

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