Can predictive factors determine the time to treatment initiation for oral and oropharyngeal cancer? A classification
Débora Rosana Alves Braga Silva Montagnoli1, Vitória Ferreira Leite2, Yasmim Silva Godoy2
1Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Plos One
|April 17, 2024
Summary
Timely oral and oropharyngeal cancer (OOC) treatment initiation is crucial. Factors like advanced treatment (chemotherapy, radiotherapy) and diagnostic support significantly impact time to treatment initiation (TTI) in Brazil.
Area of Science:
- Oncology
- Public Health
- Health Services Research
Background:
- Oral and oropharyngeal cancer (OOC) presents a significant public health challenge.
- Timely treatment initiation is critical for improving patient outcomes in OOC.
- Disparities in healthcare access and resources can delay OOC treatment.
Purpose of the Study:
- To identify key factors influencing time to treatment initiation (TTI) for oral and oropharyngeal cancer (OOC) in Brazilian municipalities.
- To analyze the discriminatory power of various patient, service, and socioeconomic variables on TTI.
- To inform strategies for improving timely OOC care delivery.
Main Methods:
- Ecological study design analyzing data from 3,218 Brazilian municipalities in 2019.
- Descriptive analysis of variables across patient characteristics, healthcare access, diagnostic support, human resources, and socioeconomic factors.
- Classification and Regression Trees (CART) technique to identify significant predictors of TTI.
Main Results:
- Most municipalities (49.4%) exceeded the 30-day target for OOC treatment initiation.
- Treatment modality (chemotherapy, radiotherapy) was the strongest predictor of TTI.
- Limited availability of diagnostic support services and specialist dentists were noted.
- Advanced disease stages (III-IV) were common, with a median of 46.97%.
Conclusions:
- The availability and accessibility of oncology services and specialized human resources are critical for timely OOC treatment.
- Interventions should focus on enhancing diagnostic capabilities and treatment infrastructure in Brazilian municipalities.
- Addressing systemic barriers is essential to reduce delays in OOC care.
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