[Difficulties in accessing colorectal cancer treatment in older adults]

Colorectal cancer (CRC) is a leading cause of cancer-related mortality among older adults. Delays in diagnosis and treatment negatively impact survival outcomes. In Argentina, access barriers in this population have not been adequately characterized.

We conducted an ambispective cohort study including older adults diagnosed with CRC within the past five years. Telephone interviews were carried out to collect data on time intervals and perceived barriers across five stages of the diagnostictherapeutic process (from symptom onset or screening to treatment initiation). Multivariable linear and logistic regression models were used to assess associations between sociodemographic factors, perceived barriers, and both total time to treatment and stage-specific delays.

A total of 225 participants were included. The median time to treatment initiation was 6 months. Perception of barriers was significantly associated with a higher likelihood of delay in all stages analyzed. The most frequently reported barrier was accessibility -mainly difficulties in obtaining medical appointments- present throughout the care continuum. In later stages, resource shortages were also reported. Female sex was associated with longer time to treatment.

Our findings highlight the need for structural health system interventions aimed at reducing treatment delays in older adults with CRC. Identifying and addressing perceived barriers could enhance equity and efficiency in access to oncological care. Time to treatment exceeded internationally recommended standards. Perceived barriers were present in all stages and were significantly associated with delays in care delivery.