Interval Between Diagnosis and Treatment of Oral Cavity Cancer in Health Services in the State of Bahia, 2000-2022

Abstract

Introduction: Oral cavity cancer shows high mortality rates in Bahia, largely attributed to late diagnosis. Objective: To investigate factors associated with the diagnostic and treatment intervals for oral cavity cancer in health services across the state of Bahia between 2000 and 2022. Method: A cross-sectional, hospital-based study was conducted with 1,305 cases retrieved from Hospital Based Cancer Registries. Descriptive statistical analyses included absolute and relative frequencies for categorical variables, and medians with interquartile ranges for age and time intervals of interest (dates) were performed. A significance level of 5% (α=0.05) was adopted, and Poisson regression with a negative binomial distribution was applied. Results: Most of the 1,305 individuals with oral cancer were diagnosed at advanced-stage (69.2%), were referred through the Brazilian National Health System (98.2%), and had to leave their city of origin to receive oncologic care (69.9%). The median of days since entry into oncology services to treatment initiation was 91 days, ranging between 61 and 144 days. Time was associated with the necessity of transportation as protective factor (IRR 0.57) and with sex, age and staging. Conclusion: Time range to begin treatment at health services in Bahia exceeds 90 days, potentially compromising treatment outcomes, prognosis, and quality of life. Referral pathways and the need to travel for care emerged as key factors influencing the diagnostic and treatment timelines.