Distribuição do câncer infantojuvenil e fatores associados ao tempo entre o diagnóstico e o início do tratamento: análise a partir dos registros hospitalares de câncer no Brasil, 2010- 2016

Abstract

Child and adolescent neoplasia presents different clinical behavior when compared to cancers that affect adult individuals. In children and adolescents it develops quickly, becoming quite invasive. Therefore, the time between diagnosis and the start of treatment is decisive in the prognosis of the disease. It aimed to analyze the distribution of childhood cancer through Brazilian geographic regions and identify the factors associated with the time established by law to start treatment based on the Hospital Cancer Records (known by the abbreviation of RHC) from 2010 to 2016. It is an observational and descriptive study of secondary basis, which extracted information from 36,187 records of children and teenagers (0 to 19 years old), belonging to the hospital base of the National Cancer Institute (known by the acronym INCA) and the Oncocenter Foundation of São Paulo (known by the acronym FOSP). Compliance with the Federal Law 12.732/12 was verified, which establishes a maximum period of 60 days for the beginning of cancer treatment after the diagnosis has been defined. In the descriptive analysis, absolute and percentage frequencies were used for the categorical variables, central tendency and dispersion measures for the quantitative variables and the coefficient of childhood cancer prevalence was calculated. Logistic regression was used, adopting a significance level of 5% to identify factors associated with time (= 60 days) for the beginning of cancer treatment. The average age was 9,3 (±6.2), 54.1% were male and 32.0% were in the age group from 0 to 4 years. Regarding skin color, information available only in the INCA records, 43.4% declared brown color. The Southeast region concentrated 40.2% of the registered cases, of these, 63.0% presented solid type neoplasia, unlike the North region, where the majority, 53.9%, developed the hematological type. Regarding the time to start treatment, 77.0% of the registered cases, from 0 to 19 years old, were carried out in a time less than or equal to 60 days, however, 24.0% of the teenagers carried out their treatment in more than 60 days. From the logistic regression model, it was observed that female individuals (OR = 1.2), aged 15 to 19 years (OR = 2.6), living in the North region (OR = 2.7) and with solid type neoplasms (OR = 2.0) were more likely to undergo cancer treatment in more than 60 days. It is concluded that characteristics related to childhood cancer have a different distribution between the Brazilian geographic regions and most patients were able to carry out their treatment within the span brought by law. However, adolescents aged 15 to 19 years, patients with solid neoplasia and who live in the northern region of the country are more susceptible to delayed treatment.