Loading
A study that followed about 3,000 Brazilian women from breast cancer diagnosis to measure how stage, waiting time and treatment differ between the public health system and private insurance.
AMAZONA III is a prospective observational cohort run by LACOG with the Brazilian breast cancer study group GBECAM, with the Brazilian Ministry of Health and the Avon Institute as collaborators. ClinicalTrials.gov records 3,000 participants (actual) at 24 sites, a start in January 2016 and completion in April 2021; the study director is Gustavo Werutsky. The first analysis (Rosa and colleagues, 2020) included 2,950 women diagnosed from January 2016 to March 2018 at 23 sites: 63.1 per cent were treated in the public system, only 34 per cent were diagnosed by screening, and publicly insured women had more stage III disease (33.5 against 14.7 per cent). A sub-analysis of 1,709 women with stage I to III disease (Maschmann and colleagues) found a median of 46 days from diagnosis to first treatment overall, 56 days in the public system against 34 in the private, with public-system patients at higher odds of starting after 60 days (odds ratio 4.74).
Brazil's 60-day law sets a ceiling, and this is a measurement of how the public system performs against it for one cancer. Knowing where the delay sits is what lets a patient or a health service push on it.
In Brazil the same disease is found later in the public system, which treats most women. The authors note that Brazil's cancer registries are limited in number and quality, which is why a cohort like this is needed to see it.
Shares Time interval between diagnosis to treatment of breast cancer and the impact of health insurance coverage: a sub analysis of the AMAZONA III Study (GBECAM 0115), The impact of sociodemographic factors and health insurance coverage in the diagnosis and clinicopathological characteristics of breast cancer in Brazil: AMAZONA III study (GBECAM 0115), Latin American Cooperative Oncology Group, HR-positive / HER2-negative breast cancer.
Shares Daniela Dornelles Rosa, Latin American Cooperative Oncology Group, HR-positive / HER2-negative breast cancer.
Shares A.C. Camargo Cancer Center, Instituto Nacional de Câncer (INCA).
Shares Instituto Nacional de Câncer (INCA), Most of the world has almost no cancer care.
Every source this page cites, grouped by who published it. Grouping is read from the web address, not assigned by hand.
A source that has moved or gone is reported by the weekly link check. /audit/