Interval between diagnosis and treatment of cervical cancer in Brazil: comparative analysis of cases with and without diagnosis prior to arrival at the hospital unit.

BACKGROUND: Timely initiation of cancer treatment is essential to improving outcomes and reducing mortality. In Brazil, Federal Law No. 12.732/12 mandates that patients with confirmed cancer diagnoses begin treatment within 60 days. This study aimed to assess compliance with this law among women diagnosed with cervical cancer, comparing cases with and without a prior diagnosis at the time of hospital admission. METHODS: Ecological study of temporary series, based on data from the Integrator of Hospital Cancer Records (IRHC). The cases were divided into two groups (cases diagnosed during hospital care and those with a previous diagnosis) and analyzed in the periods before (2006 to 2012) and after the enactment of the law (2013 to 2019). The percentage trend of adherence was analyzed by the Joinpoint Regression Program. RESULTS: Among 120,311 eligible cases, 31.7% (n = 38,143) were diagnosed at the hospital, and 68.3% (n = 82,168) had a prior diagnosis. Overall, 43.2% of women initiated treatment within 60 days. After the law was enacted, the proportion of timely treatment decreased to 66.7% in the no prior diagnosis group and 28.7% in the prior diagnosis group. Significant regional and interstate disparities were observed. Joinpoint analysis revealed both increasing and decreasing trends across states, with notable declines in timely treatment among women with a prior diagnosis. CONCLUSION: Compliance with the 60-day treatment law remains suboptimal, particularly among women with a prior cervical cancer diagnosis. These disparities suggest persistent barriers in patient navigation and systemic inefficiencies within Brazil's public healthcare network. Our findings underscore the need for strengthening integrated care pathways and implementing national patient navigation programs to ensure timely cancer treatment.