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- Title
Multilevel analysis of social determinants of advanced stage colorectal cancer diagnosis.
- Authors
Dantas, Amanda Almeida Gomes; de Oliveira, Nayara Priscila Dantas; Costa, Guilherme Augusto Barcello; Martins, Luís Felipe Leite; dos Santos, Jonas Eduardo Monteiro; Migowski, Arn; de Camargo Cancela, Marianna; de Souza, Dyego Leandro Bezerra
- Abstract
The advanced stage at diagnosis of colorectal cancer (CRC) may be related to individual factors, socioeconomic conditions, and healthcare service availability. The objective of the study was to analyze the prevalence of advanced stage CRC at the time of diagnosis and its association with individual, contextual, socioeconomic, and healthcare service indicators. An observational, cross-sectional study was conducted, analyzing cases of malignant neoplasms of the colon and rectum in individuals of both sexes, aged between 18 and 99 years, diagnosed between 2010 and 2019 in Brazil (n = 69,047). Data were collected from the Hospital Cancer Registry (HCR), Atlas of Human Development in Brazil, and from the National Registry of Health Institutions (NRHI). A Multilevel Poisson Regression model with random intercept was used. The prevalence of advanced stage CRC at diagnosis was 65.6%. Advanced stage was associated with older age groups prevalence ratio (PR) 4.40 and younger age groups (PR 1.84), low Human Development Index (HDI) (PR 1.22), and low density of family health strategy teams (PR 1.10). The study highlights the unequal distribution of social determinants of health in the diagnosis CRC in Brazil, revealing the need to evaluate and redirect public policies aimed at improving early detection and prevention of CRC in the country.
- Subjects
BRAZIL; COLORECTAL cancer; CANCER diagnosis; HEALTH facilities; AGE groups; POISSON regression; HUMAN Development Index; TUMOR markers
- Publication
Scientific Reports, 2024, Vol 14, Issue 1, p1
- ISSN
2045-2322
- Publication type
Article
- DOI
10.1038/s41598-024-60449-0