Dados do Trabalho

Título

Timeliness of hospital-based cancer registries in the State of São Paulo, Brazil

Introdução

Hospital-based cancer registries (HBCR) are important for monitoring the quality of cancer treatment. However, the procedures for their operation vary among institutions. The commonly observed delay in cancer data availability should not be considered a limitation in the analytical process, as cancer is a chronic disease without abrupt fluctuations in short periods of time. Global cancer statistics are usually released with a time lag relative to the calendar year.

Objetivo

In order to contextualize the data updating process, this study evaluated the consolidation time that can be considered safe in the analysis and reporting of data from 78 HBCR in the State of São Paulo, Brazil.

Métodos

The database of the Oncocentro Foundation of São Paulo (FOSP) was used. Among other responsibilities, FOSP coordinates the State database of HBCR for São Paulo, including hospitals accredited in the Oncology Care Network of the Brazilian Unified Health System, as well as voluntary participating institutions. From the database consolidated in March 2023, analytical cases of reportable neoplasms (with uncertain biological behavior, in situ, and invasive) diagnosed between January 2000 and December 2022 were selected, totaling 1,133,810 tumors. The analyses were conducted according to hospital accreditation, service volume, clinical staging at diagnosis, and quality and access indicators, describing absolute and relative frequencies, as well as measures of central tendency. Analysis of Variance (ANOVA test) was used to compare variances between means/medians among three or more groups at a significance level of 5% (p < 0.05). The statistical software SPSS was used for analysis.

Resultados

Among the 78 institutions, 22 are responsible for 80% of the total cases. The reduction in cases diagnosed in recent years did not occur due to data non-completion, which maintains an increasing pattern, with a high number even during the pandemic (60,075 in 2021 versus 55,033 in 2019). Approximately 83.5% of data are filled out within 3 years after diagnosis, and 95.5% between 4 and 5 years. The variation in the number of professionals per institution did not influence the time interval between data completion and year of diagnosis (p < 0.001). Quality and access variables remained within reference values, even in recent incomplete years. The change in clinical staging in 2020 suggests that the still incomplete case registration alters the expected behavior of the disease. In this regard, it should be noted that the observed pattern in previous years would be reestablished as the registration of cases by year of diagnosis becomes complete.

Conclusões

This study identified that a consolidation time of 3 years is considered suitable for reporting the profile of cancer care in the State of São Paulo, without compromising the cancer occurrence pattern. Our findings can support studies using HBCR data, enabling the creation of targeted measures for improvement in healthcare and management in state cancer care, focusing on standardizing case flow and organizing work within each hospital institution.

Palavras-chave

Hospital-based cancer registry; Cancer data; Delay, Cancer care.