Factors associated to persistence with hormonal therapy in women with breast cancer

Detalhes bibliográficos
Autor(a) principal: Brito, Cláudia
Data de Publicação: 2014
Outros Autores: Portela, Margareth Crisóstomo, Vasconcellos, Mauricio Teixeira Leite de
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/81152
Resumo: OBJECTIVE To analyze factors associated with persistence to breast cancer hormone therapy in order to contribute to the quality of care improvement. METHODS Retrospective longitudinal study, based on secondary data. A cohort of 5,861 women with breast cancer registered in different datasets of the Brazilian National Cancer Institute and the Brazilian Unified Health System were analyzed. All women were treated at this hospital, which provides free medication, and the follow-up period was from January 2004 to October 2010. Sociodemographic, behavioral, and clinical variables, as well as aspects of lifestyle and health care, were considered in the explanation of variations in the persistence to hormone therapy, applying the Kaplan-Meier method and the Cox proportional hazard model. RESULTS Overall persistence to hormone therapy was 79.0% at the end of the first year, and 31.0% in five years of treatment. The risk of discontinuing hormone therapy was higher among women under 35 years old, with more advanced disease (stages III and IV), alcohol drinkers, those undergoing chemotherapy, and for each additional hospitalization, exam performed, and month between diagnosis and beginning of treatment. In the opposite direction, the risk of discontinuity was lower among women who had at least finished high school, those with partner, with a family history of cancer, those who had undergone breast surgery, and who had outpatient visits to a Mastologist, and a Clinical Oncologist. CONCLUSIONS The majority of the women with breast cancer (69.0%) do not persist with hormone treatment for the five years recommended, increasing the risk of inadequate clinical results. The results show aspects of care that can provide better results.
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spelling Factors associated to persistence with hormonal therapy in women with breast cancer Fatores associados à persistência à terapia hormonal em mulheres com câncer de mama OBJECTIVE To analyze factors associated with persistence to breast cancer hormone therapy in order to contribute to the quality of care improvement. METHODS Retrospective longitudinal study, based on secondary data. A cohort of 5,861 women with breast cancer registered in different datasets of the Brazilian National Cancer Institute and the Brazilian Unified Health System were analyzed. All women were treated at this hospital, which provides free medication, and the follow-up period was from January 2004 to October 2010. Sociodemographic, behavioral, and clinical variables, as well as aspects of lifestyle and health care, were considered in the explanation of variations in the persistence to hormone therapy, applying the Kaplan-Meier method and the Cox proportional hazard model. RESULTS Overall persistence to hormone therapy was 79.0% at the end of the first year, and 31.0% in five years of treatment. The risk of discontinuing hormone therapy was higher among women under 35 years old, with more advanced disease (stages III and IV), alcohol drinkers, those undergoing chemotherapy, and for each additional hospitalization, exam performed, and month between diagnosis and beginning of treatment. In the opposite direction, the risk of discontinuity was lower among women who had at least finished high school, those with partner, with a family history of cancer, those who had undergone breast surgery, and who had outpatient visits to a Mastologist, and a Clinical Oncologist. CONCLUSIONS The majority of the women with breast cancer (69.0%) do not persist with hormone treatment for the five years recommended, increasing the risk of inadequate clinical results. The results show aspects of care that can provide better results. OBJETIVO Analisar os fatores associados à persistência à hormonioterapia para câncer de mama visando à melhoria da qualidade do cuidado prestado. MÉTODOS Estudo longitudinal a partir de dados secundários. Foi analisada uma coorte de 5.861 mulheres com câncer de mama registradas em diferentes bancos de dados do Instituto Nacional de Câncer e do Sistema Único de Saúde. Todas as pacientes foram tratadas nesse hospital, que dispensa a medicação gratuitamente, e o período de seguimento foi de janeiro de 2004 a outubro de 2010. Variáveis sociodemográficas, comportamentais, clínicas, de estilos de vida e de aspectos do serviço de saúde integraram-se à análise para testar associação com a persistência ao tratamento hormonal, pelo método de Kaplan-Meier e Riscos Proporcionais de Cox. RESULTADOS A persistência geral à hormonioterapia foi de 79,0% ao final do primeiro ano e 31,0% em cinco anos de tratamento. O risco de descontinuidade à hormonioterapia mostrou-se maior entre mulheres com idade inferior a 35 anos, com estadiamento mais grave (III e IV), usuárias de álcool, que realizaram quimioterapia, e para cada hospitalização, cada exame e cada mês, entre o diagnóstico e o início do tratamento adicional. Na direção oposta, o risco de descontinuidade mostrou-se menor entre as mulheres com nível médio e superior de escolaridade, com companheiro, com história familiar de câncer, submetidas à cirurgia e que tiveram consultas com mastologista e com oncologista clínico. CONCLUSÕES Das mulheres com câncer de mama, 69,0% não persistiram ao término de cinco anos do tratamento hormonal, aumentando o risco de uma resposta clínica inadequada. Os resultados mostram aspectos do cuidado que podem conduzir a melhores respostas ao tratamento. Universidade de São Paulo. Faculdade de Saúde Pública2014-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/8115210.1590/S0034-8910.2014048004799Revista de Saúde Pública; Vol. 48 No. 2 (2014); 284-295Revista de Saúde Pública; Vol. 48 Núm. 2 (2014); 284-295Revista de Saúde Pública; v. 48 n. 2 (2014); 284-2951518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporenghttps://www.revistas.usp.br/rsp/article/view/81152/84781https://www.revistas.usp.br/rsp/article/view/81152/84782Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessBrito, Cláudia Portela, Margareth Crisóstomo Vasconcellos, Mauricio Teixeira Leite de 2014-06-04T13:35:23Zoai:revistas.usp.br:article/81152Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2014-06-04T13:35:23Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Factors associated to persistence with hormonal therapy in women with breast cancer
Fatores associados à persistência à terapia hormonal em mulheres com câncer de mama
title Factors associated to persistence with hormonal therapy in women with breast cancer
spellingShingle Factors associated to persistence with hormonal therapy in women with breast cancer
Brito, Cláudia
title_short Factors associated to persistence with hormonal therapy in women with breast cancer
title_full Factors associated to persistence with hormonal therapy in women with breast cancer
title_fullStr Factors associated to persistence with hormonal therapy in women with breast cancer
title_full_unstemmed Factors associated to persistence with hormonal therapy in women with breast cancer
title_sort Factors associated to persistence with hormonal therapy in women with breast cancer
author Brito, Cláudia
author_facet Brito, Cláudia
Portela, Margareth Crisóstomo
Vasconcellos, Mauricio Teixeira Leite de
author_role author
author2 Portela, Margareth Crisóstomo
Vasconcellos, Mauricio Teixeira Leite de
author2_role author
author
dc.contributor.author.fl_str_mv Brito, Cláudia
Portela, Margareth Crisóstomo
Vasconcellos, Mauricio Teixeira Leite de
description OBJECTIVE To analyze factors associated with persistence to breast cancer hormone therapy in order to contribute to the quality of care improvement. METHODS Retrospective longitudinal study, based on secondary data. A cohort of 5,861 women with breast cancer registered in different datasets of the Brazilian National Cancer Institute and the Brazilian Unified Health System were analyzed. All women were treated at this hospital, which provides free medication, and the follow-up period was from January 2004 to October 2010. Sociodemographic, behavioral, and clinical variables, as well as aspects of lifestyle and health care, were considered in the explanation of variations in the persistence to hormone therapy, applying the Kaplan-Meier method and the Cox proportional hazard model. RESULTS Overall persistence to hormone therapy was 79.0% at the end of the first year, and 31.0% in five years of treatment. The risk of discontinuing hormone therapy was higher among women under 35 years old, with more advanced disease (stages III and IV), alcohol drinkers, those undergoing chemotherapy, and for each additional hospitalization, exam performed, and month between diagnosis and beginning of treatment. In the opposite direction, the risk of discontinuity was lower among women who had at least finished high school, those with partner, with a family history of cancer, those who had undergone breast surgery, and who had outpatient visits to a Mastologist, and a Clinical Oncologist. CONCLUSIONS The majority of the women with breast cancer (69.0%) do not persist with hormone treatment for the five years recommended, increasing the risk of inadequate clinical results. The results show aspects of care that can provide better results.
publishDate 2014
dc.date.none.fl_str_mv 2014-04-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rsp/article/view/81152
10.1590/S0034-8910.2014048004799
url https://www.revistas.usp.br/rsp/article/view/81152
identifier_str_mv 10.1590/S0034-8910.2014048004799
dc.language.iso.fl_str_mv por
eng
language por
eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/81152/84781
https://www.revistas.usp.br/rsp/article/view/81152/84782
dc.rights.driver.fl_str_mv Copyright (c) 2017 Revista de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2017 Revista de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
dc.source.none.fl_str_mv Revista de Saúde Pública; Vol. 48 No. 2 (2014); 284-295
Revista de Saúde Pública; Vol. 48 Núm. 2 (2014); 284-295
Revista de Saúde Pública; v. 48 n. 2 (2014); 284-295
1518-8787
0034-8910
reponame:Revista de Saúde Pública
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
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reponame_str Revista de Saúde Pública
collection Revista de Saúde Pública
repository.name.fl_str_mv Revista de Saúde Pública - Universidade de São Paulo (USP)
repository.mail.fl_str_mv revsp@org.usp.br||revsp1@usp.br
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