Socioeconomic factors and cancer diagnosis time in Latin America: evidence from EQUITYCancer-LA

Background

Socioeconomic (SE) inequalities influence access to cancer care, yet evidence on their role in time to diagnosis remains limited, despite its impact on cancer outcomes. This study, within the EquityCancer-LA project, examines the association between SE factors and time to cancer diagnosis in three Latin American countries - Chile, Colombia, and Ecuador.

Methods

We analysed survey data from cancer patients in Chile (n = 336), Colombia (n = 351), and Ecuador (n = 361), collected between 2022 and 2023. Provider-related time from first consultation to diagnosis (in days) was modelled using log-normal regression. SE variables included education, income, employment status, and housing conditions. Models assessed associations between time to diagnosis and SE factors individually and jointly, adjusting for age, sex, and cancer type. Quantile regression explored variations across the delay distribution.

Results

A preliminary analysis showed that most participants had low to middle SE status, with primary/secondary education, unemployment or inactivity, and income below two minimum wages. Time to diagnosis was longer in Colombia compared to Chile and Ecuador. In adjusted models, SE variables were not significantly associated with time to diagnosis. In Colombia, lower income was linked to 41% longer delays, although not statistically significant after adjustment. No consistent patterns were observed across countries, and no associations were found when SE factors were analysed jointly. Quantile regression suggested variation across the delay distribution, without consistent patterns.

Conclusions

Preliminary results show that SE factors alone may not be the main drivers of delays in cancer diagnosis in these settings, indicating that other factors, including health system factors, may play a more prominent role. Further analyses should however address heterogeneity issues, namely between cancer types and timing of hurdles across the care pathway.

Key messages

• Socioeconomic factors showed limited and inconsistent association with time to cancer diagnosis across countries.

• Reducing diagnostic delays may require broader system-level action beyond SE inequalities.