Temporal Trends in the Interval Between Diagnosis and Treatment Initiation for Esophageal Cancer in Brazil: A Temporal Analysis
Renan Garcia Artus, Leonardo Storch, Pedro Melo, Pedro Henrique Ribeiro Teixeira, Rafael Amengual Duarte, Lucas Guimarães, Henrique Da Rocha FronchetiPURPOSE
Esophageal cancer accounts for approximately 511,000 new cases annually worldwide 1 and is the tenth most frequent type of cancer in Brazil. In the management of this malignancy, treatment delays longer than two months may increase the risk of metastasis 2 . Therefore, understanding treatment timelines is essential for improving public health policies related to cancer care. Purpose: To identify changes in the interval between diagnosis and treatment initiation for esophageal cancer over recent years, with emphasis on assessing the impact of the COVID-19 pandemic.
METHODS
A temporal analysis was conducted using data from the Oncology Panel obtained through DataSUS TabNet. The study was divided into three periods: pre-pandemic (2017-2019), pandemic (2020-2022), and post-pandemic (2023-2025). Comparisons were performed using Pearson’s chi-square test and prevalence ratios (PR) with their respective 95% CIs.
RESULTS
A total of 43,867 esophageal cancer cases diagnosed between 2017 and 2025 were analyzed. Of these, 15,389 cases occurred during the pandemic period, 14,954 before the pandemic, and 13,524 after the pandemic. A progressive reduction was observed in the proportion of patients who initiated treatment within 60 days across the three periods: pre-pandemic (47.2%), pandemic (46.6%), and post-pandemic (44.3%). A statistically significant difference was identified among the analyzed periods (χ
2
= 25.82;
CONCLUSION
These findings suggest a substantial impact of the COVID-19 pandemic on esophageal cancer treatment timelines in Brazil, with a progressive decline throughout the study period in the proportion of patients treated within 60 days after diagnosis. The results indicate a persistent post-pandemic effect on oncological care access and healthcare delivery flow in Brazil. This reinforces the need for further studies to better investigate the issue and to expand the country’s diagnostic and therapeutic capacity.