Time Between Diagnosis and Treatment of Cervical Cancer in Southern Brazil: Assessment of Compliance With the 60-Day Law
Paula Lopes, Andressa Caberte de Abreu, Jéssika Frantz, Karen Isabel Klein, Amanda Colling LazarottoPURPOSE
In Brazil, cervical cancer is the third most common malignancy and the third leading cause of cancer-related death among women. This study evaluated the interval between diagnosis and treatment initiation for cervical cancer in the state of Rio Grande do Sul (RS), Brazil, from 2020 to 2025, identifying regional disparities and healthcare bottlenecks associated with noncompliance with Federal Law No. 12,732/2012, which mandates treatment initiation within 60 days of diagnosis.
METHODS
A retrospective cross-sectional study was conducted using data from the DATASUS Oncology Panel. Variables included health macro-region of residence, time to treatment initiation, female sex, cervical cancer diagnosis (ICD-10 C53), and year of diagnosis. Cases with inconclusive dates were excluded. Time to treatment was categorized as ≤60 days (legal compliance), >60 days, and >365 days (extreme delay).
RESULTS
A total of 5,905 confirmed cases were analyzed. Overall, only 53.8% (n = 3,182) of patients initiated treatment within 60 days after histopathological diagnosis. The Metropolitan Macro-region accounted for the largest proportion of cases (54.8%) and showed the highest rate of noncompliance with the legal timeframe (46.3%), followed by the Southern Macro-region (45.4%). In contrast, the Valleys (64.4%) and Central-West (64.1%) macro-regions demonstrated the highest compliance rates. Additionally, 3.48% (n = 206) of women waited more than 1 year to receive their first treatment, with the highest proportion of extreme delay observed in the Central-West Macro-region (4.35%).
CONCLUSION
Macro-regions with the highest healthcare demand demonstrated lower compliance with the legally mandated treatment timeframe, suggesting logistical and regulatory bottlenecks in oncologic care pathways. Nearly half of patients did not begin treatment within the period established by Brazilian law, falling short of current international recommendations. In line with this concern, a recent multisociety consensus statement, published in Gynecologic Oncology (2025), recommends treatment initiation within 4 weeks of diagnosis and cites evidence of a 1%-3% increase in mortality per week of delay in potentially curable tumors. These disparities highlight the urgent need to optimize oncology referral and care regulation systems to ensure equitable and timely access to treatment.