Sociodemographic and Health Insurance Factors in Breast Cancer Care among Women in Bogotá, Colombia 2017–2019
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Keywords
Breast Neoplasms, Health Status Disparities, Insurance Coverage, Socioeconomic Factors, Health Services Accessibility
Abstract
Introduction: Breast cancer is the most common malignancy among women worldwide. Timely diagnosis and initiation of treatment are critical determinants of prognosis and survival. Objective: To analyze the association between sociodemographic characteristics and type of health insurance with the timeliness of histopathological diagnosis and treatment initiation for breast cancer. Methods: This observational retrospective cohort study included 450 women diagnosed with breast cancer between 2017 and 2019 and treated at an oncology center in Bogotá. Descriptive analyses (proportions, means, and standard deviations), chi-square tests, and Student’s t tests were performed, as well as multivariable logistic regression to identify factors associated with delays in care. Timeliness indicators were assessed according to the standards of the Colombian Comprehensive Health Care Pathway for breast cancer.
Results: Histopathological diagnosis exceeded 7 days in 61.5% of cases, and treatment initiation exceeded 30 days in 60.9%. Women from socioeconomic strata 1–3, those enrolled in the subsidized insurance scheme, and unemployed women showed a higher likelihood of being diagnosed at stages III–IV.
Conclusion: Strengthening national breast cancer care strategies with differentiated approaches that account for the sociodemographic and insurance-related conditions of the most vulnerable groups is essential to reduce inequities in diagnostic and therapeutic timeliness.
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PhD Ingrid Tatiana Rojas-Ruiz, Universidad Nacional de Colombia. Bogotá, Colombia.
Enfermera, Especialista en calidad en salud y epidemiología, Magister en epidemiologia y Doctora en calidad de los sistemas en salud.
EdD Doris Verónica Ortega Altamirano, National Institute of Public Health of Mexico
Investigadora en ciencias médicas, Doctorado en Educación