Dificultades para el acceso al tratamiento del cáncer colorrectal en adultos mayores.

Introduction: Colorectal cancer (CRC) is a leading cause of cancer-related mortality among older adults. Delays in diagnosis and treatment negatively impact survival outcomes. In Argentina, access barriers in this population have not been adequately characterized. Materials and methods: We conducted...

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Published in:Medicina (Buenos Aires) Vol. 86; no. 1; pp. 99 - 113
Main Authors: Pietracci, Lilian E., Meek Torres, Silvana, Daher, Matías, Izaguirre Germain, María Pía, Caruso, Diego
Format: Article
Published: Medicina (Buenos Aires) ene/feb2026
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        atl: Dificultades para el acceso al tratamiento del cáncer colorrectal en adultos mayores.
      aug:
        au:
          Pietracci, Lilian E.
          Meek Torres, Silvana
          Daher, Matías
          Izaguirre Germain, María Pía
          Caruso, Diego
        affil:
          Hospital Dr. César Milstein
          Unidad Docente Hospitalaria, Hospital Dr. César Milstein, Universidad de Buenos Aires, Buenos Aires, Argentina
      su:
        Health services accessibility
        Cancer treatment
        Colorectal cancer
        Medical care
        Delayed diagnosis
        Older people
        Argentina
      sug:
        subj:
          Argentina
          Health services accessibility
          Cancer treatment
          Colorectal cancer
          Medical care
          Delayed diagnosis
          Older people
      keyword:
        Barriers to healthcare access
        Colorectal neoplasms
        Older adults
        Time-to-treatment
        Barreras de acceso a los servicios de salud
        Neoplasias colorrectales
        Personas mayores
        Tiempo de tratamiento
      ab:
        Introduction: Colorectal cancer (CRC) is a leading cause of cancer-related mortality among older adults. Delays in diagnosis and treatment negatively impact survival outcomes. In Argentina, access barriers in this population have not been adequately characterized. Materials and methods: We conducted an ambispec tive cohort study including older adults diagnosed with CRC within the past five years. Telephone interviews were carried out to collect data on time intervals and perceived barriers across five stages of the diagnostic-therapeutic process (from symptom onset or screening to treatment initiation). Multivariable linear and logistic regression models were used to assess associations between sociodemographic factors, perceived barriers, and both total time to treatment and stage-specific delays. Results: A total of 225 participants were includ ed. The median time to treatment initiation was 6 months. Perception of barriers was significantly as sociated with a higher likelihood of delay in all stages analyzed. The most frequently reported barrier was accessibility -mainly difficulties in obtaining medi cal appointments- present throughout the care con tinuum. In later stages, resource shortages were also reported. Female sex was associated with longer time to treatment. Conclusion: Our findings highlight the need for struc tural health system interventions aimed at reducing treatment delays in older adults with CRC. Identifying and addressing perceived barriers could enhance equity and efficiency in access to oncological care. Time to treatment exceeded internationally recommended stan dards. Perceived barriers were present in all stages and were significantly associated with delays in care delivery.
        Introducción: El cáncer colorrectal (CCR) es una cau sa importante de mortalidad en personas mayores. La demora en su diagnóstico y tratamiento se asocia con peor pronóstico. En Argentina, las barreras en el acceso a la atención en esta población no han sido adecuada mente caracterizadas. Materiales y métodos: Se realizó un estudio de cohor te ambispectiva en personas mayores con CCR diagnos ticado en los últimos cinco años. Mediante entrevistas telefónicas se recabó información sobre tiempos y barre ras en cinco etapas del proceso diagnóstico-terapéutico (desde la aparición de síntomas o tamizaje hasta el inicio del tratamiento). Se utilizaron modelos multivaria dos de regresión lineal y logística para explorar factores asociados al tiempo total al tratamiento y a las demoras en cada etapa. Resultados: Se incluyeron 225 participantes. La me diana de tiempo desde el diagnóstico hasta el tratamien to fue de 6 meses. La percepción de barreras se asoció significativamente con mayor probabilidad de demora en todas las etapas. La accesibilidad, especialmente las dificultades para obtener turnos médicos, fue la barrera más reportada. En etapas finales se agregaron obstáculos relacionados con la escasez de recursos. El género feme nino se asoció con un mayor tiempo total al tratamiento. Conclusión: Los hallazgos destacan la necesidad de intervenciones estructurales que mejoren la equidad y reduzcan los tiempos de acceso al tratamiento on cológico en adultos mayores. El tiempo al tratamiento superó lo recomendado por estándares internacionales. Las barreras estuvieron presentes a lo largo de todo el proceso y se asociaron con demoras asistenciales.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: Spanish
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