Characterization of the clinical-epidemiological profile of oncological patients referred between two public hospitals

Keywords

oncological referral - oncological referencing - oncological diagnosis

Introduction: There are many challenges that impact the time for diagnosing a neoplasm and initiating its treatment. The proposal to refer patients with suspected or newly diagnosed cancer from general hospitals to oncology services aims to enhance patient care within the Sistema Único de Saúde (SUS).

Objective: To describe the clinical and epidemiological profile of patients referred between a general hospital and an Unidade de Alta Complexidade em Oncologia (UNACON).

Methodology: This is a cross-sectional, retrospective study, based on the analysis of patient medical records from 2021 to 2022.

Results: A total of 110 patients were analyzed, of whom 61 (55.4%) were male. Their average age was 65 years. In 50% of the cases, the confirmed oncological diagnosis by biopsy was performed at the originating hospital, as well as computed tomography scans (83.6%), magnetic resonances imaging (4.5%), endoscopies and/or colonoscopies (29%), bronchoscopies (4.5%), in addition to 23 surgeries (21%). The main referral specialties were Surgical Oncology (25.4%), Clinical Oncology (24.5%), Urology (16.4%) and Thoracic Surgery (12.7%). The mean interval between the referral request and the patient's first consultation at UNACON was 12 days, with 93 patients (84.5%) attending the service. Of the 65 patients diagnosed with cancer, 40 (61.5%) received some type of treatment at UNACON. The remaining did not receive treatment due to loss of follow-up (13.8%), lack of permissible clinical performance (15.3%), absence of an indication for complementary therapy (7.5%) and death (1.5%). The mean duration between diagnosis and initiation of treatment was 83.2 days. The most prevalent tumor sites were gastrointestinal (31.7%), genitourinary (11.7%), and lung (4.5%). There was a predominance of advanced stages at diagnosis: stage III (21.5%) and stage IV (50.7%).

Conclusion: Oncological referrals from general hospitals to oncological services play a vital role in optimizing the flow of patients diagnosed with neoplasms for specialized evaluation. However, there is still a need to improve care pathways to ensure timely treatment initiation and reduce patient follow-up loss. Cancers diagnosed in the context of hospital admission tend to present at more advanced stages, and patients, often in more fragile conditions, face greater challenges in accessing adequate treatment.

Corresponding author: Felipe Guimarães Silva (e-mail: [e-mail]).

 

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Artikel online veröffentlicht:
06. Mai 2025