Comparative Analysis of Breast Cancer Care Disparities in Argentina: Diagnosis, Treatment Timeliness, and Cyclin-Dependent Kinase Inhibitor Implications.
Breast cancer (BC) is the most commonly diagnosed malignancy among women worldwide and the leading cause of cancer-related death in this population in Argentina. Despite its burden, Argentina lacks comprehensive epidemiologic data. In low- and middle-income countries (LMICs), acknowledging existing disparities and delays in treatment is essential for implementing cost-effective policies that optimize outcomes and reduce relapse and mortality.
This retrospective, observational study analyzed 786 women with operable BC treated between 2017 and 2022 in two Buenos Aires institutions. Patients were stratified by health coverage: private prepaid health insurance (PPHI, n = 557) and social security (SS, n = 229). Four quality indicators were assessed: stage at diagnosis, time from anomaly detection to pathologic diagnosis and treatment initiation, and adherence to multimodal therapy. In addition, the impact on eligibility for adjuvant cyclin-dependent kinase inhibitors (CDK4/6i) was evaluated in the hormone receptor-positive/human epidermal growth factor receptor 2-negative subgroup.
Patients with PPHI were significantly more likely to be diagnosed at earlier stages (stage I: 56.7% v 37.1%, P < .05) and to meet WHO benchmarks for timely diagnosis (<60 days) and treatment (<90 days). Median time to diagnosis and treatment was notably shorter in the PPHI group (30.5 v 61 days and 76 v 126 days, respectively; P < .05). CDK4/6i eligibility was higher among SS patients, suggesting more advanced disease and increased treatment cost burden.
Disparities between Argentina's health subsystems significantly affect the BC stage at diagnosis and treatment timelines, influencing therapeutic pathways and associated costs. These findings highlight the need for targeted, system-level interventions. While further research is needed to confirm their long-term impact, such efforts may contribute to more equitable care and improved outcomes in LMICs.
This retrospective, observational study analyzed 786 women with operable BC treated between 2017 and 2022 in two Buenos Aires institutions. Patients were stratified by health coverage: private prepaid health insurance (PPHI, n = 557) and social security (SS, n = 229). Four quality indicators were assessed: stage at diagnosis, time from anomaly detection to pathologic diagnosis and treatment initiation, and adherence to multimodal therapy. In addition, the impact on eligibility for adjuvant cyclin-dependent kinase inhibitors (CDK4/6i) was evaluated in the hormone receptor-positive/human epidermal growth factor receptor 2-negative subgroup.
Patients with PPHI were significantly more likely to be diagnosed at earlier stages (stage I: 56.7% v 37.1%, P < .05) and to meet WHO benchmarks for timely diagnosis (<60 days) and treatment (<90 days). Median time to diagnosis and treatment was notably shorter in the PPHI group (30.5 v 61 days and 76 v 126 days, respectively; P < .05). CDK4/6i eligibility was higher among SS patients, suggesting more advanced disease and increased treatment cost burden.
Disparities between Argentina's health subsystems significantly affect the BC stage at diagnosis and treatment timelines, influencing therapeutic pathways and associated costs. These findings highlight the need for targeted, system-level interventions. While further research is needed to confirm their long-term impact, such efforts may contribute to more equitable care and improved outcomes in LMICs.
Authors
Rivero Rivero, Fariña Fariña, Quiroga Quiroga, Boixart Boixart, Camargo Graffigna Camargo Graffigna, Bianchi Bianchi, Gómez Abuin Gómez Abuin
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