{ "abstract": "Female breast cancer presents high incidence and mortality rates and is considered a significant public health problem. The timeliness of oncological treatment is a fundamental factor in the prognosis and survival of patients. The objective of this study was to analyze the spatial distribution pattern of the percentage of women who initiated breast cancer treatment within 60 days and its association with socioeconomic indicators and the availability of health services in Brazil. An ecological study was conducted using 133 Intermediate Regions of Urban Articulation (IRUA), based on records from the period 2013–2019. Data on the percentage of treatment initiation within 60 days were obtained from the Hospital Cancer Registry Integrator (IHCR). Socioeconomic variables were collected from the Atlas of Human Development in Brazil and the Institute for Applied Economic Research (IPEA). Data on the availability and density of health professionals and services were obtained from the National Registry of Health Establishments (NRHE) and the Hospital Information System (HIS). The Global Moran’s Index and the Local Indicator of Spatial Association (LISA) were used to verify the existence of territorial clusters. Multivariate analysis employed models with global spatial effects. The percentage of breast cancer cases that initiated treatment within 60 days was 48.9% (95% CI: 48.6% − 49.1%), with the highest adherence observed in the IRUA of Cascavel (85%) and the lowest in the IRUA of Rio de Janeiro (16.6%). In the final Spatial Lag Model, positive associations were observed with the density of Family and Community Physicians (β = 0.35; p = 0.007) and the proportion of surgical procedures (β = 0.30; p = 0.001). The analysis indicates that compliance with the 60-day law is related to the structure and organization of health services, highlighting the importance of primary health care as the coordinator of care and the role of surgical capacity in the spatial distribution pattern.", "abstract_shown": true, "affiliations": [ "Graduate Program in Collective Health, Federal University of Rio Grande do Norte - UFRN, Natal, Rio Grande do Norte, Brazil.", "Federal University of Rio Grande do Norte - UFRN, Natal, Rio Grande do Norte, Brazil.", "Graduate Program in Rehabilitation and Functional Performance, Physiotherapy Department, University of Pernambuco - UPE, Petrolina, Pernambuco, Brazil.", "Graduate Program in Collective Health, Trairi Faculty of Health Sciences, Federal University of Rio Grande do Norte - UFRN, Natal, Rio Grande do Norte, Brazil.", "Graduate Program in Collective Health, Department of Collective Health, Federal University of Rio Grande do Norte - UFRN, Natal, Brazil." ], "article_type": "Research Article", "arxiv": null, "author_total": 9, "authors": [ { "affs": [ 0 ], "name": "Paulo Vitor de Souza Silva" }, { "affs": [ 0 ], "name": "Letícia Gabriella Souza da Silva" }, { "affs": [ 1 ], "name": "Ana Camily da Costa Cruz" }, { "affs": [ 1 ], "name": "Amarildo Gomes Cavalcante Júnior" }, { "affs": [ 1 ], "name": "Ephraim Phlorencio da Costa Júnior" }, { "affs": [ 1 ], "name": "José Levi Araújo Dutra", "orcid": "0009-0003-1902-9233" }, { "affs": [ 2 ], "name": "Nayara Priscila Dantas de Oliveira" }, { "affs": [ 3 ], "name": "Isabelle Ribeiro Barbosa" }, { "affs": [ 4 ], "name": "Dyego Leandro Bezerra de Souza", "orcid": "0000-0001-8426-3120" } ], "bibtex": "https://research.draconitic.com/paper/c7s3rgfz6qk60.bib", "cited_by": 0, "doi": "10.1371/journal.pone.0361469", "fulltext_url": "https://europepmc.org/articles/PMC13716208", "id": "c7s3rgfz6qk60", "issns": [ "1932-6203" ], "landing_url": "https://doi.org/10.1371/journal.pone.0361469", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Brazil" ], [ "heading", "Breast Cancer" ], [ "heading", "Breast Tumors" ], [ "heading", "Cancer Detection and Diagnosis" ], [ "heading", "Cancer Treatment" ], [ "heading", "Cancers and Neoplasms" ], [ "heading", "Clinical Medicine" ], [ "heading", "Clinical Oncology" ], [ "heading", "Diagnostic Medicine" ], [ "heading", "Geographical locations" ], [ "heading", "Health Care" ], [ "heading", "Medicine and Health Sciences" ], [ "heading", "Oncology" ], [ "heading", "People and places" ], [ "heading", "Public and Occupational Health" ], [ "heading", "Research Article" ], [ "heading", "Socioeconomic Aspects of Health" ], [ "heading", "South America" ], [ "heading", "Surgical Oncology" ], [ "heading", "Surgical and Invasive Medical Procedures" ], [ "openalex", "2730|Global Cancer Incidence and Screening" ], [ "plos", "/Medicine and health sciences/Clinical medicine/Clinical oncology/Surgical oncology" ], [ "plos", "/Medicine and health sciences/Diagnostic medicine/Cancer detection and diagnosis" ], [ "plos", "/Medicine and health sciences/Health care/Socioeconomic aspects of health" ], [ "plos", "/Medicine and health sciences/Oncology" ], [ "plos", "/Medicine and health sciences/Oncology/Cancer detection and diagnosis" ], [ "plos", "/Medicine and health sciences/Oncology/Cancer treatment" ], [ "plos", "/Medicine and health sciences/Oncology/Cancer treatment/Surgical oncology" ], [ "plos", "/Medicine and health sciences/Oncology/Cancers and neoplasms/Breast tumors/Breast cancer" ], [ "plos", "/Medicine and health sciences/Oncology/Clinical oncology/Surgical oncology" ], [ "plos", "/Medicine and health sciences/Public and occupational health/Socioeconomic aspects of health" ], [ "plos", "/Medicine and health sciences/Surgical and invasive medical procedures" ], [ "plos", "/People and places/Geographical locations/South America/Brazil" ] ], "openalex": "W7224137412", "pdf_url": "https://europepmc.org/articles/PMC13716208?pdf=render", "pmcid": "PMC13716208", "pmid": "42949989", "published": "2026-10-28", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/c7s3rgfz6qk60.ris", "sources": [ { "first_seen": "2026-10-30T12:17:17Z", "native_id": "10.1371/journal.pone.0361469", "source": "plos", "url": "https://doi.org/10.1371/journal.pone.0361469" }, { "first_seen": "2026-10-31T00:20:33Z", "native_id": "MED:42949989", "source": "europepmc", "url": "https://europepmc.org/article/MED/42949989" }, { "first_seen": "2026-11-01T12:23:15Z", "native_id": "PMC13716208", "source": "pmc", "url": "https://doi.org/10.1371/journal.pone.0361469" } ], "subjects": [ { "field": "medicine", "origin": "heading:Public and Occupational Health", "subfield": "epidemiology-public-health" }, { "field": "medicine", "origin": "plos:oncology", "subfield": "oncology" }, { "field": "medicine", "origin": "heading:Surgical and Invasive Medical Procedures", "subfield": "surgery" } ], "title": "Spatial distribution of the time between diagnosis and treatment of breast cancer among women in Brazil", "title_text": "Spatial distribution of the time between diagnosis and treatment of breast cancer among women in Brazil", "type": "peer-reviewed", "updated_at": "2026-11-01T12:23:15Z", "url": "https://research.draconitic.com/paper/c7s3rgfz6qk60", "venue": "PLOS One", "versions": [] }