Cancer of the gastrointestinal tract has its importance in mortality profile of Brazil, being among the ten most incidents in the country. Early detection ensures better life quality for cancer patients, but often these arrive at treatment centers in advanced stage of the disease. The study investigates the difficulties of access to diagnosis and treatment for patients with gastrointestinal cancer treated by the Unified Health System. To this end, we performed a descriptive, in the form of a questionnaire survey observational database of patients undergoing treatment were collected in two public hospitals in Belém, in the period from March to June 2013.. Fulfilled the inclusion criteria 122 patients were grouped in different trajectories. In addition, were also obtained information registered in the records of these patients. The analysis of the data obtained showed that the diagnosis of the disease in 68.1% was held by the general practitioner; the greatest difficulty at that stage, was access to diagnostic tests, because spending generating the majority of patients (68.9%) did not carry out specialized examinations through the Unified Health System, but with its own resources. In the centers/units of references in Oncology, the difficulties reported by 56 patients begin with the appointment of medical consultation, schedule delay occurring by the institution for 94.6% of these patients. The lack of bed for hospitalization was cited as the biggest obstacle (54.4%) to start surgical therapy, particularly for gastric cancer and colon and rectum. The analysis of the trajectories followed by patients, since the beginning of the symptoms until the attendance in the references reveals that the diagnosis of the disease in 50% of patients occurred only 10 months after the start of symptoms, and the treatment began only after 90 days of diagnosis. The time that patients remain symptomatic without a diagnosis impacts negatively on the prognosis. In this research, the cases of gastric cancer and colon and rectum were diagnosed late (stage IV and IIIB) and therefore the treatment did not occur within desirable.
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