{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T15:06:38Z","timestamp":1790089598307,"version":"4.0.1"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Management of sarcoma in expert centers (SECs) improves outcomes, and patient advocacy groups provide information, support, and representation of patients\u2019 needs; however, access to both remains uneven. We aimed to identify factors associated with patient referral and advocacy group awareness in Spain and Portugal, 2 universal healthcare systems with distinct sarcoma pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Between April and December 2023, we conducted a survey-based study of adults with sarcoma under active treatment or follow-up across 9 Spanish hospitals (5 SECs) and one Portuguese hospital. Sociodemographic and clinical data, referral patterns, and advocacy group awareness\/contact were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 415 patients were included (Spain, n\u2009=\u2009365; Portugal, n\u2009=\u200950). In Spain, lower income (odds ratio [OR] 2.38; 95% CI, 1.16-5.03) was associated with longer diagnostic delays. Rural residence (OR 3.48; 1.79-7.04) and longer diagnostic delays (OR 2.41; 1.26-4.66) were associated with referral to other hospitals. Cancer advocacy group awareness was lower among patients with lower income (OR 0.38; 0.17-0.81) and higher with longer diagnostic delays (OR 2.08; 1.05-4.25). Sarcoma-specific advocacy group awareness was generally low (20%) but higher with university education (OR 4.27; 1.56-12.35). Few patients contacted cancer (14%) or sarcoma-specific groups (7%); contact was more frequent with longer diagnostic delays (OR 2.27; 1.11-4.63) or symptomatic presentation (OR 2.50; 1.04-5.97). Compared with the Portuguese cohort, Spanish patients were referred less frequently and had greater awareness of advocacy groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Socioeconomic disparities affect sarcoma diagnosis, referral, and advocacy group engagement, even within universal healthcare systems. Equity-oriented care requires timely SEC referral and advocacy group visibility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyag358","type":"journal-article","created":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T11:20:58Z","timestamp":1788693658000},"source":"Crossref","is-referenced-by-count":0,"title":["Socioeconomic disparities in sarcoma diagnosis, expert center access, and advocacy group awareness: a multicenter study in Southern Europe"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5107-2345","authenticated-orcid":false,"given":"Pau","family":"Mascar\u00f3-Baselga","sequence":"first","affiliation":[{"name":"Medical Oncology Department, Vall d\u2019Hebron University Hospital \u2013 Vall d\u2019Hebron Institute of Oncology (VHIO) , Barcelona, 08035,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6925-4605","authenticated-orcid":false,"given":"V\u00edctor","family":"Navarro","sequence":"additional","affiliation":[{"name":"Statistics Unit, Vall d\u2032Hebron Institute of Oncology (VHIO) , Barcelona, 08035,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3333-2370","authenticated-orcid":false,"given":"Ana","family":"Sebio","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Santa Creu i Sant Pau Hospital , Barcelona, 08025,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0935-8298","authenticated-orcid":false,"given":"Rosa","family":"\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Gregorio Mara\u00f1on University Hospital , Madrid, 28007,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5762-0645","authenticated-orcid":false,"given":"Sara","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Portuguese Institute of Oncology of Porto Francisco Gentil , Porto, 4200-072,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1964-0388","authenticated-orcid":false,"given":"Mar\u00eda \u00c1ngeles","family":"Sala-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Basurto University Hospital , Bilbao, 48013,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8961-9787","authenticated-orcid":false,"given":"Gloria","family":"Marquina","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Cl\u00ednico San Carlos University Hospital. Universidad Complutense de Madrid (UCM), Instituto de Investigaci\u00f3n Sanitaria (IdISSC), EURACAN Referral Center , Madrid, 28040,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0997-2573","authenticated-orcid":false,"given":"Javier","family":"Mart\u00ednez-Trufero","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Miguel Servet University Hospital , Zaragoza, 50009,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2493-0988","authenticated-orcid":false,"given":"Juana Mar\u00eda","family":"Cano","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Ciudad Real General University Hospital, Ciudad Real , 13005,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Redondo","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, La Paz 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