Childhood cancer and pediatric oncologic care in Brazil: access and equity

Marilia Fornaciari Grabois,Evangelina X G De Oliveira,Marilia Sá Carvalho

doi:10.1590/s0102-311x2011000900005

Marilia Fornaciari Grabois, Evangelina X G De Oliveira + Show 1 more

Open Access

https://doi.org/10.1590/s0102-311x2011000900005

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Abstract

Cancer in children and adolescents is rare and highly curable if treatment is started early, yet it is still the main cause of death from disease in this age group. The aim of this study is to discuss access to health services for cancer patients under 19 years of age in Brazil, mapping deaths and treatment modalities in the Brazilian Unified National Health System (SUS). Data from 2000 to 2007 were analyzed according to health regions. Maps of cancer mortality rates and cancer care indicators - hospitalizations, chemotherapy, and radiotherapy financed by the national health system - revealed inequality in access, based on the small number of procedures for children in poorer regions of the country. Even with the usual concentration of specialized services in more heavily populated areas, access begins with clinical suspicion in primary care, followed by referral to more complex levels, where the diagnosis is made and treatment begins. Training pediatricians in clinical suspicion of childhood cancer and definition of more streamlined patient flows could improve the situation, thereby increasing the odds of cure.

Highlights

Cancer in children and adolescents is rare and highly curable if treatment is started early, yet it is still the main cause of death from disease in this age group
Maps of cancer mortality rates and cancer care indicators – hospitalizations, chemotherapy, and radiotherapy financed by the national health system – revealed inequality in access, based on the small number of procedures for children in poorer regions of the country
The current study aims to describe the geographic variations, mapping pediatric cancer deaths, hospitalizations, and treatment modalities under the Brazilian Unified National Health System (SUS) in order to orient potential planning measures

Summary

Introduction

Cancer in children and adolescents is rare and highly curable if treatment is started early, yet it is still the main cause of death from disease in this age group. The aim of this study is to discuss access to health services for cancer patients under 19 years of age in Brazil, mapping deaths and treatment modalities in the Brazilian Unified National Health System (SUS). Maps of cancer mortality rates and cancer care indicators – hospitalizations, chemotherapy, and radiotherapy financed by the national health system – revealed inequality in access, based on the small number of procedures for children in poorer regions of the country. Even with the usual concentration of specialized services in more heavily populated areas, access begins with clinical suspicion in primary care, followed by referral to more complex levels, where the diagnosis is made and treatment begins. Training pediatricians in clinical suspicion of childhood cancer and definition of more streamlined patient flows could improve the situation, thereby increasing the odds of cure

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