Barriers to breast cancer treatment in Brazil: A study on migration and regional disparities

Background: Breast cancer (BC) is one of the most prevalent cancers globally, with 2.3 million new cases annually in 2023. In Brazil, it is estimated that there are 74,000 new cases per year, representing 20.3 % of cancers in women in the country. Limited access to adequate treatment forces patients...

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Main Authors: Marcelo Antonini, Gabriela Moreira Santos, André Mattar, Marina Diogenes Teixeira, Andressa Gonçalves Amorim, Marina Fleury de Figueiredo, Marcellus do Nascimento Moreira Ramos, Francisco Pimentel Cavalcante, Eduardo Camargo Millen, Antonio Luis Frasson, Felipe Zerwes, Odair Ferraro, Fabricio Palermo Brenelli, Juliana Francisco, Luiz Henrique Gebrim
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Public Health in Practice
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666535225000333
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author Marcelo Antonini
Gabriela Moreira Santos
André Mattar
Marina Diogenes Teixeira
Andressa Gonçalves Amorim
Marina Fleury de Figueiredo
Marcellus do Nascimento Moreira Ramos
Francisco Pimentel Cavalcante
Eduardo Camargo Millen
Antonio Luis Frasson
Felipe Zerwes
Odair Ferraro
Fabricio Palermo Brenelli
Juliana Francisco
Luiz Henrique Gebrim
author_facet Marcelo Antonini
Gabriela Moreira Santos
André Mattar
Marina Diogenes Teixeira
Andressa Gonçalves Amorim
Marina Fleury de Figueiredo
Marcellus do Nascimento Moreira Ramos
Francisco Pimentel Cavalcante
Eduardo Camargo Millen
Antonio Luis Frasson
Felipe Zerwes
Odair Ferraro
Fabricio Palermo Brenelli
Juliana Francisco
Luiz Henrique Gebrim
author_sort Marcelo Antonini
collection DOAJ
description Background: Breast cancer (BC) is one of the most prevalent cancers globally, with 2.3 million new cases annually in 2023. In Brazil, it is estimated that there are 74,000 new cases per year, representing 20.3 % of cancers in women in the country. Limited access to adequate treatment forces patients to seek care elsewhere, straining the healthcare system and delaying treatment initiation. This study aimed to determine the migration rate of BC patients in Brazil and specifically to analyze migration rate by stage and treatment modality, as well as its costs and possible reasons for delays. Study design: A cross-sectional observational ecological study was conducted using retrospective data on the prevalence of breast cancer in Brazil, including the number of diagnoses and treatments in each state. The study evaluated patient migration rate for treatment, with information obtained from the DATASUS - SISCAN/Cancer Information System database. The selected analysis period was from 2017 to 2022, during which all necessary variables were available. Results: Among the 275,140 cases analyzed, 98.18 % were women. The national migration rate was 2.12 %, ranging from 0.35 % in the Northeast to 9.31 % in the Midwest. Stage IV had the highest migration rate (1.74 %), and migration rate for radiotherapy was significant in some states, reaching 100 % in specific cases. Conclusion: The migration rate of BC patients for treatment in Brazil shows significant regional variations, with higher rates in the Midwest and lower rates in the South. Some states exhibited a 100 % migration rate for access to radiotherapy. Stage IV patients are the most prone to migrate, and the search for radiotherapy can lead patients to move to other states. These results highlight the need for specific health policies to ensure access to treatment across the country.
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spelling doaj-art-2d91fcd8ba104f6992e76c4a176af6882025-08-20T02:34:44ZengElsevierPublic Health in Practice2666-53522025-06-01910061410.1016/j.puhip.2025.100614Barriers to breast cancer treatment in Brazil: A study on migration and regional disparitiesMarcelo Antonini0Gabriela Moreira Santos1André Mattar2Marina Diogenes Teixeira3Andressa Gonçalves Amorim4Marina Fleury de Figueiredo5Marcellus do Nascimento Moreira Ramos6Francisco Pimentel Cavalcante7Eduardo Camargo Millen8Antonio Luis Frasson9Felipe Zerwes10Odair Ferraro11Fabricio Palermo Brenelli12Juliana Francisco13Luiz Henrique Gebrim14Mastology Departament of Hospital do Servidor Público Estadual (HSPE-FMO), São Paulo, Brazil; BBREAST - Brazilian Breast Association Team, São Paulo, Brazil; Corresponding author. Mastology Department of Hospital do Servidor Público Estadual, Rua Cayowaa, 1575, São Paulo, 01258-011, Brazil.Mastology Departament of Hospital do Servidor Público Estadual (HSPE-FMO), São Paulo, BrazilMastology Departament of Women's Health Hospital, São Paulo, Brazil; BBREAST - Brazilian Breast Association Team, São Paulo, BrazilMastology Departament of Women's Health Hospital, São Paulo, BrazilMastology Departament of Women's Health Hospital, São Paulo, BrazilMastology Departament of Hospital do Servidor Público Estadual (HSPE-FMO), São Paulo, BrazilMastology Departament of Women's Health Hospital, São Paulo, BrazilMastology Departament of Hospital Geral de Fortaleza (HGF), Fortaleza, Brazil; BBREAST - Brazilian Breast Association Team, São Paulo, BrazilBreast Surgeon at Americas Oncologia, Rio de Janeiro, Brazil; BBREAST - Brazilian Breast Association Team, São Paulo, BrazilBreast Surgeon at Hospital Israelita Albert Einstein, São Paulo, Brazil; BBREAST - Brazilian Breast Association Team, São Paulo, BrazilMastology Departament of Medical School of PUC-RS, Porto Alegre, BrazilMastology Departament of Hospital do Servidor Público Estadual (HSPE-FMO), São Paulo, BrazilMastology Departament Universidade Estadual de Campinas, Campinas, BrazilBreast Surgeon at Prevent Senior, Sao Paulo, BrazilMastology Departament Beneficência Portuguesa de São Paulo, São Paulo, BrazilBackground: Breast cancer (BC) is one of the most prevalent cancers globally, with 2.3 million new cases annually in 2023. In Brazil, it is estimated that there are 74,000 new cases per year, representing 20.3 % of cancers in women in the country. Limited access to adequate treatment forces patients to seek care elsewhere, straining the healthcare system and delaying treatment initiation. This study aimed to determine the migration rate of BC patients in Brazil and specifically to analyze migration rate by stage and treatment modality, as well as its costs and possible reasons for delays. Study design: A cross-sectional observational ecological study was conducted using retrospective data on the prevalence of breast cancer in Brazil, including the number of diagnoses and treatments in each state. The study evaluated patient migration rate for treatment, with information obtained from the DATASUS - SISCAN/Cancer Information System database. The selected analysis period was from 2017 to 2022, during which all necessary variables were available. Results: Among the 275,140 cases analyzed, 98.18 % were women. The national migration rate was 2.12 %, ranging from 0.35 % in the Northeast to 9.31 % in the Midwest. Stage IV had the highest migration rate (1.74 %), and migration rate for radiotherapy was significant in some states, reaching 100 % in specific cases. Conclusion: The migration rate of BC patients for treatment in Brazil shows significant regional variations, with higher rates in the Midwest and lower rates in the South. Some states exhibited a 100 % migration rate for access to radiotherapy. Stage IV patients are the most prone to migrate, and the search for radiotherapy can lead patients to move to other states. These results highlight the need for specific health policies to ensure access to treatment across the country.http://www.sciencedirect.com/science/article/pii/S2666535225000333Breast cancerPatient migrationHealth disparitiesRadiotherapy accessCancer stagingHealthcare system
spellingShingle Marcelo Antonini
Gabriela Moreira Santos
André Mattar
Marina Diogenes Teixeira
Andressa Gonçalves Amorim
Marina Fleury de Figueiredo
Marcellus do Nascimento Moreira Ramos
Francisco Pimentel Cavalcante
Eduardo Camargo Millen
Antonio Luis Frasson
Felipe Zerwes
Odair Ferraro
Fabricio Palermo Brenelli
Juliana Francisco
Luiz Henrique Gebrim
Barriers to breast cancer treatment in Brazil: A study on migration and regional disparities
Public Health in Practice
Breast cancer
Patient migration
Health disparities
Radiotherapy access
Cancer staging
Healthcare system
title Barriers to breast cancer treatment in Brazil: A study on migration and regional disparities
title_full Barriers to breast cancer treatment in Brazil: A study on migration and regional disparities
title_fullStr Barriers to breast cancer treatment in Brazil: A study on migration and regional disparities
title_full_unstemmed Barriers to breast cancer treatment in Brazil: A study on migration and regional disparities
title_short Barriers to breast cancer treatment in Brazil: A study on migration and regional disparities
title_sort barriers to breast cancer treatment in brazil a study on migration and regional disparities
topic Breast cancer
Patient migration
Health disparities
Radiotherapy access
Cancer staging
Healthcare system
url http://www.sciencedirect.com/science/article/pii/S2666535225000333
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