Realizing the right to health in Brazil’s Unified Health System through the lens of breast and cervical cancer

Brazil has made significant progress in reducing inequality, the most commonly used inequality measure – the Gini coefficient (the closer to 1, the more unequal) – declined from 0.60 in 1990 to 0.51 in 2014 [35], but regional inequalities remain. For instance, moderate poverty was 15.1% and 17.6% in the north and northeast regions, while the same number for the south and southeast regions was 3.3% and 4.4%, respectively [36]

Biehl et al. [37] challenge this research based on their analysis of 1262 lawsuits from Rio Grande do Sul and find that most patient-litigants are poor and older individuals. They conclude that there are regional differences that should not be fit into one singular narrative.

Existing cancer registries in Brazil record data from specific capital cities, which is then used to estimate incidence and mortality rates across a larger sample of the population. However, this evidence presents a narrow perspective of select population-based cancer registries within a small segment of the population living in areas of Brazil with higher economic status. This data is not nationally representative and therefore problematic for cross-country comparisons. The authors explored using the data. However, the quality of the data was poor. There were large discrepancies among the capitals in terms of reporting information. Some of the registries had not been fed for years. Furthermore, for the registries with more recent data, data management was sometimes outsourced to third parties and without standardized guidelines for managing the data this led to inconsistencies in data reporting. For all these reasons, the authors decided to not use the data in this study.

MOH Ordinance on cancer treatment waiting time guarantee (Portaria No 876 de 16/5/2014).