US-LA CRN Partner: Brazil
Cancer Burden in Brazil
- Cancer is the third leading cause of death in Brazil following circulatory diseases and external causes.
- In 2008, the age-world-standardized incidence rate (ASR(W)) per 100,000 for cancer incidence in Brazil was 100.4, not including non-melanoma skin cancer. A total of 321,000 new cancer cases were diagnosed, not including non-melanoma skin cancer.
- Cancer mortality rates for Brazilian males are highest in lung, prostate, and stomach cancers.
- Cancer mortality rates for Brazilian females are highest in breast, cervical, and lung cancers.
Cancer Research Infrastructure in Brazil1
The Instituto Nacional de Câncer (INCA), administered under the Ministry of Health, leads nationwide cancer control efforts in Brazil and delivers cancer care within the Integrated Public Health System or Sistema Único de Saúde (SUS). In addition, the INCA coordinates public policies, develops research activities, and disseminates practices and knowledge on medical oncology. One of the most prominent research networks in Brazil is the Antonio Prudente Cancer Research Center in São Paulo, which consists of two additional institutions: the A.C. Cancer Hospital Camargo and the Ludwig Institute for Cancer Research. These institutions are supported by the São Paulo Research Foundation (FAPESP) and Center of Excellence for Production Innovation and Development (CEPID).
There are several other well-established research institutes in São Paulo State, including the University of São Paulo (USP), the Cancer Institute of the State of São Paulo (ICEPS), the Butantan Institute, a biomedical research center, the El Dorado Institute, a nonprofit research, development, and technology innovation organization, and the Cancer Hospital of Barretos, where approximately 760 new breast cancer cases are treated each year. The Cancer Hospital of Barretos has an important research unit that focuses on breast cancer.
The National Cancer Institute of Cancer (INCA) as well as the Oswaldo Cruz Foundation (Fiocruz) is located in Rio de Janeiro. Fiocruz is recognized as a federal scientific institution for research and development in the biomedical sciences and is considered to be one of the main public health research institutions in Brazil.
The Brazilian Ministry of Science and Technology (MCT) was created in 1985, signaling the increased importance of science and technology (S&T) in the federal government. The Finaciadora de Estudos e Projectos (FINEP) or Research and Projects Financing Agency and the National Council of Scientific and Technological Development (CNPq) were integrated into the new ministry.
FINEP provides grants to academic institutes or departments and to research centers to cover all needs for institutional maintenance or expansion. The CNPq provides fellowships for undergraduate research and graduate studies, as well as research grants for individuals or groups. The progress in the federal S&T system has been followed by similar initiatives among the Brazilian state governments.
Health Care in Brazil2
The Brazilian health system is composed of a large government-managed program called the Integrated Public Health System or Sistema Único de Saúde (SUS). Private health insurance is widely available in Brazil and may be purchased on an individual basis or obtained as an employee benefit. Large companies usually offer private health insurance benefits to their employees. As of March 2007, more than 37 million Brazilians had private health insurance. Public health care is still accessible for those who choose to obtain private health insurance.
The Family Health Program was introduced by the municipal health secretariats to improve primary care in Brazil. The program is based on collaborations among the health secretariats, states, and the Ministry of Public Health. The federal government supplies technical support and funding.
In 1999, there were 237,000 physicians and 77,000 nurses in Brazil. The national average ratio was 14 physicians per 10,000 population. In 1999, of the 665,000 professional positions, 65% were occupied by physicians, followed by nurses (11%), dentists (8%), pharmacists, biochemists (3.2%), physical therapists (2.8%), and by other professionals (10%). An estimated 1.4 million health sector jobs are occupied by technical and auxiliary personnel.
Health Sector Expenditure and Financing3
In 2007, the health expenditure in Brazil was 8.4% of GDP. Public spending accounted for 41.6 % and private expenditure accounted for 58.4% of health costs.
Luiz Antonio Santini Rodrigues da Silva, M.D.
Instituto Nacional de Câncer (INCA)
Praca Cruz Vermelha 23
Rio de Janiero, RJ
1 Pan American Health Organization Country Profiles (PAHO, 2010) and the Brazil Embassy in the United States.
2 International Agency for Research in Cancer (IARC-WHO, 2010); Inter American Development Bank Science & Technology Report in Latin America, (IDB, 2011).
3 World Health Statistics, World Health Organization (WHO, 2010).