Brazil's public health system lung cancer patients face shorter survival

Two Brazilian studies published in JCO Global Oncology reveal stark disparities for lung‑cancer patients treated in the public health system (SUS) versus private care. Access to the molecular test that identifies targetable genetic alterations is routine for 94 % of private‑sector oncologists but drops to less than 44 % in SUS, meaning many public patients never learn they could benefit from targeted oral therapies. Only one in five patients with a qualifying mutation receives care through SUS despite the system serving three‑quarters of the population.

Even when mutations are detected, SUS physicians report virtually no routine availability of modern kinase inhibitors. Crizotinib, incorporated into SUS in 2022, is cited as an option by just 1 in 10 public‑sector doctors, while the newer, preferred drug alectinib is reported available by 8 in 10 private‑sector physicians. Insufficient reimbursement forces public hospitals to rely on cheaper chemotherapy, prolonging time to effective treatment. The studies also show that diagnosis in SUS takes more than twice as long as in private care, contributing to poorer survival outcomes for public patients.

These findings underscore systemic gaps in genetic testing, drug access, and funding that lead to shorter survival for SUS lung‑cancer patients compared with those treated privately.