Recent Challenges and Achievements in Cancer Care in Latin American Societies

Abstract

Cancer is a public health problem in Argentina, influenced by poverty and educational levels, and is the main cause of mortality between 45 and 64 years in the country. Breast, prostate, colorectal, and lung are the most relevant cancers in the country while cervical cancer has high incidence in the poorest provinces, usually in the north part of Argentina. Pediatric cancers are fully covered by a National Pediatric Cancer registry (ROHA). The National Cancer Institute of Argentina was created in 2010, and it is the governmental body responsible for the development and implementation of health policies in cancer and the coordination of integrated prevention and cancer control actions. HPV vaccination is mandatory since 2011 through the National Immunization Program (NIP). Argentina’s health system is financed by three sectors: public health, social security, and private insurance. A fourth subsystem, known as the National Institute of Social Security and Retirement Fund (INSSJP-PAMI), specifically covers individuals aged 65 and older, younger people with disabilities and war veterans. The system is fragmented, and many persons have double or even triple affiliations. In 2007, the total health expenditures in Argentina were estimated at 10 % of GDP, which represented a per capita expenditure of approximately US$663. The specific costs for cancer care are unknown.

With respect to the Latin American region, the economies of the region are growing rapidly and the standard of living is increasing. Such growth is accompanied by increases in sedentary lifestyles, unhealthy dietary habits, smoking, alcohol consumption, environmental carcinogenic pollutants, sun exposure, urbanization, and population aging.

Although the overall incidence of cancer is lower in Latin America (age-standardized rate of 163 per 100,000) than in Europe (264 per 100,000) or the USA (300 per 100,000), the mortality burden is greater. This is mainly due to presentation at more advanced stages, and partly related to poorer access to cancer care. The public and the civil society are more conscious about the cancer problem and, with current human and economic development less cancer incidence (mainly of late stages) and better curability and survival in coming years are expected.