Lung cancer in Brazil: epidemiology and treatment challenges

Vanessa Karen de Sá,1,2 Juliano C Coelho,3 Vera Luiza Capelozzi,1 Sergio Jobim de Azevedo3 1Department of Pathology, Faculty of Medicine, University of São Paulo, 2Department of Genomics and Molecular Biology, International Research Center, A.C. Camargo Cancer Center, São Paulo, 3Department of Oncology, Clinical Research – UPCO, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil Abstract: Lung cancer persists throughout the world as a major cause of death. In 2014, data from the Brazilian National Cancer Institute (INCA) estimated 16.400 new cases of lung cancer among men (second most common) and 10.930 new cases among women (fourth most common). These data are consistent for all Brazilian regions and reflect the trends of cancer in the country over the last decade. Brazil is a continental country, the largest in Latin America and fifth in the world, with an estimated population of >200 million. Although the discrepancy in the national income between rich and poor has diminished in the last 2 decades, it is still huge. More than 75% of the Brazilian population do not have private health insurance and rely on the national health care system, where differences in standard of cancer care are evident. It is possible to point out differences from the recommendations of international guidelines in every step of the lung cancer care, from the diagnosis to the treatment of advanced disease. This review aims to describe and recognize these differences as a way to offer a real discussion for future modifications and action points toward delivery of better oncology care in our country. Keywords: NSCLC, screening, drivers mutations, diagnosis, Brazilian scenari