The majority of oncologists in Brazil, a medical specialty that treats cancer patients, are white, work in the private network and work in the Southeast region of the country. The data comes from the Brazilian Clinical Oncology Census, prepared by Sboc (Brazilian Society of Clinical Oncology) in partnership with Datafolha.
The profile has a direct effect on the care of black, quilombola, indigenous and riverside populations, mainly in the North region, where the concentration of doctors in the specialty represents 3% of the total in the country. According to data from Pnad (National Household Sample Survey), in 2022, brown people represented 70.1% of the region’s population, while black people were 8.3%.
Professionals concentrated in the Southeast are 54%, while in the Northeast they total 18%, in the South they represent 17%, and in the Central-West they represent 9%.
Sboc associates from all regions participated in the survey. 761 online interviews were carried out from May 26 to July 31, 2023. The margin of error is plus or minus 4 percentage points, and the confidence index is 95%.
The work shows that 81% of oncologists in the country are white (compared to 16% mixed race, 2% yellow and 1% black) and 70% work exclusively or mostly in the private service. Only 4% work only in the SUS (Unified Health System), responsible for providing care to more than 80% of the Brazilian population.
According to Ana Amélia Viana, clinical oncologist at the Hospital das Clínicas of UFBA (Federal University of Bahia) and member of the Sboc Diversity Committee, introducing black doctors in the treatment of cancer patients increases the “excellence of care”, as “the patient [negro] begins to see himself as an equal in that relationship.”
In the 2022 Census, the IBGE (Brazilian Institute of Geography and Statistics) published for the first time surveys relating to the quilombola population in the country, whose concentration is highest in the Northeast region (68.2%) and in the Legal Amazon (32%). The lack of professionals in these spaces can affect care for populations whose care needs may be different.
This is because, when analyzing patient complaints, it is necessary to take into account the so-called “social determinants”.
“The concentration of doctors in these regions is multifactorial, because it depends on a structure for the doctor to work. But the census data [de oncologia] are very worrying and we need to do something to minimize this effect”, says Carlos Gil, president of the association.
For Abna Vieira, oncologist at Icesp (São Paulo Cancer Institute) and founding member of the Sboc Diversity Committee, the first step would be to subsidize the training and placement of doctors in places with the greatest need.
“The survey reveals for the first time this disparity in Brazil, which was already known in other countries, such as the United States, with approximately 15% of the black population and around 3% to 5% of black oncologists. The government [americano] launched an acceleration program for young people at the beginning of their careers, enabling this medical specialization, which is very time-consuming”, he says.
We know how these biases, of race, social class, education, also impact access to care in the country
Considering public and private services, 70% of specialized professionals who work in urban centers work in the private sector, a number that drops to 50% among those who are in the interior. In relation to the public network, a third of those who work mainly or exclusively in the SUS are in capitals or metropolitan areas.
Differences in care between sectors have direct effects on patient outcomes, since access to hospital centers, quality diagnostic tests and even therapies is unequal, according to experts.
“We know how these biases, of race, social class, education, also impact access to care in the country”, says Ana Amélia Viana, from UFBA.
Other barriers cited in the public service are underfunding or inefficient management (41%) and late diagnosis of cancer (42%), which, as already indicated in other studies, is one of the main reasons for the high mortality of some types of tumors. in the country.
“Within the SUS itself we have different realities, different access whether you are treated at Icesp or in a hospital in the interior of the state”, states the president of the entity.
The journalist traveled to Rio de Janeiro at the invitation of Sboc.