Atendimento aos cânceres raros: uma análise do atendimento hospitalar ao melanoma de pele no Brasil

Abstract

Skin melanoma is a rare neoplasm that stands out due to its high lethality resulting from its metastatic potential. The present study aimed to analyze the hospital care provided to skin melanoma cases in Brazil between 2014 and 2023, from the perspective of the epidemiological profile, patient flows, and inequalities in access to high-complexity oncology care. To this end, a retrospective cross-sectional study was conducted based on secondary data from the Hospital Cancer Registry Integrator (RHC), whose clinical and sociodemographic variables were subjected to descriptive analysis and association tests in the R software. The study totaled 34,331 records during the period, with the most documented histological type being malignant melanoma, NOS (Not Otherwise Specified), accounting for 76.17% of the cases. Regarding the sociodemographic profile, a slight difference between sexes was identified (50.2% women and 49.8% men), with a predominance of the 61-to-80 age group (41.13%) and a prevalence of self-reported white individuals (44.91%), while also observing poor data completeness in the race/color variable (33.05% without information). Regarding regionality, the Southeast region held the highest concentration of records, with 16,391 entries. Increased interstate patient flows suggested vulnerabilities in the North and Midwest regions. It is concluded that the national scenario reflects asymmetries and a centralization of high-complexity care in centers of excellence. Given this, the need for public policies focused on a strategic decentralization of services and the continuous improvement of health registries is highlighted to ensure equity, a core principle of the SUS (Sistema Único de Saúde), in care for rare cancers.