Access barriers and mistanásia in cancer care

limits to the effectiveness of the right to health

Abstract

Contextualization: Cancer has become one of the leading causes of death in Brazil, in a context of demographic and epidemiological transition marked by population aging and the predominance of chronic noncommunicable diseases. To face this challenge, the country established the National Policy for Cancer Prevention and Control (PNPCC) and approved legal provisions that set maximum time limits for diagnosis and initiation of oncological treatment within the Unified Health System (SUS). Problem: However, the literature shows that, despite a normative framework, structural, logistical, and organizational barriers persist, compromising timely access to treatment and contributing to care delays and worse clinical outcomes. Objectives: This study aimed to analyze how barriers to access diagnosis and oncological treatment within the SUS contribute to the occurrence of preventable deaths (mistanasia), undermining the effectiveness of the legal guarantees of the right to health in Brazil. Methods: This is a narrative literature review with an analytical approach, conducted in national and international databases starting in 2012. The findings were organized into three thematic axes: legal and organizational frameworks, access barriers and inequities, and the implications of ineffective access for the occurrence of mistanasia. Results: The results showed that the persistence of barriers in oncological care turns potentially preventable deaths into expressions of institutional negligence and social omission. Conclusions: It is concluded that addressing such barriers is an indispensable condition to prevent mistanasia and ensure the effectiveness of the fundamental right to health in the oncological context.