Sobrevivência ao câncer no Brasil: o nível de escolaridade não elimina as desigualdades raciais

Abstract

Introduction: Cancer is the leading cause of mortality in developed countries and is also expected to become the main cause in developing countries, such as Brazil. An increase in cancer cases and related inequalities is projected, particularly in contexts of greater social vulnerability. Objective: To identify social inequalities, including racial and sex intersections among cancer survivors in Brazil. Methods: This cross-sectional study used data from the 2019 Brazilian National Health Survey (PNS). A total of 80,386 individuals aged 25 years or older, of both sexes, were included. Participants were stratified by skin color, educational level, area of residence, and sex. Cancer diagnosis was self-reported. Simple and complex measures of educational inequality were applied, including the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII). Intersections were evaluated by combining race/skin color, place of residence, and sex. Results: The proportion of cancer survivors was 2.86%. Inequality measures showed a higher likelihood of cancer survivorship among individuals with higher education (SII: 0.27; 95% CI: 0.19–0.36; RII: 1.88; 95% CI: 1.50–2.26), regardless of race/color, sex, or place of residence. However, at the same education level, survivorship was higher among White individuals than among Black and Brown individuals (3.0% vs. 1.8%). Notably, survivorship among highly educated Black individuals was similar to that observed among less educated White individuals (1.8% vs. 1.7%). Similar patterns were observed for sex and place of residence, favoring women and urban residents. Conclusion: Cancer survivorship in Brazil reflects intersecting social inequalities, indicating that education alone is insufficient to overcome racial, gender, and geographic inequities.