[Correspondence] National Lung Cancer Screening Programme in Brazil: An Urgent Need

Why It Matters

The policy gap drives preventable deaths and escalates public‑health spending, urging swift adoption of evidence‑based screening to improve outcomes and equity.

Key Takeaways

• 44k new lung cancer cases in Brazil 2022
• No national low‑dose CT screening program exists
• Bill 2.550/2024 proposes SUS‑based screening
• Early‑stage detection cuts treatment costs dramatically
• Private insurers currently provide most screening access

Pulse Analysis

Lung cancer remains the leading cause of cancer death worldwide, and Brazil mirrors that trend with over 44,000 new diagnoses and nearly 38,000 fatalities recorded in 2022. The disease’s aggressive nature translates into low five‑year survival rates and substantial strain on the Sistema Único de Saúde (SUS), where advanced‑stage treatment consumes disproportionate resources. International trials such as the National Lung Screening Trial have demonstrated that low‑dose computed tomography (LDCT) can detect tumors at a curable stage, cutting mortality by up to 20 percent. Yet Brazil’s public health agenda has yet to institutionalize this proven technology.

Several high‑income nations have already integrated LDCT into routine cancer prevention, leveraging centralized registries and reimbursement mechanisms to ensure equitable access. In Brazil, the National Cancer Institute’s cautious stance—citing potential overdiagnosis—has stalled progress, leaving screening to private insurers and fragmented regional initiatives. The recent introduction of Bill 2.550/2024 marks a legislative push to create a SUS‑funded screening network, but without clear clinical guidelines or allocated funding, the proposal risks remaining symbolic. Aligning the National Policy for Cancer Prevention with concrete operational protocols is essential to move from rhetoric to implementation.

Economically, early detection offers a compelling return on investment: treating stage I disease costs a fraction of the expenses associated with metastatic therapy, and patients retain productivity and quality of life. Pilot projects in southern Brazil have already shown high early‑stage detection rates, suggesting scalability across diverse regions. A phased rollout—starting with high‑risk cohorts, integrating smoking‑cessation programs, and establishing certified imaging centers—could mitigate initial costs while generating data to refine eligibility criteria. Prompt passage of the congressional bill, coupled with dedicated budget lines, would transform scientific consensus into a public health safeguard, potentially saving thousands of lives each year.