Rede de Atenção Oncológica: uma análise na Região de Saúde – Manaus, Entorno e Alto Rio Negro

Abstract

The redefinition of the Chronic Disease Care Network (RASPDC) within SUS established guidelines for organizing the Oncology Care Network (RAO) within RASPDC and strengthened rights primarily based on the principle of comprehensive health care. The present study aimed to analyze the composition of RAO in the state of Amazonas, focusing on the Manaus Region, Surrounding Area, and Alto Rio Negro, in light of the guidelines of the National Policy for Cancer Prevention and Control (PNPCC), in order to identify its strengths and/or weaknesses at the three levels of care. This is a qualitative and quantitative research with a descriptive documentary analysis approach, carried out through the study of governmental documents, resolutions from the Bipartite Inter-Management Commission (CIB/AM), state health plans, health information websites in SUS – DATASUS, articles, books, dissertations, and theses for theoretical foundation. The results highlighted, over the course of 10 years, the strengths and weaknesses in the construction of RAO in Amazonas: at the primary care level, there is a need to strengthen organized screening actions and active search for women in the prevention of cervical cancer, replacing the opportunistic model and intensifying campaigns and ongoing education for achieving HPV vaccination coverage. Regarding secondary care, it is evident that there is a need to fill gaps in the support systems, especially diagnostic and therapeutic outpatient support, through the establishment of more Reference Services for Diagnosis and Treatment of Precursor Lesions of Cervical Cancer (SRCs) and Reference Services for Breast Cancer Diagnosis (SDMs) in strategic municipalities of Amazonas. There is also a need to improve cytopathological exams and increase the availability of biopsies and conizations by decentralizing oncological care from the capital. In the logistical systems, the absence of a unified information system for patients throughout their journey in RAO is described, as well as a lack of integration between SUS information systems. In high complexity care, there is a need for more High Complexity Oncology Units (UNACONS) in the state. Strengths were revealed in the efforts to implement actions and strategies to address cancer, such as the following projects: Home Care Service (SAD), integrating as support to the Pain Therapy and Palliative Care Service of FCECON; “See and Treat” project, “CEPCOLO.” It is concluded that the development of RAO in Amazonas is still under construction, with the need to organize the prevention model structure actively, ensure the offer of services, especially diagnostics and specialist physicians in secondary care, with the integration of information and communication throughout the patient's journey and referral back, as prevention and early diagnosis reduce cancer cases and mortality from this health issue