Cancer patients residing in northern region of Brazil face a challenging reality: they need to travel, on average, 442 kilometers to access radiotherapy through THEIR (Unified Health System.
In contrast, residents of the South region travel around 71 km for the same treatment. This difference, which is up to six times greater, was highlighted by an international multicenter study, published in February 2026 in scientific magazine International Journal of Radiation Oncology.
Wilson José de Almeida Jr., president of the Brazilian Society of Radiotherapy, states that the study is very important because it is national and published in a high-impact journal. “It shows that there is inequality in access to radiotherapy in Brazil.”
The doctor notes that, although the Brazilian radiotherapy park is the second largest in the Americas, second only to the United States, the comparison reveals the concentration of services in larger urban centers.
The research analyzed more than 840 thousand procedures performed between 2017 and 2022 across the country. The data reveals that 514,237 consultations required travel to another municipality, which means that more than six in ten patients needed to leave their own city to undergo radiotherapy.
The national average distance was 120 km, but numbers vary drastically between regions. In the Southeast, the average was 73.8 km, close to that in the South. In the Northeast, the distance practically doubles, reaching 161.8 km.
In the Central-West, it rises to 238.9 km, and in the North, it reaches 442.2 km. This disparity reflects the lower supply in a large territorial area with large gaps in care.
For radio-oncologist Fábio Ynoe Moraes, one of the specialists leading the research, the data shows that the patient’s address directly influences their chances of accessing treatment. “These numbers show that zip code is a determining factor for access to cancer care, imposing logistical barriers that directly impact treatment and, consequently, clinical outcomes.”
Moraes explains that radiotherapy generally requires daily sessions for several weeks, making prolonged travel a factor of physical, emotional and financial strain for the patient and their family.
Almeida Jr. highlights that prolonged displacement makes it difficult to start and continue treatment, increases financial costs and physical exhaustion, and can impact the therapeutic choice and survival of patients. He also mentions the estimated deficit of 300 radiotherapy devices and the obsolescence of 40% to 50% of existing accelerators, which have an average useful life of 15 years.
Patient profile and complexity of treatment
The study also outlined the epidemiological profile of the care. Among the more than 840 thousand procedures, 56% were performed on women and 44% on men. Women traveled, on average, 122.3 km, while men traveled 117.3 km.
Analysis by race and color showed that black, mixed-race, indigenous and yellow patients traveled, on average, 145.6 km, while white patients traveled 97.3 km. According to the researchers, part of this difference is related to the greater concentration of services in the most developed regions of the country, reinforcing the weight of the territory in determining access.
The research also evaluated the type of treatment. Most procedures were radiotherapy with curative intent (75.7% of cases), while palliative treatments corresponded to 14.6%.
Complex procedures, such as brachytherapy, stereotactic radiotherapy and whole-body irradiation, represented 9.2% of cases and required even greater average travel, of 165.8 km.
“This indicates that, in addition to the lack of units, there is a concentration of cutting-edge technologies in a few centers, which increases inequalities for patients who need more sophisticated therapies to increase their chances of disease control and survival,” says Moraes.
Almeida Jr. emphasizes that more complex procedures require greater travel, up to 166 km, and that women travel a little more than men, although this difference is small. The doctor highlights that, despite advances in the last 15 years, inequality persists.
The current challenge for the healthcare system is to overcome obsolescence and inequality, considering the forecast of a 50% increase in health care by 2045.
Scenario and solutions
The most treated types of cancer in the period were digestive system, bone metastases and gynecological tumorsfollowing the national epidemiological profile.
With Brazil expecting an increase of more than 50% in cancer cases in the coming decades, and around 60% of patients requiring radiotherapy.
Radiotherapy in Brazil is mostly carried out by the SUS, which faces an estimated deficit of hundreds of pieces of equipment. Regional inequalities indicate the need for more balanced infrastructure planning and public policies that shorten the distances between the patient and treatment.
Almeida Jr. explains that the sustainability of highly complex centers is pressured by reimbursement. He states that the cost of radiotherapy treatments in Brazil is the lowest in Latin America, which could lead to a “blackout of professionals” if there is not adequate remuneration.
