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Choosing Wisely for oncology in Brazil: 10 recommendations to deliver evidence-based cancer care

Nature Medicine volume 28, pages 1738–1739 (2022)Cite this article

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To the Editor — Brazil is the largest country in South America and has a high incidence of cancer. There were an estimated 625,000 new cancer cases in 2020, representing a 17% increase compared to 2012, when there were approximately 518,000 cases1. The rise in cancer cases is increasing the pressure on the public health system, on which around 80% of Brazilians rely. There is therefore a strong need to support evidence- and value-based cancer management, capacity building for services and an investment in the development of a robust cancer workforce.

The Choosing Wisely (CW) Brazil oncology task force is a planned initiative based on the success of previous CW oncology exercises in other regions, which each aimed to identify low-value, unnecessary or harmful cancer services that are frequently used2,3,4,5. CW is a medical-specialty-driven initiative to stimulate dialogue between physicians, patients, advocates and policymakers about ways to promote high-quality and affordable cancer care while avoiding the use of unnecessary tests, procedures and treatments. However, initiatives such as CW oncology are frequently lacking in the Latin America context. The current initiative is a regional CW movement toward promoting evidence- and value-based practices in oncology that will translate into more sustainable and efficient health care6,7.

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Acknowledgements

This work was support by Clinical Teachers’ Association of Queen’s University (CTAQ Queen’s University) research grant.

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Authors and Affiliations

  1. Department of Oncology, Queen’s University, Kingston, ON, Canada

    Fabio Ynoe de Moraes & Christopher Booth

  2. Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil

    Fabio Ynoe de Moraes & Gustavo Nader Marta

  3. Department of Radiation Oncology, Hospital Sírio-Libanês, São Paulo/Brasília, Brazil

    Gustavo Nader Marta & Rafael Gadia

  4. University of Toronto, Toronto, ON, Canada

    Gunita Mitera

  5. Palliative Care Program, Hospital Sírio-Libanês, Sao Paulo, Brazil

    Daniel Neves Forte

  6. Medical Emergencies ICU, Hospital das Clínicas, Sao Paulo University, São Paulo, Brazil

    Daniel Neves Forte

  7. Vice President (2021–2023), Brazilian Society of Surgical Oncology, Rio de Janeiro, Brazil

    Rodrigo Nascimento Pinheiro

  8. Surgical Oncology Residency at Hospital de Base, Distrito Federal, Brazil

    Rodrigo Nascimento Pinheiro

  9. Clínica AMO, Salvador, Brazil

    Nivaldo F. Vieira

  10. Hospital Moinhos de Vento Porto Alegre, Porto Alegre, Brazil

    Maira Caleffi

  11. Instituto da Mama do Rio Grande do Sul (IMAMA), Porto Alegre, Brazil

    Patricia Chiappin Kauer

  12. Instituto Oncoguia, São Paulo, Brazil

    Luciana Holtz de Camargo Barros

  13. Oncoclinicas Bahia, Salvador, Brazil

    Clarissa Mathias

  14. Rede D’OR São Luiz Group/Radiotherapy ICESP, Sao Paulo University, São Paulo, Brazil

    Karina Gondim Moutinho da Conceicao Vasconcelos

  15. Division of Cancer Care and Epidemiology, Cancer Research Institute at Queen’s University, Kingston, ON, Canada

    Christopher Booth

  16. Diagnostic America (DASA), São Paulo, Brazil

    Gustavo dos Santos Fernandes

Authors
  1. Fabio Ynoe de Moraes
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Contributions

All authors contributed to the conception, design, data acquisition, data analysis and interpretation, drafting, or critical revision of the article in regard to important intellectual content. All authors had final approval of the version to be published.

Corresponding author

Correspondence to Fabio Ynoe de Moraes.

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Competing interests

F.Y.M. has received honoraria from AstraZeneca and International Association for the Study of Lung Cancer and consulting fees from Cancer em Foco, outside the submitted work. All other authors declare no competing interests. F.Y.M. has grants or contracts from the Clinical Teachers’ Association of Queen’s University.

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de Moraes, F.Y., Marta, G.N., Mitera, G. et al. Choosing Wisely for oncology in Brazil: 10 recommendations to deliver evidence-based cancer care. Nat Med 28, 1738–1739 (2022). https://doi.org/10.1038/s41591-022-01924-x

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