Female cancer patterns and treatment disparities in southeastern Pará, Brazilian Amazon.

Abstract

e13115 Background: Cancer disparities disproportionately affect women living in socio-environmentally vulnerable regions of the Brazilian Amazon. In southeastern Pará, a region characterized by intensive mining activity, social inequality, environmental exposure and limited access to specialized healthcare, these factors may influence cancer epidemiology and treatment patterns among women. Methods: This observational, descriptive study analyzed medical records of women diagnosed with cancer and treated at a public oncology referral center in southeastern Pará between 2024 and 2025. Data collected included age at diagnosis (stratified into five age groups), tumor type, and chemotherapy regimens. Analyses were performed descriptively using RStudio. Results: A total of 238 women received oncologic treatment during the study period. Mean age at diagnosis was 53.4 years for breast cancer, 46.7 years for cervical cancer, 49.6 years for ovarian cancer, and 64 years for uterine cancer. Age distribution varied by tumor type: in breast cancer, the highest proportion of patients were aged 50–59 years (32%, n = 68), although 40% were younger than 50 years. Cervical cancer predominated among women aged 41–59 years (54%, n = 8), ovarian cancer showed a higher proportion of patients younger than 40 years (33%, n = 3), and all uterine cancer cases occurred in women aged 60–69 years (100%, n = 2). Breast cancer was the most frequent malignancy (89.1%, n = 212), followed by cervical (6.3%, n = 15), ovarian (3.8%, n = 9), and uterine cancer (0.8%, n = 2). Breast cancer treatment predominantly consisted of anthracycline- and taxane-based chemotherapy, particularly doxorubicin plus cyclophosphamide followed by paclitaxel (AC→T), with carboplatin incorporated in the neoadjuvant setting for patients with triple-negative disease. In gynecologic cancers, treatment was more uniform, with predominance of platinum–taxane combinations, mainly paclitaxel plus carboplatin. Conclusions: Women treated in this mining-impacted region of the Brazilian Amazon exhibited a high burden of breast cancer, a broad age distribution, and a substantial proportion of younger patients. Oncologic care relied predominantly on conventional cytotoxic chemotherapy, with no access to targeted therapies or immunotherapy, including trastuzumab, during the study period. Notably, genetic testing for younger patients was not available, limiting genetic counseling and the identification of hereditary cancer risk. These findings highlight persistent regional disparities and underscore the need for cancer care policies and strategies aimed at expanding equitable access to modern cancer therapies and diagnostic resources in the Amazon region.