MORTALITY BY BLADDER CANCER IN BRAZIL: WHAT IS THE ROLE OF THE 60-DAY LAW?

Introduction: Bladder cancer is the most common neoplasm of the urinary tract and the 9th most incident in the world, being more diagnosed between the 6th and 7th decades of life. With heterogeneous characteristics, 70% of the patients presented superficial tumors, and 30% an invasive muscular disease associated with high risk of death due to distant metastasis. Aiming at greater therapeutic success, the 60-Day Law provides for the first treatment of a patient with proven malignant neoplasia and establishes a 60-day period for its initiation by the SUS counted from the day on which the diagnosis is established in a pathology report. Objective: To trace the epidemiological profile of the bladder cancer deaths nationwide between 2010 and 2017 in order to analyze the importance of the 60-day law. Method: It consists of a transversal, descriptive and retrospective study based on data from the National Cancer Institute (INCA), using the descriptor câncer de bexiga. The results were discussed through the analysis of articles in the Scielo and Pubmed databases. Results: The bladder cancer was responsible for 29,429 deaths, with the national mortality rate been 1.80 per 100,000. As for the regional distribution of cases, the Southeast presented the highest number of records (15,651 deaths), been followed by the South (6,176), Northeast (4,903), Midwest (1,787) and the North (912) regions. According to gender, men involved 20,293 deaths and a mortality rate of 2.94/100,000, while females had 9,133 records and a rate of 0.98/100,000. Finally, it was observed a predominance of deaths among the elderly, contemplating 25,568 notifications (87%). Conclusion: It is verified that the bladder cancer has higher rates in the southeast region, male gender and in the elderly population. Smoking is the main risk factor, in addition to other factors such as chronic infection with Schistosoma haematobium and occupational exposure to carcinogens. Given the substantial number of notifications, the 60-day law projects itself as a very important mechanism for early intervention. In this sense, it is estimated that its application guarantees a better prognosis in view of the possible reduction of the occurrence of metastasis and, consequently, drop in mortality rates. For such, improvements in the articulation of services at different levels of complexity are necessary to ensure that all patients have access to the forms of treatment they need in a timely manner.