COMPREHENSIVE CARE FOR ONCOLOGICAL PATIENTS IN THE SUS: INSTITUTIONAL ADVANCES OF ORDINANCE 6,590/2025 IN THE NEW NATIONAL POLICY FOR CANCER PREVENTION AND CONTROL

Abstract

Cancer is one of the leading causes of morbidity and mortality in Brazil, posing complex challenges to the Unified Health System (SUS) and highlighting persistent inequalities in access to early diagnosis and timely treatment. In response to this reality, Ordinance GM/MS No. 6,590 was published in February 2025, regulating the new National Policy for Cancer Prevention and Control (PNPCC), establishing innovative guidelines to restructure oncological care in the country. Thus, this study aims to carry out a comprehensive analysis of the institutional advances and strategic proposals introduced by the regulation of the PNPCC within SUS, with an emphasis on normative changes, the organization of care networks, and the structuring of assistance and regulatory flows provided for in the new policy. The general objective is to critically and exploratorily examine the main components and guidelines of the PNPCC and Ordinance GM/MS No. 6,590/2025, identifying potentialities, assumptions, and challenges for their implementation in different regional contexts and levels of care. Among the specific objectives are mapping and describing the strategic axes of the policy, discussing the normative instruments guiding the reorganization of oncological services, and analyzing future perspectives for the operationalization, monitoring, and evaluation of its effects on comprehensive cancer care. The research question guiding this work is: what conceptual, normative, and organizational advances does the new National Policy for Cancer Prevention and Control and its regulation introduce within SUS, and what challenges can be anticipated for the implementation of a model of comprehensive, continuous, and equitable oncological care in Brazil? To this end, we relied centrally on Ordinance GM/MS No. 6,590 and the new National Policy for Cancer Prevention and Control (PNPCC), as well as the works of the American Cancer Society (2008, 2009, 2011, 2012), American Institute for Cancer Research (2007), Bozzone (2007), Carolyn Compton (2020), DeVita, Lawrence and Rosenberg (2021), Donna M. Bozzone (2007), Fregnani (2023), Krieger (2011, 2021), Marmot (2003), Mukherjee (2010, 2016), Pereira (2017), Robert C. Jackson (2023), Schottenfeld and Fraumeni (2006), Scientific American (2004), Sloan and Gelband (2006), Stewart and Wild (2003, 2014), Varmus (2010), World Health Organization (2006), among others. This research is qualitative in nature (Minayo, 2007), bibliographic and descriptive (Gil, 2007), with a comprehensive analytical approach (Weber, 1949). The findings of this study show that the new National Policy for Cancer Prevention and Control and its regulation introduce significant normative advances, such as the clear definition of care deadlines, quality parameters, and transparent monitoring mechanisms. Furthermore, the policy reaffirms the centrality of comprehensive and continuous care, integrating prevention, diagnosis, treatment, and rehabilitation in regionalized networks. However, structural challenges persist, especially related to sustainable financing, inequalities in management capacities, and the need for effective federal agreements. Therefore, successful implementation will depend on collective commitment to transform legal guidelines into concrete practices that promote equity and dignity in cancer care.