OBJECTIVES : Cervical cancer-related morbimortality and survival is marked by inequalities across different geographical areas. We investigated the association between macroregion of residence and survival in women diagnosed with cervical cancer who underwent cancer treatment in the public health system (SUS) between 2002 and 2015 in Minas Gerais, Brazil.

METHODS : Non-concurrent prospective study with data from the National Database in Oncology (Base Onco), developed through deterministic-probabilistic pairing of SUS information systems. We identified women aged over 18 years, diagnosed with cervical cancer between 2002 and 2010, who underwent radiotherapy and/or chemotherapy and who were living in Minas Gerais. We estimated five-year overall and cancer-specific survival probabilities by the Kaplan-Meier method. Extended Cox models were employed to assess the association between macroregion of residence and overall and cancer-specific death risk.

RESULTS : A total of 5,613 patients were included. Five-year overall and cancer-specific survival were 56.3% (95%CI: 55.0; 57.6) and 63.6% (95%CI: 62.3; 64.9), respectively. Among the 13 macroregions, five-years survival probabilities ranged from 46.5% to 64.2% for overall survival and from 52.0% to 72.0% for cancer-specific survival. In the multivariate analysis, the risk of global death was higher than the reference macroregion for seven macroregions. Nine macroregions had a higher risk of cancer-specific death. Adjustments by age and clinical variables (stage, comorbidities and treatment), in general, did not alter the main association investigated.

CONCLUSIONS : We identified regional inequalities in survival that persisted after adjustments. Our hypothesis is that these disparities should be related mainly to the heterogeneity in the quality of cancer care in Minas Gerais and, in addition, to sociodemographic and economic inequalities observed across the state. In this sense, the improvement of cancer care networks aiming to ensure timely access and appropriate treatment is crucial for lessening this scenario of disparities.