PATTERNS OF WORK-RELATED CANCER IN BRAZIL: A 19-YEAR ANALYSIS WITH EMPHASIS ON HEALTHCARE WORKERS

Abstract

Background: Work-related cancer (WRC) is underdiagnosed and underreported due to the difficulty of establishing a causal relationship between occupational exposure and disease. Healthcare professionals exposed to antineoplastic agents, particularly nurses and pharmacists, represent a high-risk group that remains insufficiently investigated in epidemiological surveillance. Methods: An observational, retrospective, longitudinal, ecological epidemiological study was conducted using secondary data from the Notifiable Diseases Information System (SINAN/DATASUS), covering WRC notifications in Brazil from 2007 to 2025. The temporal, geographical, demographic and occupational distributions were analyzed, with particular emphasis on healthcare professionals exposed to antineoplastic agents. The variables were described using absolute and relative frequencies. Results: A total of 8,413 WRC notifications were identified during the study period. Skin, breast and lung cancers were the main diagnoses; agricultural workers accounted for the highest absolute number of cases. Men aged 50–79 years predominated, with the highest concentration of cases in the South and Southeast regions. Among healthcare professionals, nursing notifications increased gradually after 2018; however, only 30 cases were attributed to exposure to antineoplastic agents, including nine among nurses and none among pharmacists. These findings reveal a discrepancy between the low number of notifications and the evidence identifying these professionals as a high-risk group, suggesting underreporting and weaknesses in surveillance. Conclusions: Strengthening WRC surveillance requires improved training for reporting professionals, more thorough occupational investigations and more comprehensive records in SINAN, thereby supporting policies aimed at preventing occupational cancer and protecting the health of workers exposed to carcinogens, particularly in oncology and the agricultural sector.