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Instituto Nacional de Salud Pública

2026, Number 1

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salud publica mex 2026; 68 (1)

Economic impact of timely diagnosis and early referral in comprehensive cancer care in Mexico: the DERIVA strategy

Arrieta Ó, Gómez-García AP, Espinosa-Bautista KA, Gay-Molina JG, Ortiz-Blas LA, Arce-Salinas CH, Martínez-Saíd H, Valle-Mesto H, Reynoso-Noverón N

Language: English
References: 56
Page: 13-21
PDF size: 300.16 Kb.


ABSTRACT

Objective. To estimate the savings of a strategy for early diagnosis and treatment of patients with suspected cancer. Materials and methods. A financial analysis of the savings was carried out using a timely diagnostic program DERIVA. Cancers with higher mortality in Mexico were evaluated under three scenarios of earlier stage diagnosis. Optimistic: stage III to II (8-40%) and IV to III (2.6-40%). Moderate: stage III to II (4-24%) and IV to III (1.3-24%). Conservative: stage III to II (1-7%) and IV to III (0.7-10%). Results. Care in stage II is projected to increase by 13.85% for breast cancer and 5.13% for colorectal cancer, while stage III care for lung cancer is expected to rise by 14.1%. The estimated average savings amount to 4 106 834.94 ± 6 467 043.35 USD. Conclusion. Early detection and treatment of certain types of cancer can lead to significant cost savings, contributing to the financial sustainability of the health system and to improved survival rates and quality of life for patients.


REFERENCES

  1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al.Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence andMortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-49. https://doi.org/10.3322/caac.21660

  2. Ferlay J, Ervik M, Lam F, Laversanne M, Colombet M, Mery L, et al.Global Cancer Observatory: Cancer Today. Lyon: International Agency forResearch on Cancer, 2024 [cited April 20, 2025]. Available from: https://gco.iarc.who.int/media/globocan/factsheets/populations/484-mexico-factsheet.pdf

  3. Instituto Nacional de Estadística y Geografía. Principales causas de Mortalidad.Mexico: Inegi, 2025 [cited April 6, 2025]. Available from: https://www.inegi.org.mx/sistemas/olap/registros/vitales/mortalidad/tabulados/ConsultaMortalidad.asp

  4. Instituto Nacional de Estadística y Geografía. Estadísticas de defuncionesregistradas 2023. Mexico: Inegi, 2024 [cited April 20, 2025]. Availablefrom: https://www.inegi.org.mx/contenidos/saladeprensa/boletines/2024/EDR/EDR2023_Dtivas.pdf

  5. Instituto Nacional de Estadística y Geografía. Enero a junio de 2024,preliminar. 2025. Estadísticas de defunciones registradas 2024. Mexico:Inegi, 2025 [cited April 20, 2025]. Available from: https://www.inegi.org.mx/contenidos/saladeprensa/boletines/2025/edr/edr2024_en-jun_RR.pdf

  6. Edwards A, Mcclean B, Meehan D, Murphy D, Poveda A. National CancerStrategy 2017-2026. Irland, 2017 [cited April 21, 2025]. Available from:https://assets.gov.ie/9315/6f1592a09583421baa87de3a7e9cb619.pdf

  7. Kim JH, Kim SS, Lee JH, Jung DH, Cheung DY, Chung WC, et al. EarlyDetection is Important to Reduce the Economic Burden of Gastric Cancer.J Gastric Cancer. 2018;18(1):82-9 [cited February 18, 2023]. Availablefrom: https://pubmed.ncbi.nlm.nih.gov/29629223/

  8. Mohar-Betancourt A, Reynoso-Noverón N, Armas-Texta D, Gutiérrez-Delgado C, Torres-Domínguez JA. Cancer trends in Mexico: essentialdata for the creation and follow-up of public policies. J Glob Oncol.2017;3(6):7408 [cited February 18, 2023]. Available from: https://pubmed.ncbi.nlm.nih.gov/29244991/

  9. Goss PE, Lee BL, Badovinac-Crnjevic T, Strasser-Weippl K, Chavarri-Guerra Y, Louis JS, et al. Planning cancer control in Latin America and theCaribbean. Lancet Oncol. 2013(5):391-436. https://doi.org/10.1016/S1470-2045(13)70048-2

  10. Arrieta O, Quintana-Carrillo RH, Ahumada-Curiel G, Corona-Cruz JF,Correa-Acevedo E, Zinser-Sierra J, et al. Medical care costs incurred bypatients with smoking-related non-small cell lung cancer treated at theNational Cancer Institute of Mexico. Tob Induc Dis. 2014;12:25. https://doi.org/10.1186/s12971-014-0025-4

  11. Arroyo-Hernández M, Zinser-Sierra JW, Vázquez-García JC. Lungcancerscreening program in Mexico. Salud Publica Mex. 2019;61(3):347-51. https://doi.org/10.21149/10326

  12. Depinho RA, Hawk E. Cancer prevention in developing countries: avision for preserving health in Mexico. Salud Publica Mex. 2016;58(2):93-6 [cited February 18, 2023]. Available from: https://pubmed.ncbi.nlm.nih.gov/27557366/

  13. Cancer Research UK. Half of cancers diagnosed at late stage asreport shows early diagnosis saves lives and could save the NHS money.UK: Cancer Research UK, 2014 [cited February 18, 2023]. Availablefrom: https://news.cancerresearchuk.org/2014/09/22/half-of-cancersdiagnosed-at-late-stage-as-report-shows-early-diagnosis-saves-lives-andcould-save/

  14. Abrao FC, de Abreu IRLB, Rocha RO, Munhoz FD, Rodrigues JHG,Batista BN. Interaction between treatment delivery delay and stage on themortality from non-small cell lung cancer. J Thorac Dis. 2018;10:2813-9.https://doi.org/10.21037/jtd.2018.05.22

  15. Asare M, Flannery M, Kamen C. Social determinants of health: a frameworkfor studying cancer health disparities and minority participation inresearch. Oncol Nurs Forum. 2017;44(1):20-3[cited February 18, 2023].Available from: https://pubmed.ncbi.nlm.nih.gov/28060469/

  16. Barrios CH, Werutsky G, Mohar A, Ferrigno AS, Müller BG, BychkovskyBL, et al. Cancer control in Latin America and the Caribbean:recent advances and opportunities to move forward. Lancet Oncol.2021;22(11):e474-87. https://doi.org/10.1016/S1470-2045(21)00492-7

  17. Unger-Saldaña K, Ventosa-Santaulària D, Miranda A, Verduzco-BustosG. Barriers and explanatory mechanisms of delays in the patient anddiagnosis intervals of care for breast cancer in Mexico. Oncologist.2018;23(4):440-53 [cited February 18, 2023]. Available from: https://pubmed.ncbi.nlm.nih.gov/29284758/

  18. Unger-Saldaña K, Miranda A, Zarco-Espinosa G, Mainero-RatchelousF, Bargallõ-Rocha E, Miguel Lázaro-Leõn J. Health system delay andits effect on clinical stage of breast cancer: Multicenter study. Cancer.2015;121(13):2198-206. https://doi.org/10.1002/cncr.29331

  19. Natale-Pereira A, Enard KR, Nevarez L, Jones LA. The role ofpatient navigators in eliminating health disparities. Cancer. 2011;117(15Suppl):3541-50. https://doi.org/10.1002/cncr.26264

  20. Gerson R, Zatarain-Barron ZL, Blanco C, Arrieta O. Access to lungcancer therapy in the Mexican population: opportunities for reducinginequity within the health system. Salud Publica Mex. 2019;61(3):352-8.https://doi.org/10.21149/10118

  21. Zapata-Tarrés M, González-Domínguez E, Doubova SV, Menendez-AuldN, Cruz-Medina CS, Gonzalez-Ramella RO, et al. Patient and health servicefactors associated with delays in cancer treatment for children withoutsocial security in Mexico. Pediatr Blood Cancer. 2020;67(9). https://doi.org/10.1002/pbc.28331

  22. Snoswell CL, Caffery LJ, Whitty JA, Soyer HP, Gordon LG. Cost-effectivenessof skin cancer referral and consultation using teledermoscopyin Australia. JAMA Dermatol. 2018;154(6):694. https://doi.org/10.1001/jamadermatol.2018.0855

  23. National Audit Office. The NHS Cancer Plan: A Progress Report. Reportby the comptroller and auditor general. National Audit Office, 2005[cited July 6, 2025]. Available from: https://www.nao.org.uk/wp-content/uploads/2005/03/0405343es.pdf

  24. Azevedo CRAS De, Lima JTO, Almeida GFG, Bezerra MR, OrangeF. Reduction in time between cervical cancer diagnosis and treatment.2018;36(15 Suppl):e17514. https://doi.org/101200/JCO20183615_suppl.e17514

  25. The Economist Intelligence Unit. Breakaway: The global burden ofcancer-challenges and opportunities. 2009 [cited April 23, 2025]. Availablefrom: https://graphics.eiu.com/upload/eb/EIU_LIVESTRONG_Global_Cancer_Burden.pdf

  26. Jafari A, Alamdarloo PM, Dehghani M, Bastani P, Ravangard R. Economicburden of colorectal cancer: a case of Fars, Iran. Cancer Control. 2021;28.https://doi.org/10.1177/10732748211009952

  27. Joranger P, Nesbakken A, Sorbye H, Hoff G, Oshaug A, Aas E. Survivaland costs of colorectal cancer treatment and effects of changing treatmentstrategies: a model approach. Eur J Health Econ. 2020;21(3):321-34.https://doi.org/10.1007/s10198-019-01130-6

  28. Escorcia-Reyes V, Villarreal-Ríos E, Vargas-Daza ER, Galicia-RodriguezL, Martínez-González L, Paredes-Hernández E, et al. Costo del procesodiagnóstico del cáncer de mama en las Unidades de Medicina Familiardel Instituto Mexicano del Seguro Social, Querétaro, México. Rev ChilObstet Ginecol. 2013;78(2):95-101 [cited February 23, 2023]. Availablefrom: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-75262013000200005&lng=es&nrm=iso&tlng=es

  29. González-Robledo MC, Wong R, Ornelas HA, Knaul FM. Costsof breast cancer care in Mexico: analysis of two insurance coveragescenarios. Ecancermedicalscience. 2015;9:587. https://doi.org/10.3332/ecancer.2015.587

  30. Arrieta O. Needs in comprehensive cancer care in Mexico Mexican.Gac Mex Oncol. 2023;22(2):1-2 [cited April 23, 2025]. Available from:www.gamo-smeo.com

  31. Soto-Perez-de-Celis E, Chavarri-Guerra Y, Ramos-Lopez WA, Alcalde-Castro J, Covarrubias-Gomez A, Navarro-Lara Á, et al. Patient navigationto improve early access to supportive care for patients with advancedcancer in resource-limited settings: a randomized controlled trial. Oncologist.2021;26(2):157-64. https://doi.org/10.1002/onco.13599

  32. Chavarri-Guerra Y, Soto-Perez-de-Celis E, Ramos-López W, San Miguelde Majors SL, Sanchez-Gonzalez J, Ahumada-Tamayo S, et al. Patient navigationto enhance access to care for underserved patients with a suspicionor diagnosis of cancer. Oncologist. 2019;24(9):1195-200. https://doi.org/10.1634/theoncologist.2018-0133

  33. Alcalde-Castro MJ, Soto-Perez-de-Celis E, Covarrubias-Gómez A,Sánchez-Román S, Quiróz-Friedman P, Navarro-Lara Á, et al. Symptomassessment and early access to supportive and palliative care for patientswith advanced solid tumors in Mexico. J Palliat Care. 2020;35(1):40-5.

  34. Arrieta O, Gómez-García A, Reynoso N. Economic impact of timelydiagnosis and early referral in comprehensive cancer care in Mexico:The DERIVA Strategy”, Mendeley Data, 2025. https://doi.org/10.17632/h6h4bn9m2f.1

  35. Arroyo-Hernández M, Zinser-Sierra JW, Vázquez-García JC. Deteccióntemprana de cáncer de pulmón en México. Salud Publica Mex.2019;61(3):347-51. https://doi.org/10.21149/10326

  36. Gobierno de México. Programa de Acción Específico Prevencióny Control del Cáncer de la Mujer 2013-2018. México: Gobierno deMéxico, 2014 [cited April 21, 2025]. Available from: http://cnegsr.salud.gob.mx/contenidos/descargas/cama/PrevencionyControldelCancerdelaMujer_2013_2018.pdf

  37. Ferlay J, Ervik M, Lam F, Laversanne M, Colombet M, Mery L, et al.Global Cancer Observatory: Cancer Today. Lyon: International Agencyfor Research on Cancer, 2024 [cited November 6, 2024]. Available from:https://gco.iarc.who.int/today

  38. Cayetano-Alcaraz AA, Ramírez-Rivera JA, Sotomayor-De-ZavaletaM, Castillejos-Molina RA, Gabilondo-Navarro F, Feria-Bernal G, et al.Características de los casos incidentes de cáncer de próstata en losúltimos 5 años en un hospital de tercer nivel en México. Rev Mex Urol.2016;76(2):76-80. https://doi.org/10.48193/revistamexicanadeurologa.v76i2.309

  39. Lansdorp-Vogelaar I, Meester RGS, Laszkowska M, Escudero FA,Ward ZJ, Yeh JM. Cost-effectiveness of prevention and early detection ofgastric cancer in Western countries. Best Practice and Research: ClinicalGastroenterology. 2021;50-1. https://doi.org/10.1016/j.bpg.2021.101735

  40. Arrieta O, Quintana-Carrillo RH, Ahumada-Curiel G, Corona-CruzJF, Correa-Acevedo E, Zinser-Sierra J, et al. Medical care costs incurredby patients with smoking-related non-small cell lung cancer treated atthe National Cancer Institute of Mexico. Tob Induc Di. 2014;12(1):25[cited November 6, 2024]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25653577

  41. Cabrera-Galeana P, Soto-Perez-de-Celis E, Reynoso-Noveron N,Villarreal-Garza C, Lara-Medina F, Alvarado-Miranda A, et al. Real-worldoutcomes among older Mexican women with breast cancer treated withneoadjuvant chemotherapy. Oncologist. 2020;25(12):1023-31. https://doi.org/10.1634/theoncologist.2019-0891

  42. Reynoso-Noverón N, Villarreal-Garza C, Soto-Perez-de-Celis E,Arce-Salinas C, Matus-Santos J, Ramírez-Ugalde MT, et al. Clinicaland epidemiological profile of breast cancer in Mexico: results of theSeguro Popular. J Glob Oncol. 2017;3(6):757-64. https://doi.org/10.1200/JGO.2016.007377

  43. Isla-Ortiz D, Palomares-Castillo E, Mille-Loera JE, Ramírez-Calderón N,Mohar-Betancourt A, Meneses-García AA, et al. Cervical cancer in youngwomen: do they have a worse prognosis? a retrospective cohort analysisin a population of Mexico. Oncologist. 2020;25(9):e1363-71. https://doi.org/10.1634/theoncologist.2019-0902

  44. Aracena-Genao B, González-Robledo MC, González-Robledo LM,Palacio-Mejía LS, Nigenda-López G. El Fondo de Protección contraGastos Catastróficos: tendencia, evolución y operación. Salud Publica Mex.2011;53 [cited July 7, 2025]. Available from: https://www.saludpublica.mx/index.php/spm/article/view/5064/10064

  45. Arroyave-Loaiza MG, Ramírez-Navarro JF, Amador-Vázquez L. Gruposrelacionados con el diagnóstico: producto hospitalario. México: InstitutoMexicano del Seguro Social. 2020 [cited April 24, 2025]. Available from:https://salud.cdmx.gob.mx/storage/app/media/2018-2024/2024/GRD/diagnostico-grd-sedesa-2020-1.pdf

  46. Instituto Nacional de Estadística y Geografía. Calculadora de inflación.Mexico: Inegi, 2025 [cited February 5, 2024]. Available from: https://www.inegi.org.mx/app/indicesdeprecios/CalculadoraInflacion.aspx

  47. Omar MH, Shair SN, Asmuni NH. Lung cancer transition rate by stagesusing discrete time markov model. Indonesian Journal of Electrical Engineeringand Computer Science. 2020;18(3):1295-302 [cited Feb 5, 2024].https://doi.org/10.11591/ijeecs.v18.i3.pp1295-1302

  48. Spandonaro F, D’angela D, Polistena B, Bruzzi P, Iacovelli R, LuccariniI, et al. Prevalence of prostate cancer at different clinical stages in Italy:estimated burden of disease based on a modelling study. Biology (Basel).2021;10(3). https://doi.org/10.3390/biology10030210

  49. Torres-Sánchez LE, Espinoza-Giacinto R, Rojas-Martínez R, Escamilla-Nuñez C, Vázquez-Salas RA, Campuzano JC, et al. Prostate cancermortality according to marginalization status in Mexican states from 1980to 2013. Salud Publica Mex. 2016;58(2):179-86. Available from: https://pubmed.ncbi.nlm.nih.gov/27557376/

  50. Gómez-Dántes O, Sesma S, Becerril V. Sistema de salud de Mexico.Salud Publica Mex. 2011;53:220-32. Available from: https://saludpublica.mx/index.php/spm/article/view/5043

  51. National Institute for Health and Clinical Excellence. Department ofHealth. Annual Report and Accounts 2011/12 Manchester: National Institutefor Health and Clinical Excellence, 2012 [cited November 6, 2024].Available from: https://assets.publishing.service.gov.uk/media/5a7c4b7be5274a1b00422cb7/0236.pdf

  52. Tappenden P, Bessey A, McKenna C, Sculpher M. The likely impact ofearlier diagnosis of cancer on costs and benefits to the NHS. 2013 [citedApril 20, 2025]. Available from: https://share.google/LkLj780dtZmGndeXn

  53. Unger-Saldaña K, Infante-Castañeda C. Delay of medical care forsymptomatic breast cancer: A literature review. Salud Publica Mex.2009;51(suppl 2). https://doi.org/10.1590/s0036-36342009000800018

  54. Unger-Saldaña K, Infante-Castañeda CB. Breast cancer delay: agrounded model of help-seeking behaviour. Soc Sci Med. 2011;72(7):1096-104. https://doi.org/10.1016/j.socscimed.2011.01.022

  55. Porter P. “Westernizing” women’s risks? breast cancer in lower-incomecountries. N Engl J Med. 2008;358(3):213-6. https://doi.org/10.1056/NEJMp0708307

  56. Bright K, Barghash M, Donach M, de la Barrera MG, Schneider RJ, FormentiSC. The role of health system factors in delaying final diagnosis andtreatment of breast cancer in Mexico City, Mexico. Breast. 2011;20(suppl2):S54-9. https://doi.org/10.1016/j.breast.2011.02.012




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