Cancer Contact Prevalence in Peru 2019-2022

Background: Cancer is a growing public health challenge in Latin America, where fragmented health systems limit surveillance. In Peru, the Social Health Insurance System (EsSalud) covers over 10 million individuals, yet comprehensive epidemiological analyses are scarce.
Methods: We conducted a nationwide, retrospective cross-sectional study using aggregated electronic health records and mortality data from EsSalud (2019–2022). Cancer diagnoses (ICD-10 C00–C97) and cancer-related deaths were summarized at the district level, stratified by age and sex. A two-stage analytical approach was applied: first, descriptive and temporal analyses were performed to characterize trends; second, spatiotemporal Bayesian hierarchical models were used to estimate district-level cancer contact prevalence and geographic variation. Associations with district-level poverty indicators and COVID-19 burden were also evaluated.
Results: Cancer contact increased by 76%, from 442.7 (95% CI: 438.9–446.5) to 778.9 (95% CI: 774.1–783.8) per 100,000 Essalud-insured individuals over the study period. Breast, prostate, cervical, and colorectal cancers were the most prevalent, with cervical cancer nearly doubling. Stomach cancer, a leading cause of death nationally, ranked lower in EsSalud data, suggesting underdiagnosis in low-income populations. District-level spatial models revealed geographic clusters of high prevalence, particularly in coastal and Amazonian regions. Cancer reporting declined during the COVID-19 peaks, especially in high-poverty areas, followed by partial recovery.
Conclusions: This study provides the first nationwide district-level ecological assessment of cancer burden in Peru’s insured population using spatially structured Bayesian hierarchical models. The findings reveal a substantial and increasing cancer burden with pronounced geographic and socioeconomic inequities. Disparities in cancer detection, intensified by the COVID-19 pandemic and poverty, underscore the need for more equitable, territorially targeted cancer control strategies.