The National Health Insurance (Senasa) is the health risk administrator (ARS) of the State, which includes affiliates dependent on formal employees who contribute to social security, as well as the unemployed who are subsidized by the State.
As of April of this year, the number of Senasa members reached 7,520,277, including the holders and their dependents of the contributory regime and those of the subsidized regime, which is equivalent to nearly 70% of the Dominican population.
The fact that the population affiliated with Senasa is so high means that any study related to the incidence of certain diseases among its members represents a contribution as a reference to see how the situation is in the entire population.
Santiago Hazim, executive director of Senasa, presented this week the study “Prevalence of cancer in the population affiliated with Senasa”, which reveals, among other data, that from January 1, 2020, until the end of April of this year, 61,714 people with cancer of different types were registered.
Of those affected, 57% are female and 43% are male. In addition, the most common type of cancer in women is breast cancer, while in men it is prostate cancer.
According to Hazim, the paradox is that these two types of cancer are the easiest to prevent, not only because early detection can allow for adequate treatment to prevent their progression, but also because the local hospital system has sufficiently accessible personnel, equipment and laboratories for related tests.
Details
According to anatomical location, breast cancer accounts for 25% of cases, followed by prostate cancer with 22%, and lymphohematopoietic system cancer (which includes blood, bone marrow, spleen, thymus, blood vessels and lymph nodes) with 14%. The remaining 39% corresponds to other diseases.
But the incidence of breast and prostate cancer is much more noticeable when separated by sex. In the case of the 35,178 women with cancer detected between 2020 and 2024 of those affiliated with Senasa, 44.5% specifically suffer from breast cancer, with a higher incidence in women between 35 and 60 years of age.
Among the 26,537 men diagnosed, almost half, 49.8%, suffer specifically from prostate cancer, which is more common among adults aged 65 to 75.
The director of Senasa highlighted that for the treatment of cancer and other high-cost diseases, both in the contributory and subsidized regimes there is coverage of up to RD$2,000,000 annually, which is renewed each year while the process lasts.
However, he added that this situation represents a high cost, given the frequency with which these diseases are increasing.
The study indicates that in 2020 the incidence of cancer among Senasa members was 1.25 per 1,000, while at the end of 2023 it was 2.65, which implies an increase in cases.
But this is not necessarily explained by the fact that there are more people with cancer, but also by the fact that there are now more insured people and more frequent tests that allow early or late detection, which enriches the data in the case registry.
Resources
In 2020, Senasa allocated contributions of RD$2,540.1 million for the treatment of members with cancer, while in 2021 the amount increased to RD$3,536.8 million and for 2022 it rose to RD$4,359.1 million.
In 2023, the trend continued to rise with disbursements for treatments amounting to RD$4,692.7 million and for this year the projection is similar, with RD$4,697.4 million.
One of the observations made by the study is the limited number of specialized cancer treatment centers in the country, with the disadvantage that the few that exist are in the cities of Santo Domingo and Santiago.
These are the cases of the Dominican League Against Cancer, which treats 64% of the cancer patients affiliated with Senasa, while the Rosa Emilia Sánchez National Cancer Institute receives 18%. Both centers are in the capital. The remaining 18% is distributed among five other specialized private centers.
The executive director of Senasa advocates that the Government promote, possibly in alliance with the private sector, the expansion of regional medical centers specialized in cancer treatments, to facilitate access to services by patients who live in remote areas of the capital.
He said that the distance and inconvenience of travel causes many patients to give up on treatment and stay at home, which makes their situation worse and can end their lives before they are expected.
Input
Senasa Executive Director Santiago Hazim said that the study on the incidence of cancer among ARS members “is a vital tool for redirecting promotion and prevention strategies,” which would allow for the implementation of more innovative public policies adapted to the needs of the population.
“Our commitment is to continue working,” said the official, while acknowledging that the path to quality medical care requires dedication, innovation and a shared vision of collective well-being.
“This study is motivated to make informed and evidence-based decisions, which is why it allows us to work in the present to reduce the impact of cancer and other diseases in the Dominican Republic,” said Hazim.
He added that Senasa will continue to conduct studies of this nature, seeking to provide references for the design of health sector development policies and the improvement of services in specific areas of high incidence in the affiliated population.
