Key points are not available for this paper at this time.
In Latin America and the Caribbean, cancer can no longer be framed only as a clinical problem. It constitutes a public health emergency because, from the first point of contact with the health system, it exposes who can reach timely care and who falls behind. The regional burden is substantial. In 2022, the region recorded 1,551,060 new cases, 749,242 deaths, and a five-year prevalence of 4,096,032 people living with cancer (Guerron-Gomez et al., 2025). Yet the most consequential question extends beyond how many people develop cancer to how much health systems lose to preventable delays. Cancer becomes more lethal when institutions convert clinical time into administrative time, and that lost time does not fall equally across populations (Guerron-Gomez et al., 2025). This regional framing must also remain analytically precise. Latin America and the Caribbean form a heterogeneous subregion of the Americas, marked by linguistic, cultural, territorial, and institutional diversity, but connected by persistent challenges in cancer control and public health governance. Specialized literature already recognizes Latin America and the Caribbean as a relevant field of analysis in cancer control (Force et al., 2025). At the same time, recent comparative evidence available for this discussion is reported mainly at the level of South and Central America rather than through country-disaggregated analyses across all Latin American and Caribbean settings (Langselius et al., 2026). This distinction matters because regional arguments should not erase internal variation, even when a shared pattern of inequity remains visible across the subregion. This inequality does not emerge at the end of the care pathway. It emerges at the beginning. Across the region, recurring patterns mark health inequity: insufficient or intermittent screening coverage, limited awareness of warning signs among the public and health personnel, shortages of specialists and diagnostic infrastructure, high out-of-pocket costs, and cumulative delays across appointments, tests, biopsies, and pathology reports (Guerron-Gomez et al., 2025). From a public health perspective, these patterns do not reflect only "late" individual choices. They reflect social and territorial gradients that shape the real capacity to prevent, detect, and treat disease. In other words, when people arrive late, they rarely arrive late by chance. They arrive late because layered social, geographic, and administrative barriers overlap and compound (Abramo et al., 2020;Irwin 29,300 were preventable and 27,000 treatable, out of 119,300 expected deaths overall (Langselius et al., 2026). Although these data do not provide country-bycountry estimates for all Latin American settings and do not resolve the Caribbean separately in the material used here, they show that avoidable cancer mortality is already measurable at the subregional level and that it reflects both failures of prevention and failures of timely treatment.When one examines the region country by country, contexts vary, but the storyline often remains consistent. Health systems fragment services, concentrate capacity in major cities, and route patients through access pathways that penalize those who live far from referral centers or depend on weak networks. In Colombia, research on access shows how administrative barriers, including paperwork, authorizations, referrals, and waiting times, can block or delay the effective use of services even when coverage exists on paper (Rodríguez Hernández et al., 2015;Vargas Vargas Vargas Vargas & Molina, 2009). 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