Vargas, IngridMogollón-Pérez, Amparo SusanaEguiguren, PamelaTorres, Ana LucíaPeralta, AndrésRubio-Valera, MariaJervelund, Signe SmithBorras, Josep M.Dias, SóniaVázquez, María LuisaVazquez, M. L.Oliver, AidaEspinel, VerónicaFernández, ZaharaAznar-Lou, IgnacioArroyo-Uriarte, PaulaGil-Girbau, MontserratSerrano-Blanco, AntoniGarmendia, María LuisaOyarce, Ana MaríaBass, CamiloGuzmán, IsabelAlvarez, AndreaGonzález, PaolaAbarca, IsabelStock, RodneyCerda, BertaHartwig, GuillermoTabilo, CristopherAravena, CarmenStephens, GloriaGarcia, VirginiaRestrepo, Ana MariaPinzón, AngelaCardozo, CarolRangel, María CamilaCristancho, PabloArellano, Ana MaríaCala, Lilian GabrielaMerchán, Juan GabrielVelandia, OmarTorres, RafaelO'Byrne, MauricioLancheros, LilianaDuarte, OscarPereira, HugoPerelman, JulianGama, AnaMarques, PatriciaFronteira, InêsFor EquityCancer-LA2025-07-102025-07-102025-010277-9536PURE: 121542255PURE UUID: ef6fe2b1-6b0d-47a1-be1d-e1c276ca4162Scopus: 85210774295PubMed: 39626381WOS: 001390332900001ORCID: /0000-0001-5085-0685/work/187716425ORCID: /0000-0003-1406-4585/work/187717047http://hdl.handle.net/10362/185054Funding Information: This study has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 965226 on the call topic SC1-BHC-17-2020, Global Alliance for Chronic Diseases - Prevention and/or early diagnosis of cancer. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: This study has received funding from the European Union\u2019s Horizon 2020 research and innovation programme under grant agreement No 965226 on the call topic SC1-BHC-17-2020, Global Alliance for Chronic Diseases - Prevention and/or early diagnosis of cancer. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2024 The AuthorsAlthough the greatest delays in cancer diagnosis in Latin America occur in the provider interval little is known about the related factors. This study aims to analyze factors influencing access to cancer diagnosis -from initial contact with health services to confirmation- from institutional stakeholders' perspective in public healthcare networks of Chile, Colombia, and Ecuador. A qualitative, descriptive-interpretative study was conducted in two networks per country, using semi-structured individual interviews (n = 118; 23 to 58, per country) with a criterion sample of health professionals and administrative personnel from primary care (PC) (n = 41) and secondary/tertiary care hospitals (n = 47), network managers and policymakers (n = 30). The final sample size was reached through saturation. Thematic content analysis was performed, segmented by country. The analysis reveals interacting factors that cause cumulative delays throughout the patient's diagnostic pathway within healthcare networks, with differences between countries. In all three, informants identify similar characteristics of the networks: structural (deficits in diagnostic resources; geographical accessibility), organizational factors (long waiting times, especially after referral), and the limited knowledge and experience of PC doctors, which all lead to delayed diagnosis. In Chile and Colombia, health policy barriers related to care rationing/prioritization policies that hampered access to tests, and in Chile, increased delays for non-prioritized conditions. Country-specific barriers related to the organization of healthcare system also emerge: in Chile, private services subcontracting and the voucher system for using them; in Colombia, the management of care by insurers (care authorizations; fragmented and short-term contracting of providers); and in Ecuador, underfunding of the system. The barriers most affect the elderly, those with low socioeconomic status, with limited support networks, and rural areas residents. The results reveal relevant barriers in access to timely cancer diagnosis which can and should be addressed with specific cancer diagnosis policies and general measures that strengthen public healthcare systems and networks.4822875engAccess to healthcareEarly diagnosis of cancerHealth inequitiesHealth services researchLatin AmericaQualitative researchHealth(social science)History and Philosophy of ScienceSDG 3 - Good Health and Well-beingjournal article10.1016/j.socscimed.2024.117499https://www.scopus.com/pages/publications/85210774295