🇨🇴 Cancer in Colombia

The Instituto Nacional de Cancerología's estimates, published online on 27 December 2024 by Constanza Pardo-Ramos of its epidemiological surveillance group and Ricardo Cendales-Duarte, give mean annual figures for 2017 to 2021: 12,236 breast cancers in women (age-standardised rate 40.2 per 100,000), 12,090 prostate cancers (43.6), 4,694 stomach cancers in men (17.3) and 2,985 in women (9.4), 3,991 bowel cancers in men (14.7) and 4,688 in women (14.6; the text gives 4,668), 6,138 thyroid cancers in women (21.0) and 1,194 in men, and 4,331 cervical cancers (14.8). Recorded deaths averaged 44,355 a year, 21,683 in men and 22,672 in women, with the highest death rates for prostate cancer in men (11.8 per 100,000, the same as stomach cancer in the paper's table) and breast cancer in women (11.4). The highest all-cancer incidence rates were in La Guajira and Risaralda for both sexes, followed by Norte de Santander in men and Huila in women. The Ministry's 2026 cancer plan, quoting the institute's Infocáncer system and DANE's vital statistics, gives an age-standardised cancer death rate falling from 76.6 per 100,000 in 1997 (23,326 deaths) to 66.9 in 2024 (49,795 deaths), with rising death rates from bowel cancer and falling ones for breast, prostate, stomach and cervical cancer.

The institute's paper states that Colombia has seven population-based registries, all covering cities, and that its estimates use the four whose data met the quality standard for Cancer Incidence in Five Continents Volume XII: Cali, Bucaramanga, Manizales and Pasto. A model fitted to their 2013 to 2017 incidence and deaths is applied to each department's recorded deaths for 2017 to 2021, and the national figure is the sum of the departments; the paper puts the quality of mortality data at 96%. The Cali registry has run since 1962. Separately, under Resolución 0247 de 2014 every insurer, special and exception regime and departmental health authority must report to the Cuenta de Alto Costo every person with cancer it attended. Its 2025 report, covering 2 January 2024 to 1 January 2025, audited 806,503 records against clinical notes and counted 69,571 newly reported cases and 759,390 prevalent cases of all ages; it also found 18,925 people reported for the first time who had been diagnosed earlier and had no care recorded in the period, down from 22,186 a year before. The Ministry's 2026 plan sets out to make the population registries the official standard for incidence and survival where they operate.

The Cuenta de Alto Costo's 2025 report gives the age-standardised rate of newly reported cases as 108.96 per 100,000, highest in Bogotá (167.37) and lowest in Amazonía-Orinoquía (55.82), and 119.49 in the contributory regime against 75.72 in the subsidised regime. Among newly reported cases, breast cancer was the commonest (9,772), then prostate (7,297) and colon and rectum (4,958); about half of new cases were cancers outside the eleven types prioritised by the Ministry. Of the newly reported cases, 56.38% were women and the median age was 65; 66.55% were in the contributory regime. The cohort recorded 38,262 deaths from any cause. The median time from clinical suspicion to a histology result was 35 days (interquartile range 17 to 69) and from diagnosis to first treatment 51 days (25 to 92); the report names the interval after diagnosis, access to treatment, as the main delay, and its median was 48 days or more in every year from 2020 to 2025. These are cases reported by insurers, not a count of every cancer in the country.

The Cuenta de Alto Costo's 2025 report uses the national affiliation database for June 2024: 51,206,742 affiliates, of whom 28,511,097 were in the contributory regime, 20,558,122 in the subsidised regime, 2,096,836 in exception regimes (such as the police, armed forces, teachers' fund and Ecopetrol) and 40,687 in special regimes, against a DANE population of 52,613,753. Of people newly reported with cancer, 66.55% were contributory and 28.05% subsidised; 25 were uninsured. The capitation payment (Unidad de Pago por Capitación, UPC) is paid in advance to insurers through ADRES, created by article 66 of Ley 1753 de 2015. The Ministry's Resolución 2765 de 2025, dated 30 December 2025, updated the services and technologies funded by the capitation for 2026, describes the capitation as reaching coverage levels above 96%, and requires insurers to guarantee children with cancer, or suspected cancer, effective and continuous access to those services under the childhood cancer laws. Ley Estatutaria 1751 de 2015 made health a fundamental right and bars public health money from paying only for services that meet listed criteria, such as a cosmetic purpose, no scientific evidence of safety or efficacy, no authorisation, experimental status or treatment abroad, and then only after an explicit, public exclusion procedure.

Resolución 1816 de 2026, signed on 6 August 2026, governs access, prescription, supply and payment for technologies not funded by the capitation. The treating professional, who must belong to the insurer's network, prescribes through MIPRES on the SISPRO platform, and insurers may not choose which professionals prescribe or restrict their autonomy. Each hospital must have a Junta de Profesionales de la Salud to approve complementary services, nutritional products and explicitly excluded technologies that may exceptionally be prescribed; it must decide within 3 calendar days for prioritised outpatient, emergency or inpatient prescriptions and within 5 for others, and prescriptions for uses on the official list of unlicensed uses need no panel. The insurer must direct the patient to a supplier within 24 hours for prioritised outpatient, hospital, home or emergency care, or 5 calendar days for other outpatient care; for vital medicines not available in Colombia supply may not exceed 45 days after INVIMA's authorisation, and one prescription number covers repeat supplies for up to a year. Where a judge's tutela orders a technology, the insurer enters it in MIPRES and no panel is needed. ADRES verifies and pays insurers' claims for what is not covered by the capitation or the maximum budgets.

Ley 1438 de 2011 (article 92) authorised the creation of the Instituto de Evaluación Tecnológica en Salud, a mixed non-profit corporation whose assessments are a reference for defining benefit plans. Ley 1753 de 2015 (article 72) made its assessment, and the price set from it, a requirement for registering medicines the Ministry chooses, to run alongside the INVIMA process. Decreto 433 de 2018 applies this to new medicines: INVIMA sends the applicant's dossier to the IETS within five days, the IETS consults publicly on the question and on its result, and classifies the medicine as significantly more effective (category 1), more effective (2), favourable (3), similar (4) or unfavourable (5) against the comparator, or unclassifiable (6), with the level of uncertainty; it may add cost-effectiveness and budget impact analyses, and for orphan diseases does only the classification and budget impact. The result is published and passed to the price commission. If 180 days pass without a final IETS opinion, the requirement is treated as met, so the assessment cannot hold up registration. OnCo did not find a published cost-effectiveness threshold for Colombia.

The Comisión Nacional de Precios de Medicamentos y Dispositivos Médicos regulates medicine prices under article 245 of Ley 100 de 1993 as amended. Its method, in Circular 18 de 2024, groups medicines into markets by active ingredient and dosage form and sets the base price as the minimum of the international reference price and the national reference price. Circular 22 de 2026, dated 19 June 2026, prioritised medicines for orphan diseases, HIV, vital medicines not otherwise available and high-cost medicines; it brought 33 markets and 4 submarkets under direct control for the first time, among them abemaciclib, acalabrutinib, alectinib, atezolizumab, avelumab, cabozantinib, inotuzumab ozogamicin, lenvatinib and regorafenib, revised the ceilings of 22 markets and 10 submarkets including abiraterone, bevacizumab, enzalutamide, lenalidomide and pembrolizumab, and adjusted 528 markets by minus 7.43% for exchange-rate movements. A ceiling is the most that can be charged in the supply chain; it does not decide whether the medicine is funded.

Decreto 677 de 1995 reserves the pharmacological evaluation of a medicine, a judgement on its efficacy, safety, dosage, indications, benefit-risk balance, toxicity and pharmacokinetics, to INVIMA's specialist committee. Article 28 gives the committee 180 working days, with the clock stopped while the applicant answers questions, and its paragraph gives 30 working days, on a summary of the clinical information, when the medicine is registered in at least two reference countries and has not been rejected in any: the United States, Canada, Germany, Switzerland, France, England, Denmark, the Netherlands, Sweden, Japan and Norway. Decreto 1782 de 2014 sets three routes for biological medicines, the full dossier, comparability with a reference biologic, and an abbreviated comparability route for well-characterised ingredients with long clinical experience, all judged to the same standard; INVIMA then has three months after a favourable evaluation to decide on registration, which lasts five years. For a cancer medicine, registration is only the first step: funding depends on the benefit plan or on MIPRES.

INVIMA announced on 20 March 2025 that Resolución 2025010547 adopted a contingency plan for six months to streamline the issue and modification of sanitary registrations handled by its directorate of medicines and biological products, with meetings with applicants to complete information within legal time limits, checking of foreign certificates such as good manufacturing practice on the issuing authorities' own websites, and a technical committee with the Ministry to monitor it. In March 2026 AFIDRO, FIFARMA and AmCham Colombia presented a roadmap stating that 12,470 procedures were pending, that the approval of new registrations had gone from 22 months in 2024 to 29 months in 2025, that 45% of applications for new cancer molecules were rejected in 2025, and that innovative products could take up to five years to reach Colombia after approval by reference agencies. Those are the associations' own figures, reported by Consultorsalud; OnCo found no INVIMA publication of measured approval times or rejection rates for cancer medicines with which to check them.

Resolución 3280 de 2018 sets the screening rules of the Ruta Integral de Atención para la Promoción y Mantenimiento de la Salud. For the cervix: cytology at 25 to 29 on a 1-3-3 schedule (every three years after negative results); tests for high-risk human papillomavirus DNA for all women aged 30 to 65 on a 1-5-5 schedule; and visual inspection with acetic acid and Lugol's iodine only for women aged 30 to 50 in dispersed areas with difficult access, on a 1-3-3 schedule, with immediate cryotherapy. Every woman having an HPV test gives a cytology sample at the same visit, read only if the HPV test is positive; after a positive HPV test the woman should be seen within two weeks, and if the triage cytology is also positive she should have colposcopy and biopsy within 30 days. Screening stops at 65 if recent HPV tests were negative. Under 25, screening is by clinical judgement of risk. The Cuenta de Alto Costo's 2025 report counted 4,040 newly reported cervical cancers, 10.30% of new cancers reported in women.

Resolución 3280 de 2018 sets clinical breast examination every year from age 40 and two-view mammography every two years from 50 to 69, continuing every two years after normal results (BI-RADS 1 and 2) and with active follow-up for BI-RADS 4A to 5. For the colon and rectum, the target population is men and women aged 50 to 75, screened by faecal immunochemical test every two years (three samples on different days) or colonoscopy every ten years when available, with people at higher personal or family risk referred to a separate pathway. Prostate screening is described as opportunistic, for men aged 50 to 75: PSA with a rectal examination by a trained general practitioner every five years, after explaining potential risks and benefits and agreeing the decision; the rectal examination may start from 40 in men with a family history or of Black ethnicity. The PSA result should be available within 15 calendar days. The Cuenta de Alto Costo's 2025 report gives 56.17% of newly reported prostate cancers as diagnosed at a localised stage (0, I or II). OnCo found no national figure for the share of the eligible population screened.

The Defensoría del Pueblo's April 2026 summary of its report on health tutelas in 2024, built from the Constitutional Court's databases, counts 912,614 tutelas of all kinds filed in 2024, the highest since the action was created in 1991; 265,173 (29.06%) invoked the right to health, 34.08% more than in 2023, and 2,779,815 health tutelas had been filed from 1999 to 2024. The commonest facts invoked were appointments with specialists (71,455), medicines (63,943), transport and travel costs (57,718), hospital care (53,317), comprehensive treatment (47,313) and surgery (44,653). Judges granted 74.3% overall, 83.0% for transport and 82.1% for comprehensive treatment. The report finds neoplasms among the conditions most over-represented in tutelas relative to how often they are treated, and finds the lowest tutela rates in some of the poorest departments, which it reads as exclusion from both care and justice rather than better service. Ley 2360 de 2024 declared people with suspected or diagnosed cancer subjects of special constitutional protection, and Resolución 1816 de 2026 lets an insurer supply what a tutela orders without a hospital panel.

Resolución 2475 de 2016, dated 14 June 2016, declared the existence of reasons of public interest for imatinib under chapter 24 of Decreto 1074 de 2015, the procedure that can lead to a compulsory licence, and instead asked the Comisión Nacional de Precios de Medicamentos y Dispositivos Médicos to consider placing Glivec under direct price control using a general method for public interest situations. The request came from Fundación Ifarma, Acción Internacional por la Salud, Misión Salud and the Centro de Información de Medicamentos of the Universidad Nacional; the resolution records that a conciliation with Novartis, holder of patent 29270, over a voluntary licence failed in 2015. The commission adopted a method for medicines declared of public interest in Circular 03 de 2016 and, by Circular 04 de 2016 of 22 December 2016, removed Glivec from its earlier price control and set its maximum selling price at 206.42 pesos per milligram for all presentations. The resolution was confirmed by Resoluciones 4002 and 4148 de 2016.

Ley 1388 de 2010, for the right to life of children with cancer, covers everyone under 18 with confirmed cancer, certain blood disorders, or a doctor's suspicion of cancer until it is ruled out; from confirmation until treatment ends, insurers must authorise immediately every service the child needs in a specialised childhood cancer unit, outside pathologists must process a biopsy within 7 days, and families are entitled to a hostel (hogar de paso), travel costs and psychosocial and school support. Ley 2026 de 2020, the Ley Jacobo, made this care prioritised and continuous and gave providers of children's cancer care priority in payment. Ley 1384 de 2010, the Ley Sandra Ceballos, covers adult cancer: contracts only with providers that have multidisciplinary functional units led by an oncology specialist, palliative care and rehabilitation, a national cancer network and adult registry coordinated by the Instituto Nacional de Cancerología, and a cancer observatory. Ley 1384 already declared cancer a national priority; Ley 2360 de 2024 amended it to recognise people with suspected or diagnosed cancer as subjects of special constitutional protection and to give people with suspected cancer priority for diagnostic tests. The Cuenta de Alto Costo's 2024 paediatric report counted 13,772 people under 18 with cancer attended and 1,406 newly reported cases; five-year overall survival for children with acute lymphoblastic leukaemia diagnosed in 2014 to 2022 was 70.08%.

The Cuenta de Alto Costo was created by Decreto 2699 de 2007, which obliges the insurers of both regimes to join together to deal with high-cost diseases; it runs as a self-managed fund that offsets uneven concentrations of these patients, and it evaluates and ranks insurers and providers each year on health results. For the 2025 report its audit reviewed 806,503 records, found 5.72% with no evidence supporting the diagnosis, and inactivated 16,815 records whose diagnosis had been ruled out; a committee of clinical experts named by the Asociación Colombiana de Hematología y Oncología reviewed relevant cases. Its survival report for 2014 to 2022 found five-year overall survival lower in the subsidised than in the contributory regime for every cancer it reports by regime, 65.67% against 80.69% for breast cancer and 60.20% against 79.37% for prostate cancer. The Ministry adopted a new ten-year cancer plan, the Plan Decenal para el Control del Cáncer 2026-2035, by Resolución 1233 de 2026, with evaluations in 2028, 2030 and 2035.

Counted from ClinicalTrials.gov participation data in OnCo's graph on 4 November 2026: 147 trials list Colombia among their countries, 122 of them phase 3, 10 phase 2/3, 9 phase 2 and 6 phase 1/2. ClinicalTrials.gov lists 47 as recruiting, 54 as active and not recruiting, 41 as completed and 5 as terminated. It names Merck Sharp & Dohme as lead sponsor of 64, Bristol-Myers Squibb of 20, Hoffmann-La Roche of 13 and AstraZeneca of 8; non-small cell lung cancer is the first-listed cancer for 21, prostate cancer for 13, and triple-negative breast cancer and kidney cancer for 8 each. Cervical cancer trials with Colombian sites include KEYNOTE-826, KEYNOTE-A18 and the LACC surgical trial. The trials listing the fewest countries include two run by the US SWOG group, a phase 3 trial of treating the primary tumour in metastatic prostate cancer (5 countries) and MAVERICK, on brain scans instead of preventive brain radiation in small cell lung cancer (7), and RxPONDER in breast cancer (10). OnCo's OpenAlex snapshot of 8 September 2026 also records 2,308 ClinicalTrials.gov studies of all conditions with a site in Colombia.

OpenAlex, counting works whose primary topic is oncology and counting a paper for every country among its authors' affiliations, gives Colombia 304 works in 2021, 261 in 2022, 272 in 2023, 266 in 2024 and 283 in 2025, 1,386 in total, of which 1,087 are open access and 22 highly cited. The Instituto Nacional de Cancerología's epidemiological surveillance group produced the national estimates for 2017 to 2021, and Ley 2291 de 2023 made the institute the technical and scientific authority for cancer control and a reference centre for cancer care and research, according to the Ministry's 2026 cancer plan. The Cuenta de Alto Costo publishes yearly reports and survival analyses with clinical reviewers from the Asociación Colombiana de Hematología y Oncología. The Cali registry's 2018 methods paper reports 88.5% morphological verification and participation in the CONCORD and SURVCAN-3 survival studies.

Every request to www.cancer.gov.co on 4 November 2026 returned 403, and the Internet Archive answered with a 403 copy and then was temporarily offline. The institute's full tables by department and its Infocáncer mortality figures were therefore not read directly: the 2017 to 2021 estimates come from its epidemiological surveillance group's paper in the Revista Colombiana de Cancerología (December 2024), and the 1997 to 2024 mortality series and the 2024 count of 49,795 deaths from the Plan Decenal para el Control del Cáncer 2026-2035, which cites Infocáncer and DANE. The DOI printed on that paper, 10.35509/01239015.1061, did not resolve at doi.org or Crossref when checked, so the paper is linked through the journal's own site and is not recorded as a paper in OnCo. The Cali registry's own website did not answer either.

Resolución 3280 de 2018 sets ages and intervals but no coverage figure was found in a national source read for this page; IARC's CanScreen5 fact sheets for Colombia load only through a script and were not read. The approval figure of 29 months and the 45% rejection rate for new cancer molecules are industry associations' figures, and no INVIMA publication of measured times was found to check them against. No cost-effectiveness threshold published by the IETS or the Ministry was found. ADRES's spending on technologies outside the capitation, and the share of it for cancer, were not read. Resolución 3280 de 2018 was read in its 2018 text; later amendments, such as Resolución 0276 de 2019, were not checked line by line for changes to the cancer screening chapters.

Resolución 1816 de 2026 is a scan of the signed resolution bearing the Minister's name and date of 6 August 2026; Circular 22 de 2026 is a scan dated 19 June 2026; and the Defensoría del Pueblo's executive summary carries its own masthead and the date April 2026. The Ministry's resolution on the cancer plan was read in the Keralty legal compilation and in a PDF of the Diario Oficial annex hosted by Cerlatam. A reader relying on any of them should check the issuing body's own site, the Ministry of Health, the price commission's secretariat or the Defensoría, for later amendments.