Reflection on strategies to reduce delays in cancer diagnosis between levels of care in Chile
On 28 October 2025, the Northern Metropolitan Health Service (SSMN) and EquityCancer-LA organised a meeting between health services to share a methodology that has enabled the design and implementation of an intervention in the northern network that has tangibly improved coordination between primary care and other specialist services.
The Dr Salvador Allende School of Public Health at the University of Chile hosted the meeting, entitled "Research, action and knowledge in motion in public care networks: Inter-level training strategy for the timely diagnosis of cancer," which brought together 60 people, mainly managers, professionals and teams from the oncology networks of the Northern, Southern, Central, Western and South-Eastern Metropolitan Health Services. The purpose was to promote dialogue and the exchange of experiences between the different networks.
The day began with a presentation by Dr María Luisa Vázquez, director of the Health Policy Studies and Forecasting Service of the Health and Social Consortium of Catalonia and general coordinator of EquityCancer-LA, who presented the central elements of the project and the baseline results of the three participating countries (Colombia, Ecuador and Chile).
Next, Dr. Pamela Eguiguren Bravo, an academic at the Dr. Salvador Allende School of Public Health at the University of Chile and principal investigator for EquityCancer-LA in Chile, presented the results in Chile, highlighting the existence of fragmented trajectories and long time intervals in cancer diagnosis in the North and South Metropolitan Health Services. Using a participatory action research methodology, collective reflection among different levels of care on these results led to the design of a multi-component intervention in the Northern Network, which included an innovative inter-level training programme for primary care physicians on the timely diagnosis of cancer.
Nurses Glasfira Leyton, head of the Coordination Unit with the San José Hospital Complex Network, and María Alejandra Cura, head of Non-Medical Teaching at the National Cancer Institute, both members of the local steering committee of EquityCancer-LA in Chile, presented the Inter-level Training Programme for the Timely Diagnosis of Cancer. Co-developed by professionals from different levels of care within the SSMN, the programme has trained 72 primary care physicians in its two editions to date. It includes internships for these physicians in hospitals, thereby helping to strengthen coordination between levels. Far from being a traditional course, the programme established permanent channels of communication and spaces for dialogue between the different levels, generating sustainable results in optimising referrals and reducing diagnosis times.
With the next edition about to begin, it constitutes a milestone in collaboration between levels to improve times and equity in the cancer diagnosis process in the northern part of the Metropolitan Region.
The methodology combined presentations with group discussions, in which primary care physicians, hospital doctors, nurses and managers—key players in the design and implementation—shared their experiences, highlighting co-construction and networking as drivers of change. The spirit of the meeting was clearly collaborative; the aim was for other services to learn from and take advantage of these lessons to promote their own participatory processes and adapt solutions to their local needs and contexts.
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