[Clinical coordination and strengthening of primary care for cancer diagnosis in Latin America: a scoping reviewCoordenação clínica e fortalecimento da atenção primária no diagnóstico do câncer na América Latina: revisão de escopo].

Objective: To summarize the knowledge available in Latin America about clinical coordination (CC) between levels of care, the knowledge of primary care (PC) providers about cancer diagnosis, associated factors, and interventions for the improvement thereof. Methods: A scoping review was conducted in the MEDLINE, LILACS, and SciELO databases. After reviewing titles, abstracts, and full texts, data on study characteristics and main results were extracted and synthesized in accordance with the conceptual framework of CC. Results: Of 4,937 records identified, 20 were included, mostly from Brazil and Mexico, covering breast, cervical, and oral cancer. Very few studies analyzed CC in cancer diagnosis; those that did reported issues in both management coordination and clinical information. Additionally, limited knowledge of signs and symptoms that should prompt diagnostic suspicion and limited adherence to clinical practice guidelines were identified among PC providers. No interventions to improve CC were identified. Studies of those aimed at improving diagnostic suspicion did not assess intermediate outcomes, although a reduction in time to diagnosis was demonstrated. Conclusions: There is a significant knowledge gap in Latin America regarding CC in cancer diagnosis, and few interventions to improve diagnostic capacity in the PC setting. Strengthening PC and improving CC is essential to reducing diagnostic delays that contribute to cancer mortality in fragmented health systems, such as those of Latin America, which entails significant challenges for research in the region.