Geographic Variation in Diagnosis, Treatment, and Outcomes of Adrenocortical Carcinoma in the Americas: A Narrative Review.
5 affiliations
- 1Department of Clinical Oncology, AC Camargo Cancer Center, São Paulo , São Paulo, Brazil.
- 2Endocrine Oncology Section, Developmental Therapeutics Branch, National Cancer Institute (NCI), National Institutes of Health (NIH) , Bethesda, Maryland, USA.
- 3Instituto de Oncología Ángel H. Roffo , Buenos Aires, Argentina.
- 4Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Ribeirão Preto , São Paulo, Brazil.
- 5Division of Endocrinology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo (HC-FMUSP) , São Paulo, Brazil.
Abstract
Objective
Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy of the adrenal cortex. Given the heterogeneity of healthcare systems across the Americas, this review examines regional differences in access to diagnosis, treatment availability, and clinical outcomes, as well as their association with structural and socioeconomic factors.Design
Narrative literature review of observational studies and relevant regional evidence.Methods
PubMed, Scopus, and Web of Science were investigated for studies published between 2010 and 2025 reporting on diagnostic resources, treatment availability, clinical outcomes, or ACC-related population-specific genetic epidemiology across the Americas and the Caribbean. Due to substantial heterogeneity in study design, populations, and outcome measures, results were synthesized narratively and organized by geographic region and thematic domain.Results
Available evidence, particularly from the United States, indicates greater representation of high-volume referral centers, specialized multidisciplinary care, and structured diagnostic and treatment pathways. Conversely, reports from selected settings in Central and South America and the Caribbean describe limitations related to healthcare funding, fragmented care networks, and access to specialized therapies. These differences may be associated with diagnostic delays and reduced access to specialized treatment; however, the strength, depth, and comparability of the available evidence vary substantially across regions.Conclusions
Available evidence indicates regional variation in ACC diagnosis, treatment access, and reported outcomes across the Americas. Structural, socioeconomic, and geographic factors may contribute to these differences. Potential priorities include strengthening referral pathways, expanding specialized care, and supporting multidisciplinary management. More representative data are needed to enable robust regional comparisons and guide context-specific strategies.
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BibTeX
@article{tanaka2026geographic,
title = {{Geographic Variation in Diagnosis, Treatment, and Outcomes of Adrenocortical Carcinoma in the Americas: A Narrative Review.}},
author = {Hugo Tanaka and George I Karadimov and María Laura Iglesias and Mariano Dioca and Luis Eduardo C Pinto and Sonir R Antonini and Maria C B V Fragoso and Jaydira Del Rivero},
journal = {Endocrine oncology (Bristol, England)},
year = {2026},
month = oct,
doi = {10.1530/eo-26-0043},
url = {https://europepmc.org/article/MED/42847807},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Geographic Variation in Diagnosis, Treatment, and Outcomes of Adrenocortical Carcinoma in the Americas: A Narrative Review.
AU - Hugo Tanaka
AU - George I Karadimov
AU - María Laura Iglesias
AU - Mariano Dioca
AU - Luis Eduardo C Pinto
AU - Sonir R Antonini
AU - Maria C B V Fragoso
AU - Jaydira Del Rivero
PY - 2026
DA - 2026/10/08
JO - Endocrine oncology (Bristol, England)
DO - 10.1530/eo-26-0043
UR - https://europepmc.org/article/MED/42847807
AB - Objective Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy of the adrenal cortex. Given the heterogeneity of healthcare systems across the Americas, this review examines regional differences in access to diagnosis, treatment availability, and clinical outcomes, as well as their association with structural and socioeconomic factors.Design Narrative literature review of observational studies and relevant regional evidence.Methods PubMed, Scopus, and Web of Science were investigated for studies published between 2010 and 2025 reporting on diagnostic resources, treatment availability, clinical outcomes, or ACC-related population-specific genetic epidemiology across the Americas and the Caribbean. Due to substantial heterogeneity in study design, populations, and outcome measures, results were synthesized narratively and organized by geographic region and thematic domain.Results Available evidence, particularly from the United States, indicates greater representation of high-volume referral centers, specialized multidisciplinary care, and structured diagnostic and treatment pathways. Conversely, reports from selected settings in Central and South America and the Caribbean describe limitations related to healthcare funding, fragmented care networks, and access to specialized therapies. These differences may be associated with diagnostic delays and reduced access to specialized treatment; however, the strength, depth, and comparability of the available evidence vary substantially across regions.Conclusions Available evidence indicates regional variation in ACC diagnosis, treatment access, and reported outcomes across the Americas. Structural, socioeconomic, and geographic factors may contribute to these differences. Potential priorities include strengthening referral pathways, expanding specialized care, and supporting multidisciplinary management. More representative data are needed to enable robust regional comparisons and guide context-specific strategies.
SN - 2634-4793
ER -