Mortality Risk of Colorectal Cancer in Brazil From 1980 to 2013

Abstract

-Background -Colorectal cancer is one of the most common cancer worldwide, and variation in its mortality rates indicates the importance of environmental factors in its occurrence. While trend studies have indicated a reduction in colorectal cancer mortality rates in most developed countries, the same trends have not been observed in developing countries. Moreover, trends may differ when analyzed by age and sex. Objective -The present study aimed to analyze the trends in risk of colorectal cancer death in Brazil based on sex and age group. Methods -Death records were obtained from the Mortality Information System of the Ministry of Health. The risk of death and the average annual percent changes (AAPC) in the mortality rates were estimated using joinpoint analysis of long-term trends from 1980 to 2013. All of the statistical tests were two-sided and had a significance level of 5%.Results -Colorectal cancer mortality rates were found to have increased in the last 15 years for both sexes and for all age ranges. The rate ratio (RR) was statistically higher at ages 70 to 79 for men (RR: 1.37; 95% CI: 1.26; 1.49) compared to women (RR: 1.14; 95% CI: 1.06; 1.24). Increases in AAPC were observed in both sexes. Although men presented higher percent changes (AAPC: 1.8; 95% CI: 1.1; 2.6) compared to women (AAPC: 1.2; 95% CI: 0.4; 2.0), this difference was not statistically significant. Growth trends in mortality rates occurred in all age groups except for in women over 70. Conclusion -Unlike Europe and the US, Brazil has shown increases in death rates due to colorectal cancer in the last three decades; however, more favorable trends were observed in women over 70 years old. The promotion of healthier lifestyles in addition to early diagnosis and improved treatment should guide the public health policies targeting reductions in colorectal cancer.

Magnitude e variação da carga da mortalidade por câncer no Brasil e Unidades da Federação, 1990 e 2015

“…The highest rates were observed in states the south and southeast regions. This increase is in accordance with a study that analyzed the trend of mortality from colorectal cancer from 1980 to 2013 and verified an increased risk of death in both sexes in the country, being higher in men 24 . There was also a trend of increase in mortality from the disease from 1979 to 2010, in both sexes in Latin American countries, particularly Brazil, Chile, and Mexico 25 .…”

Cholecystectomy can increase the risk of colorectal cancer: A meta-analysis of 10 cohort studies

“…It is well known that gene mutations, polyp disease and the long-term effects of anaerobic bacteria (particularly clostridium) on intestinal mucosa play important roles in the pathogenesis of CRC [ 42 , 43 ]. Furthermore, the main physiological function of the gallbladder is to store and concentrate bile acids (BAs) [ 44 ], which is thought to provide a buffer for the effect of bile on the intestinal tract.…”

Describing mortality trends for major cancer sites in 133 intermediate regions of Brazil and an ecological study of its causes

“…In Brazil, 211 thousand (16.14%) of all death certificates in 2016 identified cancer as the underlying cause of death, and it is expected that around 320 thousand will receive a cancer diagnosis in 2019, excluding non-melanoma skin cancers [1]. Incidence rates for several types of cancer are increasing over time in Brazil [2], such as breast [3], colon and rectum [4], pancreas [5], prostate [6], some head and neck cancers [7, 8], and lung cancer in women [9]. Cancer incidence trends, however, vary significantly according to region and sex.…”