Disparities in cervical and breast cancer mortality in Brazil

Abstract

OBJECTIVE To analyze cervical and breast cancer mortality in Brazil according to socioeconomic and welfare indicators.METHODS Data on breast and cervical cancer mortality covering a 30-year period (1980-2010) were analyzed. The data were obtained from the National Mortality Database, population data from the Brazilian Institute of Geography and Statistics database, and socioeconomic and welfare information from the Institute of Applied Economic Research. Moving averages were calculated, disaggregated by capital city and municipality. The annual percent change in mortality rates was estimated by segmented linear regression using the joinpoint method. Pearson’s correlation coefficients were conducted between average mortality rate at the end of the three-year period and selected indicators in the state capital and each Brazilian state.RESULTS There was a decline in cervical cancer mortality rates throughout the period studied, except in municipalities outside of the capitals in the North and Northeast. There was a decrease in breast cancer mortality in the capitals from the end of the 1990s onwards. Favorable socioeconomic indicators were inversely correlated with cervical cancer mortality. A strong direct correlation was found with favorable indicators and an inverse correlation with fertility rate and breast cancer mortality in inner cities.CONCLUSIONS There is an ongoing dynamic process of increased risk of cervical and breast cancer and attenuation of mortality because of increased, albeit unequal, access to and provision of screening, diagnosis and treatment.

Cancer survival in Brazil: Estimate through the mortality to incidence ratio

“…Survival estimates for cervical cancer have been hampered owing to the under-estimation of mortality due to this cancer. According to Girianelli et al (2014), the mortality rates for cervical cancer are in fact higher than those disclosed in the nation's Mortality Information System (SIM), if they are corrected by the death certificates that give ill-defined causes and, moreover, cases classified as deaths due to malignant neoplasm of the uterus, which are unspecified. According to Gamarra's study, after correction for ill-defined causes and the unspecified portion of the uterus, cervical cancer mortality rates have actually risen by no less than 103.4% for Brazil overall.…”

Risk factors of breast cancer and knowledge about the disease: an integrative revision of Latin American studies

“…In contrast, three authors identified increased educational level as risk factor (Chart 2) 34,36,40 . Decreased educational level may explain increased risk of non-participation on screening programs and BSE in three out of four studies (Chart 2) 22,29,50 .…”

“…In a Chilean study on the relationship between BC and malathion aerial spraying, Cabello et al extracted additional data on BC patients from medical records 47 . Three studies used databases instead of interviews (Chart 1) 35,36,50 . Most studies were case-control (N = 15) or cross-sectional (N = 10) (Chart 1).…”

“…In contrast, two studies from Mexico and Chile that identified higher educational level as risk factor were based on data obtained from hospitals of urban centres (Chart 2) 34,40 . The third study that identified higher educational level as risk factor was based on a large data set of BC mortality rates and selected socioeconomic and health care indicators in Brazil 36 . The latter study included data from urbanized centres and rural regions.…”

Análise de custo-efetividade de estratégias de rastreamento do câncer do colo do útero no Brasil

“…Histerectomia devido ao câncer: no rastreamento, o CCU microinvasivo pode ser detectado e tratado com a histerectomia extrafacial ou radical, indo para os estado de saúde "Histerectomizada (câncer)" ou realizar um procedimento onde há a preservação do colo (e.g., conização), que é o caso de mulheres que desejam manter a fertilidade, geralmente para mulheres com menos de 40 anos probabilidade de transição de infectado por HPV para câncer microinvasivo p 15,2 probabilidade de transição de infectado por HPV para câncer invasivo p 1, 3 probabilidade de transição de NIC I para suscetível p 3,3 probabilidade de NIC I permanecer como NIC I p 4,3 probabilidade de transição de NIC I para NIC II/III p 6,2 probabilidade de detectar e tratar NIC I (permanece por 1 ano em observação) p 5,4 probabilidade de NIC I permanecer em observação após 2 anos de lesão detectada e tratada p 1, 5 probabilidade de transição de NIC I para suscetível após 3 anos de lesão detectada e tratada p 6,6 probabilidade de NIC II/III permanecer como NIC II/III p 7,6 probabilidade de transição de NIC II/III para câncer microinvasivo p 9,6 probabilidade de detectar e tratar NIC II/III (permanece por 1 ano em observação) p 8,7 probabilidade de NIC II/III permanecer em observação após 2 anos de lesão detectada e tratada p 1, 8 probabilidade de transição de NIC II/III para suscetível após 3 anos de lesão detectada e tratada p 9,9 probabilidade de câncer microinvasivo permanecer como câncer microinvasivo p 10, 9 probabilidade de transição de câncer microinvasivo para câncer invasivo p 15,9 probabilidade de detectar e tratar câncer microinvasivo (permanece por 1 ano em observação) (até 39 anos) p 16,9 probabilidade de câncer microinvasivo permanecer em observação após 2 anos de lesão detectada e tratada p 11,10 probabilidade de câncer microinvasivo permanecer em observação após 3 anos de lesão detectada e tratada p ...…”