Bladder cancer trends and mortality in the brazilian public health system

Abstract

Introduction: Considering the lack of data on BC trends in Brazilian population, mainly as a result of the diffi culty on gathering data, the present manuscript provides an overview of bladder cancer incidence, hospitalization, mortality patterns and trends using the Brazilian Data Center for The Public Health System (DATASUS). Materials and Methods: All hospital admissions associated with BC diagnosis (ICD-10 C67) between 2008 and 2017 were analyzed. Distributions according to year, gender, age group, ethnicity, death, length of hospital stay, and costs were evaluated. Demographic data was obtained from the last Brazilian national census. Results: From 2008 to 2017 there were 119,058 public hospital admissions related to BC. Patients were mostly white males aged 60 to 79 years-old. Mortality rates for patients who have undergone surgery was 6.75% on average, being 7.38% for women and 6.49% for men. Mortality rates were higher when open surgeries were performed compared to endoscopic procedures (4.98% vs 1.18%). Considering only endoscopic procedures, mortality rates were three times higher after urgent surgeries compared to elective ones (2.6% vs 0.6%). Over the years the cystectomy/transurethral bladder resection (C/T) ratio signifi cantly decreased in all Brazilian Regions. In 2008, the C/T ratio was 0.19, while in 2017 it reduced to 0.08. Conclusions: Despite BC relatively low incidence, it still represents a signifi cant social economic burden in Brazil, as it presents with recurrent episodes that might require multiple hospitalizations and surgical treatment. The set of data collected might suggest that population access to health care has improved between 2008-2017.

Mortality from cervical cancer in Brazil: an ecological epidemiologic study of a 22-year analysis

“…To determine the sociodemographic factors that may predict cervical cancer mortality in Brazil, similarly to other developing countries, there are limitations in the quality of data collection with a large number of unknown or unreported data that significantly impair several studies using secondary banks [ 36 ]. Finally, in this study, we did not analyse the mortality rate before 2001 and according to marital status because the national databases do not offer data from the female population, regardless of the presence of cancer.…”

High mortality rates after radical cystectomy: we must have acceptable protocols and consider the rationale of cutaneous ureterostomy for high-risk patients

“…In developing countries, reality seems to be much tougher in the public scenario. We have recently published a study demonstrating a 7.38% in-hospital mortality rate, with a wide variation according to geographic regions, varying from 6.2% in the south to 28.6% in certain regions of the North of Brazil (18). Data from the public health system (DATASUS) in the State of São Paulo, the most populated and wealthier state of Brazil, between 2008-2018 demonstrated amid 1,377 radical cystectomies reported, and 117 in-hospital deaths (8.5%).…”

“…Data from the public health system (DATASUS) in the State of São Paulo, the most populated and wealthier state of Brazil, between 2008-2018 demonstrated amid 1,377 radical cystectomies reported, and 117 in-hospital deaths (8.5%). In the five largest academic institutions in the city of São Paulo that treat exclusively patients from the public health system, in-hospital mortality varied from 6.0% to 15.9% (18). And it is important to state that these numbers represent in-hospital mortality.…”

Mortality after radical cystectomy is strongly related to the institution's volume of surgeries

“…(12) In Brazil, it is estimated 7.23 new cases per 100 thousand men and 2.80 per 100 thousand women, resulting in a relevant social and economic burden to the Brazilian government. (13)(14)(15) From 2008 to 2017, there were 8,925 open surgeries for BC in Brazil, with a mortality rate of 7.5%. (14) São Paulo is the richest and most populated state of Brazil.…”

“…(13)(14)(15) From 2008 to 2017, there were 8,925 open surgeries for BC in Brazil, with a mortality rate of 7.5%. (14) São Paulo is the richest and most populated state of Brazil. It is located in the Southeast Region of the country, which is accountable for as much as 47.2% of all open surgeries for BC in Brazil.…”