Childhood cancer mortality trends in Brazil, 1979 – 2008

Abstract

OBJECTIVES:Childhood cancer mortality has substantially declined worldwide as a result of significant advances in global cancer care. Because limited information is available in Brazil, we analyzed trends in childhood cancer mortality in five Brazilian regions over 29 years.METHODS:Data from children 0-14 years old were extracted from the Health Mortality Information System for 1979 through 2008. Age-adjusted mortality rates, crude mortality rates, and age-specific mortality rates by geographic region of Brazil and for the entire country were analyzed for all cancers and leukemia. Mortality trends were evaluated for all childhood cancers and leukemia using joinpoint regression.RESULTS:Mortality declined significantly for the entire period (1979-2008) for children with leukemia. Childhood cancer mortality rates declined in the South and Southeast, remained stable in the Middle West, and increased in the North and Northeast. Although the mortality rates did not unilaterally decrease in all regions, the age-adjusted mortality rates were relatively similar among the five Brazilian regions from 2006-2008.CONCLUSIONS:Childhood cancer mortality declined 1.2 to 1.6% per year in the South and Southeast regions.

Analysis of childhood leukemia mortality trends in Brazil, from 1980 to 2010

“…16 Estimativas descrevem que as mortes vinculadas ao tratamento das leucemias linfoides agudas em países menos desenvolvidos oscilam entre 11-20%, e para leucemias mieloides agudas podem chegar a 33%. 19 Com esta pesquisa, concluiu-se que, para as leucemias, de forma geral, ocorreu uma tendência de diminuição nas taxas de mortalidade, assim como em outros estudos. O sistema de informação de mortalidade (SIM) brasileiro foi criado em 1975/1976, sendo um dos mais antigos do Brasil.…”

“…17 Informações sobre qualidade dos dados e a possível ''migração'' dos casos, bem como a heterogeneidade das taxas brasileiras, são limitações do estudo e precisam ser consideradas nas conclusões. 19,20 Porém, em uma análise mais detalhada, verificando subgrupos de leucemias e especificando o sexo, essas tendências se modificaram: enquanto as leucemias linfoides (exceto para a faixa etária de 0 a 4 anos em meninos) e mieloides apresentaram ascendência das taxas, o subgrupo classificado como ''outros tipos de leucemias'' obteve queda. A qualidade dos dados de mortalidade tem melhorado ao longo dos anos, apesar de ainda conter falhas.…”

Analysis of childhood leukemia mortality trends in Brazil, from 1980 to 2010

“…While Brazil generally showed a decreasing trend in the estimated mean annual growth rates of leukemia mortality, there was an increasing trend in the North and Northeast regions. 19 This study demonstrated that for leukemias, in general, there was a decreasing trend in mortality rates, as did other studies. 19,20 However, on a more detailed analysis, when assessing subgroups of leukemias and specifying gender, these trends changed: while the lymphoid (except for the age group of up to four years in boys) and myeloid leukemia rates showed an increase, the subgroup classified as ''other leukemias'' showed a decrease.…”

“…19 This study demonstrated that for leukemias, in general, there was a decreasing trend in mortality rates, as did other studies. 19,20 However, on a more detailed analysis, when assessing subgroups of leukemias and specifying gender, these trends changed: while the lymphoid (except for the age group of up to four years in boys) and myeloid leukemia rates showed an increase, the subgroup classified as ''other leukemias'' showed a decrease. Observing all leukemias and considering gender, mortality rates of males and females showed an increase.…”

Relação entre mortalidade infantojuvenil por leucemia e causas maldefinidas no Brasil segundo regiões, 1996 a 2013

“…Porém, há um padrão de aumento significativo nas regiões Norte e Nordeste, com crescimento médio percentual anual estimado de 2% e 1,7%, respectivamente 6 . Um dos achados deste estudo foi a disparidade dos resultados no que se refere às regiões analisadas.…”