Analysis of the effects of the age-period-birth cohort on cervical cancer mortality in the Brazilian Northeast

Abstract

Cervical cancer (CC) is a public health problem with a high disease burden and mortality in developing countries. In Brazil, areas with low human development index have the highest incidence rates of Brazil and upward temporal trend for this disease. The Northeast region has the second highest incidence of cervical cancer (20.47 new cases / 100,000 women). In this region, the mortality rates are similar to rates in countries that do not have a health system with a universal access screening program, as in Brazil. Thus, this study aimed to analyze the effects of age, period and birth cohorts on mortality from cervical cancer in the Northeast region of Brazil. Estimable functions predicted the effects of age, period and birth cohort. The average mortality rate was 10.35 deaths per 100,000 women during the period analyzed (1980-2014). The highest mortality rate per 100,000 women was observed in Maranhão (24.39 deaths), and the lowest mortality rate was observed in Bahia (11.24 deaths). According to the period effects, only the state of Rio Grande do Norte showed a reduction in mortality risk in the five years of the 2000s. There was a reduction in mortality risk for birth cohorts of women after the 1950s, except in Maranhão State, which showed an increasing trend in mortality risk for younger generations. We found that the high rates of cervical cancer mortality in the states of northeastern Brazil remain constant over time. Even after an increase in access to health services in the 2000s, associated with increased access to the cancer care network, which includes early detection (Pap Test), cervical cancer treatment and palliative care. However, it is important to note that the decreased risk of death and the mortality rates from CC among women born after the 1960s may be correlated with increased screening coverage, as well as increased access to health services for cancer treatment observed in younger women.

Temporal Trends in Notification and Mortality of Tuberculosis in China, 2004–2019: A Joinpoint and Age–Period–Cohort Analysis

“…Res. Public Health 2021, 18, 5607 2 of 11 factors influencing disease incidence and mortality [8]. Considering that previous studies in China possibly ignored the interaction between age, period and cohort effects [9,10], we used an age-period-cohort (APC) model to simultaneously calculate these three variables [11].…”

“…This study also aimed to estimate age, period and cohort effects on TB notification and mortality in mainland Chinese residents. Age, period and cohort are usually three key factors influencing disease incidence and mortality [ 8 ]. Considering that previous studies in China possibly ignored the interaction between age, period and cohort effects [ 9 , 10 ], we used an age–period–cohort (APC) model to simultaneously calculate these three variables [ 11 ].…”

Cervical cancer mortality in Peru: regional trend analysis from 2008–2017

“…The greater access to health care services and socioeconomic income of the population in this region further explains the findings of this study [ 3 , 7 ]. Similarly, studies in Brazil and the United States reported a lower mortality rates in states with both higher human development indexes and economic incomes [ 38 , 39 ]. Nevertheless, it is to be expected that rapid access to healthcare facilities and the availability of therapy would result in lower mortality trends in the coastal region.…”

Mortality due to breast cancer in a region of high socioeconomic vulnerability in Brazil: Analysis of the effect of age-period and cohort

“…The risk of death was estimated by relative risk (RR) estimates and 95% confidence intervals according to period and cohort effects. Estimates for the Age Period and Cohort models were made using the Epi library 1.1.18 (R Foundation of Computational Statistics, Vienna, Austria http://www.r-project.org) of the R program (version 4.1) [25].…”