Breast cancer mortality and associated factors in São Paulo State, Brazil: an ecological analysis

Abstract

ObjectiveIdentify the factors associated with the age-standardised breast cancer mortality rate in the municipalities of State of São Paulo (SSP), Brazil, in the period from 2006 to 2012.DesignEcological study of the breast cancer mortality rate standardised by age, as the dependent variable, having each of the 645 municipalities in the SSP as the unit of analysis.SettingsThe female resident population aged 15 years or older, by age group and municipality, in 2009 (mid-term), obtained from public dataset (Informatics Department of the Unified Health System).ParticipantsWomen 15 years or older who died of breast cancer in the SSP were selected for the calculation of the breast cancer mortality rate, according to the municipality and age group, from 2006 to 2012.Main outcome measuresMortality rates for each municipality calculated by the direct standardisation method, using the age structure of the population of SSP in 2009 as the standard.ResultsIn the final linear regression model, breast cancer mortality, in the municipal level, was directly associated with rates of nulliparity (p<0.0001), mammography (p<0.0001) and private healthcare (p=0.006).ConclusionsThe findings that mammography ratio was associated, in the municipal level, with increased mortality add to the evidence of a probable overestimation of benefits and underestimation of risks associated with this form of screening. The same paradoxical trend of increased mortality with screening was found in recent individual-level studies, indicating the need to expand informed choice for patients, primary prevention actions and individualised screening. Additional studies should be conducted to explore if there is a causality link in this association.

The Prefectural Participation Rates of Lung Cancer Screening Had a Negative Correlation with the Lung Cancer Mortality Rates

“…Therefore, evaluating the relationship between the cancer mortality and the participation rate of cancer screening is very important. Although several investigators have reported a correlation between the participation rate of other cancer screening and the respective cancer mortality (Cramer, 1974;Lazcano-Ponce et al, 2008;Harding et al, 2015, Diniz et al, 2017Lynge et al, 2017;Yoshida et al, 2018), no reports have explored the relationship between the participation rate of lung cancer screening and the lung cancer mortality.…”

The Revised Champion’s Health Belief Model Scale: Predictive Validity Among Brazilian Women

“…Low rates of mammogram screening have also been found in other low- and middle-income countries around the world, for example, in Tanzania ( Ng’ida et al., 2019 ) and Turkey ( Yılmazel, 2018 ) as well as in the rural Appalachian area of the United States ( VanDyke & Shell, 2017 ). Breast cancer mortality has continued to increase in Brazil ( Diniz et al., 2017 ), in contrast to North American and European countries where mortality has been decreasing ( Siegel et al., 2017 ; Torre et al., 2017 ). Between 2008 and 2013, the total number of breast cancer deaths in Brazil increased by an average of 3.75% per year ( Diniz et al., 2017 ).…”

“…Breast cancer mortality has continued to increase in Brazil ( Diniz et al., 2017 ), in contrast to North American and European countries where mortality has been decreasing ( Siegel et al., 2017 ; Torre et al., 2017 ). Between 2008 and 2013, the total number of breast cancer deaths in Brazil increased by an average of 3.75% per year ( Diniz et al., 2017 ). Thus, it is important to identify factors that are associated with poor participation in mammography screening so that service providers can target health promotion messages and screening programs more effectively.…”

Análise espacial e espaço-temporal dos óbitos por câncer de mama e do colo do útero,município de São Paulo, 2000 a 2016

“…Ainda, entre 1985Ainda, entre -1999 proporcional (PRADO, 2002;MÜLLER, 2009; NEVES e NAFFAH, 2014). gravidez após os 30 anos; ausência ou curto período de aleitamento materno; uso de contraceptivos orais; uso de terapias de reposição hormonal; exposição a radiações ionizantes (mamografia e radioterapia); dieta rica em alimentos processados e ultraprocessados e carnes vermelhas; trabalho por turnos; e uso de sistema privado de saúde (HULKA e STARK, 1995;VINEIS e WILD, 2014;SIU, 2016;SÃO PAULO, 2017;BRASIL, 2017;DINIZ et al, 2017;FIOLET et al, 2018…”

“…. O estudo ecológico de DINIZ et al (2017), no Brasil, também encontrou associação a nível municipal da mortalidade com o rastreamento mamográfico e o uso de serviços privados de saúde.…”