Disparities in cervical and breast cancer mortality in Brazil
Disparities in cervical and breast cancer mortality in Brazil
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DOI：
10.1590/s0034-8910.2014048005214
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发表时间：
2014-06-01
期刊：
影响因子：
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通讯作者：
Azevedo e Silva, Gulnar
中科院分区：
文献类型：
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作者：
Girianelli, Vania Reis;Gamarra, Carmen Justina;Azevedo e Silva, Gulnar
目的：根据社会经济和福利指标分析巴西的宫颈癌和乳腺癌死亡率。方法：分析巴西30年来(1980-2010年)的乳腺癌和宫颈癌死亡率数据。这些数据来自国家死亡率数据库，来自巴西地理和统计研究所的人口数据，以及来自应用经济研究所的社会经济和福利信息。移动平均数被计算出来，按首府城市和直辖市分类。死亡率的年度百分比变化通过使用连接点方法的分段线性回归来估计。皮尔逊相关系数在州首府和巴西各州三年结束时的平均死亡率和选定的指标之间进行。结果：除了北部和东北部首府以外的城市，宫颈癌死亡率在整个研究期间都有所下降。自1990年代末以来，首都的乳腺癌死亡率有所下降。有利的社会经济指标与宫颈癌死亡率呈负相关。结论：由于筛查、诊断和治疗机会的增加和提供的不平等，宫颈癌和乳腺癌的风险增加，死亡率下降，这是一个持续的动态过程。
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.