Temporal trends in female breast cancer
mortality in Brazil:
Correlations with social inequalities
Carolina M R Gonzaga1, Ruffo Freitas-Junior1,2, Maria-Paula Curado1,2,3, AnaLuiza L Sousa1, José-Augusto Souza-Neto1, Marta R Souza1
1Federal
University of Goias (UFG), Goiania, Goias, Brazil.
2 Hospital Araujo Jorge, Goias Anticancer Association (ACCG), Goiania, Goias, Brazil.
3International Prevention Research Institute (IPRI) Lyon, France.
Conflicts of Interest and Source of Funding:
Carolina M R Gonzaga received a scholarship from CAPES (Coordenação de
Aperfeiçoamento de Pessoal de Nível Superior). None of the other authors
have any conflicts of interest to declare.
Introduction
Goiás Mastology Research Network
Figure 1. Female breast cancer mortality rates in the
macro-regions of Brazil from 1980 to 2009.
Figure 2. Distribution of female breast cancer
mortality rates in states of Brazil: 2009.
Figure 3. Female breast cancer mortality rates in Urban
Centers e Rural areas of Brazil from 1980 to 2010.
Introduction
Objective: to describe the temporal trends in female
breast cancer mortality between 1990 and 2011 and
their correlation with social inequalities in Brazil.
Figure 4. Temporal trends in female breast cancer mortality rates (A. Southeast; B. Parana; C. Rio de Janeiro; D. Maranhao)
Materials and Methods
Design: Ecological time-series study.
Brazilian National Health Service (SUS) database:
Mortality and population: 1990-2011.
Age-specifc and age-standardized mortality rates (≥20 years).
Trends: joinpoint regression model and linear regression.
HDI
Figure 5. Map of the Human Development Index, Brazil, 2000 and 2010.
Materials and Methods
SEI
Pearson’s correlation association between the SEI
and the HDI and the variations
in mortality rates in each state.
MINISTÉRIO DA EDUCAÇÃO
UNIVERSIDADE FEDERAL DE
GOIÁS
PRÓ-REITORIA DE PESQUISA E
PÓS-GRADUAÇÃO
COMITÊ DE ÉTICA EM
PESQUISA/CEP PROTOCOLO
CEP: 75793
Figure 6. Map of social exclusion, Brazil, 2000
Results
Mortality rate (per 100.000)
Total (1990-2011): 195,596 deaths
85,1
80,1
75,1
70,1
65,1
60,1
55,1
50,1
45,1
40,1
35,1
30,1
25,1
20,1
15,1
10,1
5,1
0,1
20-39 years
40-49 years
50-69 years
≥70 years
BRAZIL
Figure 7. Age-specific and age-standardized female breast cancer mortality rates according
to year: Brazil, 1990-2011.
Rio de Janeiro (17.22/100,000) | Maranhão (3.28/100,000)
Results
Brazil (APC = 0.3; 95%CI: -0.1 – 0.7)
Results
Statistically significant decrease:
3 states
Results
Results
Results
No significant decrease: 2 states
Results
Results
Increasing trends: 18 states
Results
Results
Results
(r = -0.75; p<0.001)
(r = -0.79; p<.001)
Conclusions
Conclusions
Considerable inequalities are found, with rate decline or
stabilization in states with higher socioeconomic levels and a
substantial rate increase in those with lower socioeconomic
levels.
Reductions in these rates were found in the more developed
states, possibly reflecting better healthcare.
Limitations
The use of the mortality data from the mortality data system
is subject to correction due to an under-registration of deaths
that is unfortunately common in less developed areas.
Social inequality: Our common goal should
be to remove that enormous barrier to
development and human dignity.
Desigualdade social: Nosso objetivo comum
deve ser remover essa enorme barreira ao
desenvolvimento e à dignidade humana.
Thank You
Carolina Maciel Reis Gonzaga
[email protected]