Background In Brazil, inequalities in access may interfere with cancer care. This study aimed to evaluate the influence of race on breast cancer mortality in the state of São Paulo, from 2000 to 2017, contextualizing with other causes of death. Methods A population-based retrospective study using mortality rates, age and race as variables. Information on deaths was collected from the Ministry of Health Information System. Only white and black categories were used. Mortality rates were age-adjusted by the standard method. For statistical analysis, linear regression was carried out. Results There were 60,940 deaths registered as breast cancer deaths, 46,365 in white and 10,588 in black women. The mortality rates for 100,000 women in 2017 were 16.46 in white and 9.57 in black women, a trend to reduction in white (p = 0.002), and to increase in black women (p = 0.010). This effect was more significant for white women (p < 0.001). The trend to reduction was consistent in all age groups in white women, and the trend to increase was observed only in the 40–49 years group in black women. For ‘all-cancer causes’, the trend was to a reduction in white (p = 0.031) and to increase in black women (p < 0.001). For ‘ill-defined causes’ and ‘external causes’, the trend was to reduce both races (p < 0.001). Conclusion The declared race influenced mortality rates due to breast cancer in São Paulo. The divergences observed between white and black women also were evident in all cancer causes of death, which may indicate inequities in access to highly complex health care in our setting.

Background Breast cancer is the main cause of female death by neoplasia in Brazil. Although half of the Brazilian population is black/brown (BB), socio-economic disparities translate in a vulnerable situation to those women. Access to health care is an important barrier to improve the health of BB women. This study aims to investigate trends in breast cancer mortality rates regarding race and age. Methods This is a population-based study of trends evaluation on breast cancer mortality in São Paulo state, Brazil, from 2000 to 2017. The absolute number of deaths and population figures (including race) by age-groups and years were available online from government data. Data on race were not available by ten-year age-groups, so the figures were projected according to the female age structure by year. Total rates by year and race were age-adjusted to the 'World Population (2000)'. For trend analysis, linear regression was used, with 5% level of significance. Results In the period were observed 60,940 breast cancer deaths, 76.7% in white and 17.5% in BB women. The absolute number of deaths in white and BB women was respectively 2,095 and 333 in 2000, and 3,076 and 999 in 2017. The total age-adjusted mortality rates per 100,000 women of white and BB in 2000 were respectively 16.4, 17.2 and 7.5. In 2017 rates were 14.6, 16.6 and 16.1. There was a trend towards reducing the mortality rates of white women (P = 0.002) and in their age-groups from 40 to 79 years (P &lt; 0.03). There was a trend towards increasing the mortality rates of BB women (P &lt; 0.001) and in all their age-groups (P &lt; 0.02). Conclusions Although breast cancer figures of death and mortality rates in BB women have more than doubled in 18 years, rates reached almost the same figures of white women in the period. Changes in behaviour risk factors may explain this result. However, it is very likely that access to health care to these women has been improved, reducing the disparities in the health system. Key messages Breast cancer mortality rates in black/brown women have reached almost the same figures as white women from 2000 to 2017 in São Paulo, Brazil. Access to health care in black women may have improved in São Paulo, Brazil.

Background In Brazil, inequalities in access to care are present. This study aimed to evaluate the influence of race on breast cancer mortality in the state of São Paulo, from 2000 to 2017, contextualizing with other causes of death. Methods A retrospective cross-sectional time-series study using age and race as variables. Information on deaths was collected from the Ministry of Health Information System. Only white and black/brown categories were used. Mortality rates were age-adjusted by the standard method. For statistical analysis, trend-tests were carried out. Results: There were 60,940 deaths registered as breast cancer deaths, 46,365 in white and 10,588 in black women. The mortality rates for 100,000 women in 2017 were 16.46 in white and 9.57 in black women, a trend to reduction in white (p=0.002), and to increase in black women (p=0.010). This effect was more significant for white women (p<0.001). The trend to reduction was consistent in all age groups in white women, and the trend to increase was observed only in the 40-49 years group in black women. For 'all-cancer causes', the trend was to a reduction in white (p=0.031) and to increase in black women (p<0.001). For 'ill-defined causes' and 'external causes', the trend was to reduce both races (p<0.001). Conclusion The declared race influenced mortality rates due to breast cancer in São Paulo. The divergences observed between white and black women also were evident in all cancer causes of death, which may indicate inequities in access to highly complex health care in our setting.

Purpose To evaluate the influence of race on breast cancer mortality, this work aims to demonstrate the evolution of rates in the state of São Paulo, from 2000 to 2017, contextualizing with other causes of death. Methods A retrospective cross-sectional time-series study using age and race as variables. Information on deaths was collected from the Ministry of Health Information System. Only white and black/brown categories were used. Mortality rates were age-adjusted by the standard method. For statistical analysis trend-tests were carried out. Results In the period there were 60,940 deaths registered as breast cancer deaths, 46,365 in white and 10,588 in black women. The rates for 100,000 women in 2017 were 16.46 in white and 9.57 in black women, a trend to reduction in white (p=0.002), and to increase in black women (p=0.010). This effect was more significant for white women (p<0.001). The trend to reduction was consistent in all age-groups in white women, and the trend to increase was observed only in the 40-49 years group in black women. For ‘all-cancer causes’ the trend was to a reduction in white (p=0.031) and to increase in black women (p<0.001). For ‘ill-defined causes’ and ‘external causes’, the trend was to a reduction in both races (p<0.001). Conclusion Mortality rates due to breast cancer in São Paulo were influenced by race. The divergences observed between white and black women may indicate differentiated access to health resources, contributing to the inequities that exist in the health of the black population in our setting.