Evolution of Mortality for Colorectal Cancer in Brazil and Regions, by Sex, 1996-2015

Abstract

BACKGROUND: Colorectal cancer is among the three most frequent neoplasms in Brazil, being a public health problem. OBJECTIVE: To describe distribution pattern of colorectal cancer mortality in Brazil and regions, according to sex, between 1996 and 2015. METHODS: Values of standardized and stratified mortality rates by sex between 1996 and 2015 were used, through polynomial regression models and joinpoint analysis. RESULTS: It was observed that, for linear trends in mortality rates, for both sexes, there is a statistically significant trend increasing in both models, with rates and trends, and higher for men than for women, respectively, 7.3% per year (R2=0.95, P<0.001) and 6.5% per year (R2=0.87, P<0.001). It is observed a difference in magnitude and behavior of trend between the regions. CONCLUSION: It is understood that it is important to know the trend of rates in order to define priority populations for early interventions that increase survival and reduce mortality.

Reported mortality for colorectal cancer in Brazil in the first 16 years of the 21st century

“…The impact of cancer mortality is significantly higher in regions with a high human development index (HDI), accounting for 40% of global disease burden but only 15% of the world population. While in low HDI regions, the impact is only 2% for 6% of the population 24 .…”

“…For decades in Brazil, there has been an increase in the longevity of the population 22 , which also contributes to this growth in CRC cases. In a historical CRC cohort conducted in Rio de Janeiro, men began to show significant increases in mortality at age 55 years and women at age 40 years 24 .…”

“…In a study conducted in New Orleans, United States, the average time between onset of symptoms and diagnosis of neoplasia was 4.9 months, while in a Brazilian sample the average time was 9.1 ± 3.6 months. This delay between first clinical presentation and diagnosis is mainly due to administrative and structural difficulties in performing the exams, lack of interest or personal denial of health condition 24 .…”

Quipazine Elicits Swallowing in the Arterially Perfused Rat Preparation: A Role for Medullary Raphe Nuclei?

“…Despite extensive experimental and clinical studies, swallowing remains one of the most important and least appreciated functions [ 1 ]. Dysfunctions in the brainstem’s swallowing central pattern generator (swCPG) and other medullary or supra-medullary structures may be an important causal factor of oropharyngeal dysphagia, a severe disease whose neural pathophysiology remains poorly understood [ 2 , 3 , 4 ].…”

“…The aims of our study were (1) to investigate the effects of QPZ on swallowing and breathing in situ, (2) to compare swallowing motor patterns and swallow-breathing phase relationship between spontaneous and QPZ-induced swallows, and (3) to identify brainstem nuclei mediating the stimulatory effect of QPZ on swallowing. Identifying both the neural structures and neurotransmitters (or neuromodulators) involved in swallowing represents one of the challenges to better understand this important function, and to find therapeutic strategies for patients suffering from swallowing disorders [ 1 , 2 , 3 , 24 , 25 , 26 ].…”