Mortality due to breast cancer in a region of high socioeconomic vulnerability in Brazil: Analysis of the effect of age-period and cohort

Abstract

Introduction Breast cancer is an important public health problem worldwide, with important disparities in incidence, mortality, and survival rates between developed and developing countries due to inequalities regarding access to measures for the prevention and treatment of the disease. In Brazil, there are higher rates of incidence and a downward trend in mortality in regions of greater socioeconomic development. Objective To evaluate the effect of age, period, and birth cohort on breast cancer mortality in women aged 20 years and older in the states of the Northeast Region of Brazil, an area of high socioeconomic vulnerability, from 1980 to 2019. Methods The death records were extracted from the DATASUS Mortality Information System website (Department of National Health Informatics) from the Ministry of Health of Brazil. Estimable functions were used to estimate the age-period and cohort models (APC) using the Epi library from the R statistical software version 6.4.1. Results The average breast cancer mortality rate for the period was 20.45 deaths per 100,000 women. The highest coefficients per 100,000 women were observed in the states of Pernambuco (21.09 deaths) and Ceará (20.85 deaths), and the lowest in Maranhão (13.58 deaths) and Piauí (15.43 deaths). In all of the locations, there was a progressive increase in mortality rates in individuals over 40 years of age, with higher rates in the last five-year period (2015–2019). There was an increase in the risk of death for the five-year period of the 2000s in relation to the reference period (1995–1999) in the Northeast region and in the states of Alagoas, Bahia, Maranhão, Paraíba, and Piauí. In addition, there was an increased risk of death for women born after the 1950s in all locations. Conclusion The highest mortality rates in all five-year periods analyzed were observed in states with greater socioeconomic development, with an increase in mortality rates in the 2000s, and a higher risk of death in the younger cohorts.

Impacts of Sociodemographic Factors, Screening, and Organization of Health Services on Breast Cancer Mortality in Brazil: An Ecological Study of 20 Years

“…In this context, Brazil finds itself enmeshed in an intricate tapestry of internal disparities with regard to breast cancer mortality metrics. The influence exerted by socioeconomic factors upon breast cancer mortality outcomes resonates harmoniously with the findings gleaned from parallel Brazilian investigations, thereby coalescing into a collective narrative that strives to unravel shared patterns and incongruities [ 43 , 44 ].…”

Tendência da taxa de mortalidade por câncer de mama em mulheres com 20 anos ou mais no Brasil, 2005-2019

“…Embora a tendência tenha sido crescente em todas as regiões, observou-se maior crescimento nas regiões Nordeste e Norte. Resultados de outros estudos 5,23,24,26 enquanto as regiões Sul e Sudeste apresentam tendências decrescentes das taxas. Contudo, as maiores taxas de mortalidade padronizadas por câncer de mama ainda se encontram em estados do Sudeste e do Sul.…”

“…As maiores taxas são nas regiões Sudeste (12,6 óbitos por 100.000 mulheres) e Sul (12,8 óbitos por 100.000 mulheres), regiões com maior índice de desenvolvimento no país. 4 O câncer de mama é multifatorial, sendo associado a fatores ambientais (exposição frequente a radiações ionizantes, gases atmosféricos tóxicos e microrganismos patogênicos), comportamentais (inatividade física, hábitos alimentares não saudáveis, tabagismo e excesso de peso), história reprodutiva e hormonal (menarca antes de 12 anos, nuliparidade, primeira gestação após os 30 anos, menopausa após os 55 anos, uso de contraceptivos hormonais, reposição hormonal) e fatores genéticos e hereditários (histórico familiar de câncer de mama e alteração genética, principalmente nos breast cancer genes 1 e 2), entre outros determinantes [5][6][7] .…”

“…Além desses fatores, ressalta-se que o envelhecimento é um fator importante que tem contribuído para o aumento da magnitude do câncer de mama nos países, como no Brasil [5][6][7] . Alinhado ao envelhecimento, os determinantes sociais de saúde (DSS), sobretudo o baixo nível socioeconômico, têm mostrado associação com taxas de mortalidade por câncer de mama mais elevadas.…”

Peripheral intravenous catheter-induced phlebitis in a tertiary hospital of Karachi: A cohort study

“…By 2040, 67% of such patients will inhabit low or middleincome countries (Wilson et al, 2019). Survival rates from cancer have improved, with five-year survival increasing from 45% to 61% in the past decade and 5-year survival for breast cancer now stands at 82% (Dantas de Araújo Santos Camargo et al, 2021). The emergence of immunotherapy and targeted agents to treat cancer has contributed to this.…”