Overall survival and time trends in breast and cervical cancer incidence and mortality in the Regional Health District (RHD) of Barretos, São Paulo, Brazil

Abstract

BackgroundBreast and cervical cancers represent a significant cause of morbidity and mortality among women. The purpose of this study was to analyse the survival and time trends in two of the most common female cancers in the Regional Health District (RHD) of Barretos, São Paulo, Brazil.MethodsFrom 2000 through 2015, we calculated the breast and cervical cancer incidence and mortality rates per 100,000 women who were age-standardized to the world population. We obtained the time trends using the Joinpoint Regression software. We estimated the overall survival rates using the Kaplan-Meier methods.ResultsThe age-standardized rates (ASR) for incidence of breast cancer increased annually, with an average annual percentage change (AAPC) of 4.3 (95% Confidence Interval (CI): 2.4 to 6.3) for invasive breast cancer and 10.2 (95% CI: 6.1 to 14.5) for in situ breast cancer. The mortality rates for invasive breast cancer decreased with an AAPC of 0.2 (95% CI: -1.9 to 2.4). The ASR incidence of invasive cervical cancer showed an AAPC of − 1.9 (95% CI: -4.7 to 0.9). For in situ cases, the ASR showed an AAPC of 9.3 (95% CI: 3.3 to 15.7). The ASR mortality for cervical cancer showed an AAPC of − 5.3 (95% CI: -9.5 to − 0.8). The Kaplan-Meier analysis indicated 5-year overall survival rates of 74.3% for breast cancer and 70.7% for cervical cancer.ConclusionsThe incidence of in situ and invasive breast cancer is increasing, while the mortality rates remain stable. We observed an increase in the incidence of in situ cervical cancer and a decrease in invasive incidence rates during the study period, and we noted that the cervical cancer mortality significantly declined during the study period.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4956-7) contains supplementary material, which is available to authorized users.

Inequalities in the burden of female breast cancer in Brazil, 1990–2017

“…In the present study, when considering the Brazilian regions and states, there was an increase in breast cancer mortality in the seven states, the less developed regions, while the greatest reductions were observed in the more developed regions. These findings were also observed in other Brazilian studies that worked on a subnational scale [ 8 – 13 , 16 , 32 ].…”

Assessing trends of breast cancer and carcinoma in situ to monitor screening policies in developing settings

“…A 5-year survival rate of 72.5% was observed. This is similar to the survival rate in our study estimated by the complement of the mortality-to-incidence ratio, which is also comparable to the survival rates observed in other regions with equal HDI 18,23 . Reis et al .…”

“…Da Costa et al . 23 demonstrated an increase in the incidence of carcinoma in situ , with incidence rates much higher than those found in our study, in the Regional Health District of Barretos, SP, Brazil. This turns out to reflect the policy of mass screening, including the use of mobile mammography, conducted in the region by a cancer-fighting institution.…”

“…The Ministry of Health has recommended prioritizing women aged 50 to 69 years for mammographic screening every two years. However, opportunistic and sometimes organized screening of women under 50 years of age, has also occurred, contrary to official recommendations 23 .…”

“…Whether breast cancer screening results in an earlier diagnosis that improves prognosis or simply contributes to a rise in incidence without decreasing mortality is still a matter of debate. North American and European studies indicate that the 50–69 year age group is the one that benefits from screening practices 11,22,23 . Some medical organizations in those developed countries have started to revise their guidelines accordingly because the increased incidence of breast cancer due to early diagnosis has not had a significant impact on the reduction of mortality.…”