Race Disparities in Mortality By Breast Cancer From 2000 to 2017 in São Paulo, Brazil: A Time-Series Study

Abstract

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.

Fotobiomodulação para o tratamento de Neuropatia Periférica Induzida por Paclitaxel: uma revisão integrativa

“…Em contrapartida, um estudo com 126 mulheres nos Estados Unidos não mostrou associação com idade, doenças crônicas preexistentes ou estado nutricional, porém observou relação com a raça, evidenciando uma maior incidência de NPIQ em negras ou afroamericanas (estudo 24) 30 . A mortalidade de mulheres negras também é maior se comparada à população branca com a mesma patologia, o que leva a crer que as diferenças socioeconômicas podem influenciar essa correlação, bem como a iniquidade de acesso ao tratamento enfrentada pelas mulheres negras 53 . Quando comparadas às mulheres negras, apresentam menor escolaridade, menor acesso à exames diagnósticos, portanto, maior risco de não terem sido avaliadas para a detecção precoce do câncer de mama.…”