Disparities in time trends of cervical cancer mortality rates in Brazil

被引:31
|
作者
Vale, Diama Bhadra [1 ,2 ]
Sauvaget, Catherine [1 ]
Muwonge, Richard [1 ]
Ferlay, Jacques [3 ]
Zeferino, Luiz Carlos [2 ]
Murillo, Raul [1 ]
Sankaranarayanan, Rengaswamy [1 ]
机构
[1] Int Agcy Res Canc, Sect Early Detect & Prevent, 150 Cours Albert Thomas, F-69372 Lyon 08, France
[2] Univ Estadual Campinas, Dept Obstet & Gynecol, Caixa Postal 6111, BR-13081970 Campinas, SP, Brazil
[3] Int Agcy Res Canc, Sect Canc Surveillance, 150 Cours Albert Thomas, F-69372 Lyon 08, France
关键词
Mortality; Uterine cervical neoplasms; Population register; Healthcare disparities; SCREENING-PROGRAMS; CORPUS UTERI; DEATH; CARCINOMA; COUNTRIES; BREAST; CARE;
D O I
10.1007/s10552-016-0766-x
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose This study aimed to correct and describe cervical cancer mortality rates and trends by regions and age-groups in Brazil. It may help planning and implementing policies for cervical cancer control. Methods Data from 2003 to 2012 were accessed through the centralized national mortality database. Correction of the age-specific mortality rates was done by proportional redistribution of ill-defined causes of death and deaths coded as 'uterine, part unspecified'. Annual percentage change (APC) was obtained by trend analysis (Joinpoint regression). Results In the 10-year period, cancer and ill-defined causes corresponded, respectively, to 18.9 and 10.8 % of all deaths (except injuries). The proportion of ill-defined causes was reduced by more than a half in the period. The age-standardized cervical cancer mortality rate was 7.2 per 100,000 women-years after correction. The total increase in rates after corrections was 50.5 %. A significant decreasing trend in rates was observed at the national level (APC = -0.17, p < 0.001). North was the only region that did not show a decreasing significant trend (APC + 0.07, p = 0.28). Decreasing trends were restricted to age-groups over 40 years. Conclusions A consistent decreasing trend of cervical cancer mortality rates in Brazil from 2003 to 2012 was observed, although this was not consistent in all regions and restricted to older age-groups. Quality of data needs to be improved. Cancer control policies may consider the differences in access to care and the characteristics of regions to improve their efficiency.
引用
收藏
页码:889 / 896
页数:8
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