Mortality due to cervical and breast cancer in health regions of Brazil: impact of public policies on cancer care

Data de publicação

Novembro de 2024

Periódico

Public Health

Resumo

Objetives – This analysis assessed the association between regional income, screening coverage for cervical and breast cancer, and temporal trends in mortality from these cancers in different Brazilian health regions.

Study design – Spatiotemporal ecological study across 450 health regions of Brazil.

Methods – Data from 2010 Demographic Census were used to assess income. Variations in income distribution within health regions were measured using the Gini index. Data on screening coverage were obtained from the Ambulatory Information System (SIA/SUS). Mortality was assessed from the Global Burden of Disease Study 2019 data. The average annual percentage change (AAPC) in cervical and breast cancer mortality rates, 2010–2018, was calculated by health regions. Results were presented in regional maps. The associations between income, screening coverage and mortality changes were estimated by bivariate spatial correlation.

Results – Health regions located in the South and Southeast regions of Brazil had the greatest percentages of screening coverage and highest per capita incomes with the lowest Gini index values. From 2010 to 2018, mortality rates for cervical cancer were highest in the North and Northeast health regions. Breast cancer mortality rates were highest in the South and Southeast health regions. The AAPC in breast and cervical cancer mortality had a negative association with per capita income and screening coverage, and a positive association with the Gini index.

Conclusions – There are large regional variations in income, screening coverage, and mortality rates for women with breast and cervical cancer. These inequities could be mitigated by policies to address income disparities and improved access to screening.

DOI/link

https://doi.org/10.1590/S1679-49742021000100017

Autoria

Vínculo institucional

Lattes

Orcid

Mário Círio Nogueira

Universidade Federal de Juiz de Fora, Programa de Pós-Graduação em Saúde Coletiva, Juiz de Fora, MG, Brazil

Maximiliano Ribeiro Guerra

Universidade Federal de Juiz de Fora, Programa de Pós-Graduação em Saúde Coletiva, Juiz de Fora, MG, Brazil

Maria Teresa Bustamante-Teixeira

Universidade Federal de Juiz de Fora, Programa de Pós-Graduação em Saúde Coletiva, Juiz de Fora, MG, Brazil

Gulnar Azevedo e Silva

Universidade do Estado do Rio de Janeiro, Instituto de Medicina Social, Rio de Janeiro, RJ, Brazil

Jeane Tomazelli

Instituto Nacional de Câncer, Divisão de Pesquisa Populacional, Rio de Janeiro, RJ, Brazil

Daniela de Almeida Pereira

Universidade Federal de Viçosa, Viçosa, MG, Brazil

Caroline Madalena Ribeiro

Instituto Nacional de Câncer, Divisão de Detecção Precoce e Apoio à Organização de Rede, Rio de Janeiro, RJ, Brazil

Mohsen Naghavi

University of Washington, Institute for Health Metrics and Evaluation, Seattle, WA, USA

Deborah Carvalho Malta

Universidade Federal de Minas Gerais, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Belo Horizonte, MG, Brazil