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