Abstract P1-11-08: The impact of social inequalities on breast cancer mortality in Brazil

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Abstract Introduction: Female breast cancer mortality has decreased considerably in developed nations. In contrast, an increase has been observed in developing countries. Objective: To describe the impact of social inequalities in female breast cancer mortality in Brazil, between the years of 1990 and 2011. Methods: Breast cancer mortality data and estimates for the resident population were obtained from the Brazilian National Health Service (SUS) database for the 1990-2011 period. Age-standardized mortality rates were calculated (20-39, 40-49, 50-69 and ≥70 years) by direct standardization using the 1960 standard world population. Trends were modeled using linear regression, with mortality rates as the dependent variable and the year of death as the independent variable. The Social Exclusion Index (SEI) and the Human Development Index (HDI) were used to classify the 27 Brazilian states. Pearson’s correlation was used to describe the association between the SEI and the HDI and the variations in mortality rates in each state. Results: Age-standardized mortality rates in Brazil were found to be stable (annual percent change [APC] = 0.32; 95%CI: -0.1 – 0.7). Statistically significant decreases in mortality rates were found in the states of Rio Grande do Sul, Rio de Janeiro and São Paulo. Increases in mortality rates were most notable in the states of Maranhão (APC = 11.2; 95%CI: 5.8 – 16.9), Piauí (APC = 9.8; 95%CI: 7.6 – 12.1) and Paraíba (APC = 9.3; 95%CI: 6.0 – 12.8). There was a statistically significant correlation between SEI and a change in female breast cancer mortality rates in the Brazilian states between 1990 and 2011 and between HDI and mortality between 2001 and 2011. This reduction was most notable in the Brazilian states with better socioeconomic conditions. Conclusions: It was observed a direct impact of social inequalities in female breast cancer mortality rates in Brazil. Reductions in these rates were found in the more developed states, possibly reflecting a better local healthcare. Citation Format: Ruffo Freitas-Junior, Carolina M Gonzaga, Maria-Paula Curado, Ana-Luiza L Sousa, Marta R Souza. The impact of social inequalities on breast cancer mortality in Brazil [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-11-08.