Abstract
Stomach cancer is the fourth most common malignant tumor in the world, and although numbers have fallen in recent years, mortality from this cause is still high (1–3). In Brazil, some studies have shown a reduction in mortality from stomach cancer since the 1980s (4, 5), which can be attributed to improved eating habits, food preservation, and treatment of Helicobacter pylori infection (6, 7). In addition, there were significant advances related to socioeconomic development and the reduction of inequalities and socioeconomic inequities, which improved the population's access to health care and reduced the morbidity and mortality of diseases such as breast cancer (8–10). Brazil is a middle-income country characterized by great internal heterogeneity (11, 12). It is notorious that poverty in Brazil has a location (13) and, in terms of disparities, the country has a very striking feature that is the regional inequalities, where the north and northeast regions have the worst indicators. The central region has intermediate rates, and the south and southeast are the best conditions, regardless of the socioeconomic indicator being evaluated (14). These social inequalities in the country still today directly reflect on health inequality, explaining the unfavorable scenarios for the north and northeast, and a very evident polarization in relation to the south and southeast (15). The country presents regions with different socioeconomic characteristics, which impacts health services, lifestyle, and socio-cultural aspects. In other words, there are developed regions with high technology for cancer-oriented health services and underdeveloped regions that cannot properly treat and diagnose its citizens (16). Thus, considering that Brazil is a country with territorial extension of continental characteristics and high socioeconomic plurality, and that the mortality due to stomach cancer is related to the socioeconomic status of the site, what level of development does the behavior of stomach cancer mortality in Brazil follow? Thus, the aim of this study was to describe the temporal trend of stomach cancer mortality in Brazil from 1990 to 2016, analyzing its behavior in relation to low, middle, and high income countries.
Highlights
Stomach cancer is the fourth most common malignant tumor in the world, and numbers have fallen in recent years, mortality from this cause is still high [1,2,3]
In Brazil, some studies have shown a reduction in mortality from stomach cancer since the 1980s [4, 5], which can be attributed to improved eating habits, food preservation, and treatment of Helicobacter pylori infection [6, 7]
With regard to socioeconomic status, stomach cancer mainly affects middle-income countries. In these countries, ∼25 people die from stomach cancer per 100,000 inhabitants, representing 2.3% of all deaths from known causes and 12.3% of deaths from some form of cancer
Summary
Stomach cancer is the fourth most common malignant tumor in the world, and numbers have fallen in recent years, mortality from this cause is still high [1,2,3]. There were significant advances related to socioeconomic development and the reduction of inequalities and socioeconomic inequities, which improved the population’s access to health care and reduced the morbidity and mortality of diseases such as breast cancer [8,9,10]. The central region has intermediate rates, and the south and southeast are the best conditions, regardless of the socioeconomic indicator being evaluated [14]. These social inequalities in the country still today directly reflect on health inequality, explaining the unfavorable scenarios for the north and northeast, and a very evident polarization in relation to the south and southeast [15]
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