Cancer mortality among indigenous people in western amazon

Abstract

TPS 723: Low and middle income countries: sanitation infections and other health effects, Exhibition Hall, Ground floor, August 26, 2019, 3:00 PM - 4:30 PM Aim: to estimate the cancer mortality and cancer Standardized Mortality Ratio (SMR) in western Amazon indigenous population. Methods: A cancer mortality descriptive study was accomplished among indigenous people in the state of Acre, Brazil, located in the western Amazon region. Cancer deaths diagnosed from January 1, 2000 to December 31, 2012 were obtained from Death Certificate Information System. Population at risk was obtained from the Brazilian Institute of Geography and Statistics. Cancer deaths distributions stratified by sex, age, and ethnic group were proceeded according to anatomic sites. The SMR, with 95% confidence intervals, were estimated using the cancer-mortality rates of Goiania, Acre state, and Brazilian North region as references. Results: A total of 81 cancer-deaths among indigenous people were recorded from 2000-2012, mostly among men (59.3%), those aged 70+ (37%), and Huni Kuin/Kaxinawá ethnic group (38.8%). Among men, the main cancer sites were stomach(27.1%), liver(18.7%), colorectal(8.3%), leukemia(8.3%), and prostate(8.3%); while among women were cervix(36.4%), stomach(12.1%), liver(6.1%), leukemia(6.1%), and uterus(6.1%). In men, cancer deaths excess were observed for stomach as compared to men from Goiânia(SMR=2.72;95%CI:2.58-2.87), Acre state(SMR=2.05;95%CI:1.94-2.16), and North region(SMR=3.10;95%CI:2.93-3.27); and also for liver comparing to Goiânia(SMR=3.89;95%CI:3.66-4.14), Acre state(SMR=1.79;95%CI:1.68-1.91), and North region(SMR=4.04;95%CI:3.77-4.30). In women, cancer deaths excess were observed for cervix as compared to cervical cancer rates from Goiânia(SMR=4.67;95%CI:4.41-4.93), Acre state(SMR=2.12;95%CI:2.00-2.24), and North region(SMR=2.60;95%CI:2.45-2.75). Conclusion: Cancer mortality among indigenous people from western Amazon affected mainly men, elderly people (aged 70+), and Huni Kuin/Kaxinawá ethnic group. In men, stomach and liver cancer-deaths excess were observed among indigenous people comparing to non-indigenous population from Goiania, Acre state, and North region. In women, a cervical cancer-death excess were observed among indigenous people comparing to non-indigenous population from the same areas. It suggests that indigenous people in western Amazon have lack of cancer prevention, diagnosis and treatment access, as compared to non-indigenous population in the same area.