Abstract
The main objective of the study was to analyze the effect of age, period and birth cohort on esophageal cancer mortality in Brazil and its geographic regions, per sex. An ecological study is presented herein, which evaluated the deaths by esophageal cancer and the distribution, per geographic region. Poisson Regression was utilized to calculate the effects of age, period and birth cohort, and projections were made with the statistical software R, using the age-period-cohort model. Projection of data covered the period 2015–2029. Regarding the geographic regions of Brazil, a decrease was verified, throughout time, for the mortality rates of the South and Southeast regions, for men and women. For the North, Northeast and Midwest regions, an increase was evidenced in mortality rates, mainly for men, after the 2000's. Regarding the projections, a progressive increase of mortality rates was verified for the Northeast and North regions. Divergences evidenced for observed and projected esophageal cancer mortality rates revealed inequalities among the geographic regions of Brazil.
Highlights
Esophageal cancer is the eighth most incident type of cancer in the world, and is the sixth cancer-related cause of death, presenting high lethality with global 5-year survival under 15%[1,2,3]
Brazil is a country of continental dimensions, with pronounced socioeconomic disparities and healthcare inequalities, which could explain the differences in the demographic and epidemiologic transition processes experienced by its five geographic regions [25,26]
While the South and Southeast regions present the best socioeconomic indicators, the North and Northeast regions suffer with the worst indicators
Summary
Esophageal cancer is the eighth most incident type of cancer in the world, and is the sixth cancer-related cause of death, presenting high lethality with global 5-year survival under 15%[1,2,3]. Disparities are highlighted in the distribution of this neoplasm around the world, as approximately 80% of cases and mortality occur in developing countries. In this context, the highest incidence and mortality rates are verified in Oriental Asia, Micronesia/Polynesia, and Oriental Africa, while intermediate rates are observed in South America and the Caribbean, and the lowest rates are found in North America, North Europe and Occidental Africa [1,2]. 1979 to 1995, by ICD-9" for deaths that occurred from 1980 to 1995, while the menu "Mortality 1996 to 2015, by CID -10" was accessed to obtain the deaths that occurred from 1996 to 2014 Access to such data occurred without privileged access
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