Overall survival and time trends in breast and cervical cancer incidence and mortality in the Regional Health District (RHD) of Barretos, S\xe3o Paulo, Brazil

Allini Mafra da Costa,Elisabete Weiderpass,Dana Hashim,José Humberto Tavares Guerreiro Fregnani

doi:10.1186/s12885-018-4956-7

Abstract

BackgroundBreast and cervical cancers represent a significant cause of morbidity and mortality among women. The purpose of this study was to analyse the survival and time trends in two of the most common female cancers in the Regional Health District (RHD) of Barretos, São Paulo, Brazil.MethodsFrom 2000 through 2015, we calculated the breast and cervical cancer incidence and mortality rates per 100,000 women who were age-standardized to the world population. We obtained the time trends using the Joinpoint Regression software. We estimated the overall survival rates using the Kaplan-Meier methods.ResultsThe age-standardized rates (ASR) for incidence of breast cancer increased annually, with an average annual percentage change (AAPC) of 4.3 (95% Confidence Interval (CI): 2.4 to 6.3) for invasive breast cancer and 10.2 (95% CI: 6.1 to 14.5) for in situ breast cancer. The mortality rates for invasive breast cancer decreased with an AAPC of 0.2 (95% CI: -1.9 to 2.4). The ASR incidence of invasive cervical cancer showed an AAPC of − 1.9 (95% CI: -4.7 to 0.9). For in situ cases, the ASR showed an AAPC of 9.3 (95% CI: 3.3 to 15.7). The ASR mortality for cervical cancer showed an AAPC of − 5.3 (95% CI: -9.5 to − 0.8). The Kaplan-Meier analysis indicated 5-year overall survival rates of 74.3% for breast cancer and 70.7% for cervical cancer.ConclusionsThe incidence of in situ and invasive breast cancer is increasing, while the mortality rates remain stable. We observed an increase in the incidence of in situ cervical cancer and a decrease in invasive incidence rates during the study period, and we noted that the cervical cancer mortality significantly declined during the study period.

Highlights

Breast and cervical cancers represent a significant cause of morbidity and mortality among women
The incidence and mortality rates per 100,000 women are shown in Table 2, and the incidence and mortality trend curves are displayed in Figs. 1 and 2
The incidence rates for in situ breast cancer increased from 1.55/100,000 in year 2000 to 16.04/100,000 in year 2015 (AAPC: 10.2; 95% confidence interval (CI): 6.1 to 14.5) and for invasive breast cancer, the incidence rates increased from 29.09/100,000 in year 2000 to 64.09/100,000 in year 2015 (AAPC: 4.3; 95% CI: 2.4 to 6.3)

Summary

Introduction

Breast and cervical cancers represent a significant cause of morbidity and mortality among women. Mammography screening can often detect breast cancer at an earlier stage when treatment is more da Costa et al BMC Cancer (2018) 18:1079 efficient, and the cure rate is higher, thereby decreasing mortality in a population [4]. For cervical cancer, such variation may be explained by the differences in the availability of screening techniques, allowing the detection and removal of precancerous lesions and the human papillomavirus (HPV) infection [1, 3, 5, 6]. HPV vaccines Gardasil [Merck and Company, Whitehouse Station, NJ] and Cervarix [Glaxo Smith Kline, Brentford, UK] are available for protection against exposure to the most common risk of HPV for cervical cancers

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