Abstract
BackgroundBreast cancer is the most common cause of death from cancer in women in less developed regions. Therefore, the objective of this study was to provide data on the temporal trends in female breast cancer mortality between 1990 and 2011 and to evaluate its association with the social inequalities present in Brazil.MethodsBreast cancer mortality data and estimates for the resident population were obtained from the Brazilian National Health Service 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 joinpoint regression model and linear regression. The Social Exclusion Index and the Human Development Index were used to classify the 27 Brazilian states. Pearson’s correlation was used to describe the association between the Social Exclusion Index and the Human DeveIopment and the variations in mortality rates in each state.ResultsAge-standardized mortality rates in Brazil were found to be stable (annual percent change [APC] = 0.3; 95% CI: −0.1 – 0.7) between 1994 and 2011. Considering the Brazilian states, significant decreases in mortality rates were found in 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 Social Exclusion Index and a change in female breast cancer mortality rates in the Brazilian states between 1990 and 2011 and between Human Development Index and mortality between 2001 and 2011.ConclusionsFemale breast cancer mortality rates are stable in Brazil. Reductions in these rates were found in the more developed states, possibly reflecting better healthcare.
Highlights
Breast cancer is the most common cause of death from cancer in women in less developed regions
Data collected in the United States over the past two decades show that breast cancer mortality rates have decreased by more than 30% since their peak in 1991; breast cancer is still the most common cause of death from cancer in women of 20 to 59 years of age [2]
A statistically significant increase in breast cancer mortality rates in Brazil, was found for the following age groups: 20–39 years (APC = 0.7; 95% Confidence intervals (CI): 0.3 – 1.1, p < 0.01), 50–69
Summary
Breast cancer is the most common cause of death from cancer in women in less developed regions. Data collected in the United States over the past two decades show that breast cancer mortality rates have decreased by more than 30% since their peak in 1991; breast cancer is still the most common cause of death from cancer in women of 20 to 59 years of age [2]. In Brazil, mortality rates range from 14 per 100,000 in the south and southeast to 6.6 per 100,000 in the north of the country. A significant decrease has been seen in the southeast since 1997 (APC = −0.9%) and a non-significant decrease in the south of the country. Rates were lower, there was a tendency towards an increase.
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