TY - JOUR
T1 - Disparities in time trends of cervical cancer mortality rates in Brazil
AU - Vale, Diama Bhadra
AU - Sauvaget, Catherine
AU - Muwonge, Richard
AU - Ferlay, Jacques
AU - Zeferino, Luiz Carlos
AU - Murillo, Raul
AU - Sankaranarayanan, Rengaswamy
N1 - Publisher Copyright:
© 2016, Springer International Publishing Switzerland.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Purpose: This study aimed to correct and describe cervical cancer mortality rates and trends by regions and age-groups in Brazil. It may help planning and implementing policies for cervical cancer control. Methods: Data from 2003 to 2012 were accessed through the centralized national mortality database. Correction of the age-specific mortality rates was done by proportional redistribution of ill-defined causes of death and deaths coded as ‘uterine, part unspecified’. Annual percentage change (APC) was obtained by trend analysis (Joinpoint regression). Results: In the 10-year period, cancer and ill-defined causes corresponded, respectively, to 18.9 and 10.8 % of all deaths (except injuries). The proportion of ill-defined causes was reduced by more than a half in the period. The age-standardized cervical cancer mortality rate was 7.2 per 100,000 women-years after correction. The total increase in rates after corrections was 50.5 %. A significant decreasing trend in rates was observed at the national level (APC = −0.17, p < 0.001). North was the only region that did not show a decreasing significant trend (APC + 0.07, p = 0.28). Decreasing trends were restricted to age-groups over 40 years. Conclusions: A consistent decreasing trend of cervical cancer mortality rates in Brazil from 2003 to 2012 was observed, although this was not consistent in all regions and restricted to older age-groups. Quality of data needs to be improved. Cancer control policies may consider the differences in access to care and the characteristics of regions to improve their efficiency.
AB - Purpose: This study aimed to correct and describe cervical cancer mortality rates and trends by regions and age-groups in Brazil. It may help planning and implementing policies for cervical cancer control. Methods: Data from 2003 to 2012 were accessed through the centralized national mortality database. Correction of the age-specific mortality rates was done by proportional redistribution of ill-defined causes of death and deaths coded as ‘uterine, part unspecified’. Annual percentage change (APC) was obtained by trend analysis (Joinpoint regression). Results: In the 10-year period, cancer and ill-defined causes corresponded, respectively, to 18.9 and 10.8 % of all deaths (except injuries). The proportion of ill-defined causes was reduced by more than a half in the period. The age-standardized cervical cancer mortality rate was 7.2 per 100,000 women-years after correction. The total increase in rates after corrections was 50.5 %. A significant decreasing trend in rates was observed at the national level (APC = −0.17, p < 0.001). North was the only region that did not show a decreasing significant trend (APC + 0.07, p = 0.28). Decreasing trends were restricted to age-groups over 40 years. Conclusions: A consistent decreasing trend of cervical cancer mortality rates in Brazil from 2003 to 2012 was observed, although this was not consistent in all regions and restricted to older age-groups. Quality of data needs to be improved. Cancer control policies may consider the differences in access to care and the characteristics of regions to improve their efficiency.
KW - Healthcare disparities
KW - Mortality
KW - Population register
KW - Uterine cervical neoplasms
UR - http://www.scopus.com/inward/record.url?scp=84973138137&partnerID=8YFLogxK
U2 - 10.1007/s10552-016-0766-x
DO - 10.1007/s10552-016-0766-x
M3 - Article
C2 - 27255650
AN - SCOPUS:84973138137
SN - 0957-5243
VL - 27
SP - 889
EP - 896
JO - Cancer Causes and Control
JF - Cancer Causes and Control
IS - 7
ER -