[Magnitude of mortality from cervical cancer in the Brazilian Northeast and socioeconomic factors].
OBJECTIVE
To analyze the time trend of cervical cancer mortality based on adjusted or unadjusted mortality data and to investigate the association between these data and socioeconomic indicators in women aged 20 years or older in the Brazilian Northeast (in capitals and non-capital cities) during the period from 1996 to 2005.


METHODS
All deaths from cervical cancer recorded in the Brazilian Health Ministry's Mortality Data System (SIM) were included in the study. Also included were the cervical cancer deaths identified after the adjustment process. Simple linear regression was used to analyze the time trends for mortality and their correlations (Pearson) with selected socioeconomic indicators.


RESULTS
The highest mortality coefficients with unadjusted data were observed in capitals and the lowest were observed in non-capital cities. Conversely, the highest mortality coefficients with adjusted data were observed in non-capital cities. Similarly, the lowest unadjusted mortality rates were observed in the states with the most poverty, illiteracy, fertility, and child mortality, whereas the highest unadjusted mortality rates were observed in the regions with the best social indicators. Adjusted mortality rates showed a negative association with the indicators describing better living conditions, and a positive association with the indicators describing worse living conditions.


CONCLUSIONS
The use of unadjusted mortality data may lead to underestimation of cervical cancer rates and compromise the interpretations of comparative analyses of the magnitude, distribution, and factors associated with this disease. The magnitude of cervical cancer should be reassessed at least in the Brazilian Northeast. However, the findings show that positive results have been obtained with early detection efforts in Brazil.
Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. carmengamarra@gmail.com
Carmen Justina
CJ
Gamarra
Joaquim Gonçalves
JG
Valente
Gulnar
G
Azevedo e Silva
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D042241:Early Diagnosis; D004522:Educational Status; D005260:Female; D006801:Humans; D008875:Middle Aged; D011203:Poverty; D017584:Reproductive History; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000401:mortality*; D055815:Young Adult