title: Cancer mortality trends in Brazilian state capitals and other municipalities between 1980 and 2006.
abstract: OBJECTIVE
  To analyze the corrected trend of overall cancer mortality and leading sites in the state capitals and other municipalities of Brazil between 1980 and 2006.
  
  
  METHODS
  Data on deaths (n = 2,585,012) caused by cancer between 1980 and 2006 were obtained from Sistema de Informações sobre Mortalidade (Mortality Information System), and demographic data were provided by Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics). The rates of overall cancer mortality and major types were corrected by proportionally redistributing 50% of ill-defined causes of death and standardizing them by age according to the standard world population. Trend curves for Brazil and its major regions were calculated for state capitals and other municipalities according to sex, and were evaluated by means of simple linear regression.
  
  
  RESULTS
  Among men, ascending mortality rates were observed for lung, prostate and colorectal cancer; declining rates for stomach cancer; and stable rates for esophagus cancer. Among women, mortality from breast, lung and colorectal cancer increased, and the rates for cervical and stomach cancer declined. Mortality evolution varied across the regions of Brazil, with distinct patterns between state capitals and other municipalities.
  
  
  CONCLUSIONS
  The correction of mortality rates based on redistribution of ill-defined causes of death increased the magnitude of the overall cancer mortality in Brazil by approximately 10% in 1980 and 5% in 2006. In the inland municipalities no decrease or stability was identified, differently from what was observed in the state capitals. Limited scope of prevention actions and lower access to services of cancer diagnosis and treatment for the population living away from large urban centers may partly explain these differences.
authors: Departamento de Epidemiologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil. gulnar@ims.uerj.br
authors: Gulnar Azevedo e
authors: GA
authors: Silva
authors: Carmen Justina
authors: CJ
authors: Gamarra
authors: Vania Reis
authors: VR
authors: Girianelli
authors: Joaquim Gonçalves
authors: JG
authors: Valente
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002947:Cities / Q000453:epidemiology; D005260:Female; D040362:Geographic Information Systems; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D008297:Male; D009026:Mortality / Q000639:trends; D009369:Neoplasms / Q000401:mortality*; D012111:Residence Characteristics; D017678:Sex Distribution; D012737:Sex Factors; D013997:Time Factors; D014505:Urban Population