Disparities in female breast cancer mortality rates in Brazil between 1980 and 2009.
OBJECTIVE
To describe the temporal trends in female breast cancer mortality rates in Brazil in its macro-regions and states between 1980 and 2009.


METHODS
This was an ecological time-series study using data on breast cancer deaths registered in the Mortality Data System (SIM/WHO) and census data on the resident population collected by the Brazilian Institute of Geography and Statistics (IBGE/WHO). Joinpoint regression analyses were used to identify the significant changes in trends and to estimate the annual percentage change (APC) in mortality rates.


RESULTS
Female breast cancer mortality rates in Brazil tended to stabilize from 1994 onward (APC = 0.4%). Considering the Brazilian macro-regions, the annual mortality rates decreased in the Southeast, stabilized in the South and increased in the Northeast, North, and Midwest. Only the states of Sao Paulo (APC = -1.9%), Rio Grande do Sul (APC = -0.8%) and Rio de Janeiro (APC = -0.6%) presented a significant decline in mortality rates. The greatest increases were found in Maranhao (APC=12%), Paraiba (APC=11.9%), and Piaui (APC=10.9%).


CONCLUSIONS
Although there has been a trend toward stabilization in female breast cancer mortality rates in Brazil, when the mortality rate of each macro-region and state is analyzed individually, considerable inequalities are found, with rate decline or stabilization in states with higher socioeconomic levels and a substantial increase in those with lower socioeconomic levels.
Federal University of Goias, Program of Mastology, Goiania/GO, Brazil. ruffojr@terra.com.br
Ruffo
R
Freitas-Junior
Carolina Maciel Reis
CM
Gonzaga
Nilceana Maya Aires
NM
Freitas
Edesio
E
Martins
Rita de Cássia de Maio
Rde C
Dardes
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D001943:Breast Neoplasms / Q000401:mortality*; D005260:Female; D062306:Geography, Medical / Q000706:statistics & numerical data; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D012959:Socioeconomic Factors; D055815:Young Adult