title: Disparities in female breast cancer mortality rates between urban centers and rural areas of Brazil: ecological time-series study.
abstract: OBJECTIVE
  To evaluate trends in breast cancer mortality in urban centers and rural areas of Brazil.
  
  
  METHODS
  Ecological time-series study using data on breast cancer deaths and census. Mortality trends were analyzed using change-point regression: 1980-2010.
  
  
  RESULTS
  A declining trend was found in five urban centers: São Paulo (APC = -1.7%), Porto Alegre (APC = -1.6%), Belo Horizonte (APC = -1.2%), Rio de Janeiro and Recife (APC = -0.9%). An increasing was found in: Porto Velho (APC = 9.0%), Teresina (APC = 4.6%), João Pessoa (APC = 1.6%), Belém (APC = 0.8%) and Fortaleza (APC = 0.5%). In the majority of rural areas, mortality continues to rise, with the exception of some areas in the southern.
  
  
  CONCLUSIONS
  Disparities in breast cancer mortality were found across the country, with increasing trends occurring predominantly in the north and northeastern regions. One of the reasons for this disparity may be that access to treatment is more difficult for patients living in rural areas and in the north of Brazil.
authors: Federal University of Goiás (UFG), Goiânia, Brazil. Electronic address: cmrgonzaga@gmail.com.
authors: Carolina M R
authors: CM
authors: Gonzaga
authors: Federal University of Goiás (UFG), Goiânia, Brazil; Hospital Araújo Jorge, Goiás Anticancer Association (ACCG), Goiânia, Brazil.
authors: Ruffo
authors: R
authors: Freitas-Junior
authors: Federal University of Goiás (UFG), Goiânia, Brazil.
authors: Marta R
authors: MR
authors: Souza
authors: Hospital Araújo Jorge, Goiás Anticancer Association (ACCG), Goiânia, Brazil; International Prevention Research Institute (IPRI), Ecully, France.
authors: Maria Paula
authors: MP
authors: Curado
authors: Hospital Araújo Jorge, Goiás Anticancer Association (ACCG), Goiânia, Brazil.
authors: Nilceana M A
authors: NM
authors: Freitas
mesh_terms: D001938:Brazil; D001943:Breast Neoplasms / Q000401:mortality*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D012424:Rural Population / Q000706:statistics & numerical data*; D015996:Survival Rate / Q000639:trends*; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: Brazil; Breast cancer; Mortality; Trends