title: Brain cancer mortality in an agricultural and a metropolitan region of Rio de Janeiro, Brazil: a population-based, age-period-cohort study, 1996-2010.
abstract: BACKGROUND
  Individuals who live in rural areas are at greater risk for brain cancer, and pesticide exposure may contribute to this increased risk. The aims of this research were to analyze the mortality trends and to estimate the age-period-cohort effects on mortality rates from brain cancer in two regions in Rio de Janeiro, Brazil.
  
  
  METHODS
  This descriptive study examined brain cancer mortality patterns in individuals of both sexes, >19 years of age, who died between 1996 and 2010. They were residents of a rural (Serrana) or a non-rural (Metropolitan) area of Rio de Janeiro, Brazil. We estimated mortality trends using Joinpoint Regression analysis. Age-period-cohort models were estimated using Poisson regression analysis.
  
  
  RESULTS
  The estimated annual percentage change in mortality caused by brain cancer was 3.8% in the Serrana Region (95% confidence interval (CI): 0.8-5.6) and -0.2% (95% CI: -1.2-0.7) in the Metropolitan Region. The results indicated that the relative risk was higher in the rural region for the more recent birth cohorts (1954 and later). Compared with the reference birth cohort (1945-49, Serrana Region), the relative risk was four times higher for individuals born between 1985 and 1989.
  
  
  CONCLUSIONS
  The results of this study indicate that there is an increasing trend in brain cancer mortality rates in the rural Serrana Region in Brazil. A cohort effect occurred in the birth cohorts born in this rural area after 1954. At the ecological level, different environmental factors, especially the use of pesticides, may explain regional disparities in the mortality patterns from brain cancers.
authors.affiliation: Environmental and Public Health Program, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. filhoalm@gmail.com.
authors.forename: Adalberto Luiz
authors.initials: AL
authors.lastname: Miranda Filho
authors.forename: Rosalina Jorge
authors.initials: RJ
authors.lastname: Koifman
authors.forename: Sergio
authors.initials: S
authors.lastname: Koifman
authors.forename: Gina Torres Rego
authors.initials: GT
authors.lastname: Monteiro
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000382:Agricultural Workers' Diseases / Q000175:diagnosis / Q000401:mortality*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000401:mortality*; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D010575:Pesticides / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D012423:Rural Health / Q000639:trends*; D013997:Time Factors; D014504:Urban Health / Q000639:trends*; D055815:Young Adult
chemical_list: D010575:Pesticides