title: Disparities in cervical and breast cancer mortality in Brazil.
abstract: OBJECTIVE To analyze cervical and breast cancer mortality in Brazil according to socioeconomic and welfare indicators. METHODS Data on breast and cervical cancer mortality covering a 30-year period (1980-2010) were analyzed. The data were obtained from the National Mortality Database, population data from the Brazilian Institute of Geography and Statistics database, and socioeconomic and welfare information from the Institute of Applied Economic Research. Moving averages were calculated, disaggregated by capital city and municipality. The annual percent change in mortality rates was estimated by segmented linear regression using the joinpoint method. Pearson's correlation coefficients were conducted between average mortality rate at the end of the three-year period and selected indicators in the state capital and each Brazilian state. RESULTS There was a decline in cervical cancer mortality rates throughout the period studied, except in municipalities outside of the capitals in the North and Northeast. There was a decrease in breast cancer mortality in the capitals from the end of the 1990s onwards. Favorable socioeconomic indicators were inversely correlated with cervical cancer mortality. A strong direct correlation was found with favorable indicators and an inverse correlation with fertility rate and breast cancer mortality in inner cities. CONCLUSIONS There is an ongoing dynamic process of increased risk of cervical and breast cancer and attenuation of mortality because of increased, albeit unequal, access to and provision of screening, diagnosis and treatment.
authors.affiliation: Plataforma de Pesquisa Clínica, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
authors.forename: Vania Reis
authors.initials: VR
authors.lastname: Girianelli
authors.affiliation: Instituto Latino-americano de Ciências da Vida e da Natureza, Universidade Federal da Integração Latino-americana, Foz do Iguaçu, PR, Brasil.
authors.forename: Carmen Justina
authors.initials: CJ
authors.lastname: Gamarra
authors.affiliation: Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
authors.forename: Gulnar
authors.initials: G
authors.lastname: Azevedo e Silva
mesh_terms: D001938:Brazil / Q000453:epidemiology; D001943:Breast Neoplasms / Q000401:mortality*; D005260:Female; D062306:Geography, Medical; D006801:Humans; D009026:Mortality / Q000639:trends; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000401:mortality*