MORTALITY RISK OF COLORECTAL CANCER IN BRAZIL FROM 1980 TO 2013.
Colorectal cancer is one of the most common cancer worldwide, and variation in its mortality rates indicates the importance of environmental factors in its occurrence. While trend studies have indicated a reduction in colorectal cancer mortality rates in most developed countries, the same trends have not been observed in developing countries. Moreover, trends may differ when analyzed by age and sex.


OBJECTIVE
- The present study aimed to analyze the trends in risk of colorectal cancer death in Brazil based on sex and age group.
Death records were obtained from the Mortality Information System of the Ministry of Health. The risk of death and the average annual percent changes (AAPC) in the mortality rates were estimated using joinpoint analysis of long-term trends from 1980 to 2013. All of the statistical tests were two-sided and had a significance level of 5%.


RESULTS
- Colorectal cancer mortality rates were found to have increased in the last 15 years for both sexes and for all age ranges. The rate ratio (RR) was statistically higher at ages 70 to 79 for men (RR: 1.37; 95% CI: 1.26; 1.49) compared to women (RR: 1.14; 95% CI: 1.06; 1.24). Increases in AAPC were observed in both sexes. Although men presented higher percent changes (AAPC: 1.8; 95% CI: 1.1; 2.6) compared to women (AAPC: 1.2; 95% CI: 0.4; 2.0), this difference was not statistically significant. Growth trends in mortality rates occurred in all age groups except for in women over 70.


CONCLUSIONS
- Unlike Europe and the US, Brazil has shown increases in death rates due to colorectal cancer in the last three decades; however, more favorable trends were observed in women over 70 years old. The promotion of healthier lifestyles in addition to early diagnosis and improved treatment should guide the public health policies targeting reductions in colorectal cancer.
Hospital Universitário Professor Alberto Antunes, Universidade Federal de Alagoas, Maceió, AL, Brasil; , Universidade Federal de Alagoas, Hospital Universitário Professor Alberto Antunes, Universidade Federal de Alagoas, Maceió AL , Brazil.
Ronaldo Coimbra
RC
Oliveira
Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brasil., Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador BA , Brazil.
Marco Antônio Vasconcelos
MA
Rêgo
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution