Inequalities in the burden of female breast cancer in Brazil, 1990-2017.

IF 3.2 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Population Health Metrics Pub Date : 2020-09-30 DOI:10.1186/s12963-020-00212-5

Maximiliano Ribeiro Guerra, Mário Círio Nogueira, Deborah Carvalho Malta, Camila Soares Lima Côrrea, Maria de Fatima Marinho de Souza, Maria Paula Curado, Mariana Santos Felisbino-Mendes, Meghan Mooney, Mohsen Naghavi, Maria Teresa Bustamante-Teixeira

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引用次数: 11

Abstract

Background: Breast cancer is the most frequently diagnosed cancer in women and the leading cause of cancer death among females worldwide. In recent decades, breast cancer death rates have been stable or decreasing in more developed regions; however, this has not been observed in less developed regions. This study aims to evaluate inequalities in the burden of female breast cancer in Brazil including an analysis of interregional and interstate patterns in incidence, mortality and disability-adjusted life years (DALYs) rates from 1990 to 2017, and mortality-to-incidence ratio (MIR), and their association with the Socio-demographic Index (SDI).

Methods: Using estimates from the global burden of disease (GBD) study, we applied a spatial exploratory analysis technique to obtain measurements of global and local spatial correlation. Percentage changes of breast cancer incidence, mortality, and DALYs rates between 1990 and 2017 were calculated, and maps were developed to show the spatial distribution of the variables. Spatial panel models were adjusted to investigate the association between rates and SDI in Brazilian states.

Results: In Brazil, while breast cancer mortality rate have had modest reduction (-4.45%; 95% UI: -6.97; -1.76) between 1990 and 2017, the incidence rate increased substantially (+39.99%; 95% UI: 34.90; 45.39). Breast cancer incidence and mortality rates in 1990 and 2017 were higher in regions with higher SDI, i.e., the most developed ones. While SDI increased in all Brazilian states between 1990 and 2017, notably in less developed regions, MIR decreased, more notably in more developed regions. The SDI had a positive association with incidence rate and a negative association with MIR.

Conclusion: Such findings suggest an improvement in breast cancer survival in the period, which may be related to a broader access to diagnostic methods and treatment. This study also revealed the inequality in breast cancer outcomes among Brazilian states and may guide public policy priorities for disease control in the country.

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1990-2017年巴西女性乳腺癌负担的不平等

背景:乳腺癌是女性中最常见的癌症，也是全世界女性癌症死亡的主要原因。近几十年来，较发达地区的乳腺癌死亡率保持稳定或有所下降;然而，在较不发达地区没有观察到这种情况。本研究旨在评估巴西女性乳腺癌负担的不平等，包括分析1990年至2017年发病率、死亡率和残疾调整生命年(DALYs)率、死亡率与发病率比(MIR)的区域间和州际模式，以及它们与社会人口指数(SDI)的关联。方法:利用全球疾病负担(GBD)研究的估算值，我们应用空间探索性分析技术来获得全球和局部空间相关性的测量值。计算了1990年至2017年间乳腺癌发病率、死亡率和DALYs率的百分比变化，并绘制了地图来显示这些变量的空间分布。调整空间面板模型以调查巴西各州的比率与SDI之间的关系。结果:在巴西，虽然乳腺癌死亡率略有下降(-4.45%;95% ui: -6.97;-1.76)，发病率大幅上升(+39.99%;95% ui: 34.90;45.39)。1990年和2017年的乳腺癌发病率和死亡率在SDI较高的地区，即最发达的地区较高。1990年至2017年期间，巴西所有州的SDI都有所增加，尤其是在欠发达地区，而MIR则有所下降，在较发达地区更为明显。SDI与发病率呈正相关，与MIR呈负相关。结论:这些发现表明，这一时期乳腺癌的生存率有所提高，这可能与更广泛地获得诊断方法和治疗有关。这项研究还揭示了巴西各州乳腺癌预后的不平等，并可能指导该国疾病控制的公共政策优先事项。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Population Health Metrics PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.50

自引率

0.00%

发文量

审稿时长

29 weeks

期刊介绍： Population Health Metrics aims to advance the science of population health assessment, and welcomes papers relating to concepts, methods, ethics, applications, and summary measures of population health. The journal provides a unique platform for population health researchers to share their findings with the global community. We seek research that addresses the communication of population health measures and policy implications to stakeholders; this includes papers related to burden estimation and risk assessment, and research addressing population health across the full range of development. Population Health Metrics covers a broad range of topics encompassing health state measurement and valuation, summary measures of population health, descriptive epidemiology at the population level, burden of disease and injury analysis, disease and risk factor modeling for populations, and comparative assessment of risks to health at the population level. The journal is also interested in how to use and communicate indicators of population health to reduce disease burden, and the approaches for translating from indicators of population health to health-advancing actions. As a cross-cutting topic of importance, we are particularly interested in inequalities in population health and their measurement.