Inequalities in Temporal Effects on Cervical Cancer Mortality in States in Different Geographic Regions of Brazil: An Ecological Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design, Study Population, and Location Characterization
2.2. Study Variables
- (i)
- (ii)
- the proportional redistribution classified as incomplete diagnosis among all cancers and the deaths classified as incomplete diagnosis of female genital tract cancer, by age group, year of death and state (184, 195, 196, 197, 198, 199, C57, C76, C77, C78, C79, C80, and C97);
- (iii)
- the proportional redistribution of deaths classified as unspecified uterine cancer relating to cancers of the uterus (179, and C55), cervical cancer (189 and C53) and endometrial cancer (182 and C54), according to age group, year of death and state.
2.3. Statistical Analysis
3. Results
4. Discussion
Limitations and Strengths of the Study
5. Conclusions
Policy Implication
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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South and Southeast | 1980–1984 | 1985–1989 | 1990–1994 | 1995–1999 | 2000–2004 | 2005–2009 | 2010–2014 | 2015–2019 | SMR * |
Paraná | 12.81 | 13.41 | 14.28 | 14.93 | 12.94 | 10.87 | 10.35 | 11.03 | 14.38 |
Rio Grande do Sul | 18.45 | 18.40 | 18.36 | 17.64 | 14.04 | 11.51 | 9.94 | 10.19 | 13.73 |
Santa Catarina | 13.32 | 13.83 | 15.71 | 15.77 | 13.34 | 11.66 | 10.45 | 10.56 | 12.33 |
Espírito Santo | 15.55 | 18.42 | 18.40 | 19.86 | 16.43 | 14.15 | 12.10 | 11.23 | 14.67 |
Minas Gerais | 16.15 | 14.90 | 15.17 | 13.46 | 11.46 | 10.31 | 8.63 | 8.20 | 11.22 |
Rio de Janeiro | 16.48 | 15.24 | 16.91 | 16.20 | 15.24 | 12.59 | 11.83 | 11.19 | 13.91 |
São Paulo | 16.64 | 14.06 | 15.23 | 13.96 | 11.72 | 8.91 | 7.42 | 6.88 | 10.53 |
North | 1980–1984 | 1985–1989 | 1990–1994 | 1995–1999 | 2000–2004 | 2005–2009 | 2010–2014 | 2015–2019 | SMR |
Acre | 21.48 | 20.32 | 27.71 | 21.77 | 19.86 | 17.40 | 25.23 | 24.75 | 22.57 |
Amazonas | 28.71 | 33.92 | 25.79 | 30.89 | 31.45 | 37.67 | 40.14 | 36.66 | 35.03 |
Amapá | 40.88 | 49.16 | 46.07 | 38.44 | 29.94 | 30.29 | 33.02 | 29.96 | 35.02 |
Pará | 28.25 | 28.60 | 25.56 | 22.99 | 26.02 | 26.20 | 24.89 | 26.65 | 26.05 |
Rondônia | 23.80 | 30.70 | 20.66 | 19.44 | 20.28 | 16.37 | 14.18 | 15.76 | 17.91 |
Roraima | 33.44 | 15.94 | 31.87 | 24.81 | 28.46 | 39.48 | 25.19 | 32.35 | 30.02 |
Tocantis | _ | _ | _ | 19.45 | 21.31 | 24.18 | 22.71 | 21.12 | 21.36 |
Age Group | 20 to 24 | 25 to 29 | 30 to 34 | 35 to 39 | 40 to 44 | 45 to 49 | 50 to 54 | 55 to 59 | 60 to 64 | 65 to 69 | 70 to 74 | 75 to 79 | 80 and More Years | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
States * | AC | 0.76 | 1.04 | 7.23 | 11.12 | 18.63 | 24.34 | 33.06 | 42.92 | 45.79 | 42.21 | 55.16 | 70.38 | 104.28 |
AM | 1.03 | 4.68 | 12.09 | 19.80 | 32.37 | 41.82 | 52.81 | 53.54 | 62.42 | 70.88 | 94.15 | 109.74 | 131.10 | |
AP | 2.47 | 4.66 | 9.06 | 17.60 | 27.73 | 41.43 | 38.22 | 54.18 | 59.70 | 79.32 | 91.76 | 152.11 | 170.89 | |
PA | 0.99 | 3.30 | 8.33 | 14.59 | 23.24 | 32.29 | 36.98 | 44.50 | 49.66 | 56.53 | 63.99 | 78.61 | 90.76 | |
RO | 0.39 | 1.63 | 4.46 | 8.00 | 12.73 | 19.47 | 22.24 | 28.83 | 34.74 | 42.35 | 53.98 | 75.37 | 80.52 | |
RR | 0.60 | 3.74 | 6.53 | 12.21 | 24.42 | 30.45 | 33.57 | 57.56 | 50.87 | 85.59 | 96.40 | 109.66 | 118.51 | |
TO | 0.88 | 1.99 | 4.20 | 10.45 | 14.97 | 22.46 | 28.01 | 36.29 | 35.61 | 49.28 | 58.66 | 83.62 | 118.62 | |
PR | 1.48 | 2.64 | 5.25 | 8.32 | 11.05 | 16.51 | 18.21 | 21.96 | 27.28 | 31.21 | 42.56 | 48.19 | 49.85 | |
RS | 0.56 | 2.34 | 5.67 | 9.81 | 14.18 | 18.20 | 20.19 | 21.77 | 23.50 | 28.08 | 30.03 | 33.62 | 40.98 | |
SC | 0.36 | 1.94 | 4.33 | 8.39 | 12.60 | 16.23 | 18.49 | 19.66 | 22.29 | 22.58 | 29.26 | 34.54 | 38.09 | |
ES | 0.27 | 1.65 | 4.07 | 7.76 | 11.57 | 16.18 | 21.76 | 24.84 | 29.53 | 32.67 | 40.40 | 43.80 | 59.24 | |
MG | 0.24 | 1.07 | 2.73 | 5.09 | 8.71 | 12.29 | 16.37 | 19.26 | 22.35 | 25.94 | 31.89 | 38.11 | 46.20 | |
RJ | 0.44 | 2.05 | 4.58 | 8.09 | 12.54 | 17.38 | 20.69 | 23.05 | 26.32 | 30.07 | 34.15 | 38.63 | 47.23 | |
SP | 0.31 | 1.21 | 2.72 | 5.00 | 8.44 | 12.00 | 15.57 | 18.86 | 20.96 | 24.63 | 28.89 | 33.91 | 36.50 |
State | Age–Drift | 95% CI | Trend |
---|---|---|---|
North | |||
Acre | 1.005 | 0.998–1.010 | Stationary |
Amazonas | 1.007 | 1.005–1.010 | Ascending |
Amapá | 0.986 | 0.980–0.991 | Descending |
Pará | 0.998 | 0.996–1.000 | Stationary |
Rondônia | 0.982 | 0.978–0.986 | Descending |
Roraima | 1.002 | 0.995–1.011 | Stationary |
Tocantins | 1.003 | 0.996–1.011 | Stationary |
South | |||
Paraná | 0.980 | 0.979–0.981 | Descending |
Rio Grande do Sul | 0.978 | 0.977–0.980 | Descending |
Santa Catarina | 0.989 | 0.987–0.991 | Descending |
Southeast | |||
Espírito Santo | 0.984 | 0.982–0.987 | Descending |
Minas Gerais | 0.981 | 0.980–0.982 | Descending |
Rio de Janeiro | 0.987 | 0.986–0.988 | Descending |
São Paulo | 0.975 | 0.973–0.975 | Descending |
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Meira, K.C.; Magnago, C.; Mendonça, A.B.; Duarte, S.F.S.; de Freitas, P.H.O.; dos Santos, J.; de Souza, D.L.B.; Simões, T.C. Inequalities in Temporal Effects on Cervical Cancer Mortality in States in Different Geographic Regions of Brazil: An Ecological Study. Int. J. Environ. Res. Public Health 2022, 19, 5591. https://doi.org/10.3390/ijerph19095591
Meira KC, Magnago C, Mendonça AB, Duarte SFS, de Freitas PHO, dos Santos J, de Souza DLB, Simões TC. Inequalities in Temporal Effects on Cervical Cancer Mortality in States in Different Geographic Regions of Brazil: An Ecological Study. International Journal of Environmental Research and Public Health. 2022; 19(9):5591. https://doi.org/10.3390/ijerph19095591
Chicago/Turabian StyleMeira, Karina Cardoso, Carinne Magnago, Angelo Braga Mendonça, Stephane Fernanda Soares Duarte, Pedro Henrique Oliveira de Freitas, Juliano dos Santos, Dyego Leandro Bezerra de Souza, and Taynãna César Simões. 2022. "Inequalities in Temporal Effects on Cervical Cancer Mortality in States in Different Geographic Regions of Brazil: An Ecological Study" International Journal of Environmental Research and Public Health 19, no. 9: 5591. https://doi.org/10.3390/ijerph19095591