Análise idade-período-coorte da mortalidade por câncer de mama nas capitais e interior do Brasil

Abstract

Breast cancer is the malignant neoplasm with highest mortality in women in the world and in Brazil, and therefore deserves attention for its control. Research on trends in breast cancer mortality is mostly on two aspects, age and time of death. The Age-Period-Cohort method offers the inclusion of birth cohorts trend analysis, which enables the visualization of the 3 aspects of time, the effects of Age, Period and Birth Cohort on breast cancer mortality. To analyze the trend of breast cancer mortality in Brazil, observing state capitals and the countryside, data from the Department of Information and Informatics of the Brazilian Unified Health System (DATASUS) were used. Population and death data for women aged 30 years or older, for the years between 1980 and 2019, were analyzed using the Age-Period-Cohort model as proposed by Carstensen (2007). The data from the state capitals were subtracted from the data from the states, generating the data called interior. The effects of age on breast cancer mortality are observed in the model as higher mortality rates at older ages. The period effect is similar in all regions, in the form of a more pronounced increase in the rate ratio (RR) in the municipalities of the interior than in the capitals. The RR of birth cohorts in the capitals remained stable (for the North, the Northeast and the Central-West regions) or decreased followed by an increase in the most recent cohorts (Brazil as a whole and the Southeast and the South regions). The RRs for the other municipalities (the interior), however, showed a progressive increase in cohorts’ effects for all regions. These findings indicate differences in breast cancer mortality trends from the capitals to the interior of the country, pointing to the need for further research to improve health practices and policies appropriate to the needs of each territory.