Iniquidade social e câncer em mulheres: análise da mortalidade por câncer de mama e colo do útero nas microrregiões de saúde de Minas Gerais no período de 2008-2012

Abstract

The breast and cervical cancer are the most frequent neoplasms in women; its incidence and mortality rates are presented differently in regions of the country being observed elevated breast cancer rates in developed sites and cervix in less developed. This study aims to investigate the association between social inequality and mortality from these two types of cancers in Minas Gerais state and their health micro-regions, between 2008 and 2012. The adopted research methods were: integrative literature review and ecological study. First, through descriptors, there was a systematic survey of scientific production on social inequality and mortality from breast and cervical cancer. The number of deaths by both cancers and information about variables that compose the social and health indicators in Minas Gerais were taken in national databases. Deaths have been corrected considering the ill-defined causes; specific mortality rates were then calculated for age and standardized rates by age for MG and its 77 micro-regions. For cervical cancer this method was only adopted after the reallocation of deaths classified as malignant neoplasm of the uterus without another specification. Results indicate that mortality from breast cancer occurs mainly among women living in more developed areas, since cervical cancer presents reverse pattern, and this fact also observed in health micro-regions of Minas Gerais. Among the neoplasms, breast cancer ranked first as cause of death of the female population and micro-regions with the highest rates are located in the the Southeast and Center and the variables that explain the rates found are: Vulnerability Index in Health, Total fertility rate, distance to mammography and number of doctors / 1000 inhabitants.The lowest rates were observed in the North and Northeast, where the micro-regions showed high vulnerability in health, low human development index and degree of urbanization in addition to high mortality rates by breast cancer. This study demonstrates that when evaluating the health conditions of the population considering the incidence and mortality by breast and cervical cancer, it should be considered the influence of social and economic factors, then it is possible to establish health policies and health actions that comply with the woman full-time and promoting equity from the structuring of a more equitable, regionalized and hierarchical health care network.