Análise da taxa de mortalidade por câncer de mama nos municípios brasileiros no período de 1987 a 2013 e fatores associados

Abstract

Some researchers have indicated an increase on breast cancer mortality in Brazil in recent decades. However, this growth has not been homogeneous along the national territory. Therefore, this research aimed to analyze the factors associated to mortality rate from breast cancer of Brazilian counties. In order to accomplish this task, mortality rates, standardized by age group, were calculated to each county of Brazil to the years 1990, 2000 and 2010. It allowed us to estimate regression models, with cross-section and panel data, in order to verify the degree of association of these factors to different periods and regions of Brazil. The results revealed that a growth rate of per capita income, an increase of longevity, a decrease in the level of education, a reduction of fertility rates and a reduction of public spending on health could increase the mortality from breast cancer. However, when considering the mortality rate with correction by ill-defined causes, the results indicated that only the longevity and public spending on health would affect mortality. It was also found that mortality is higher in the South and Southeast and it is lower in the North, Northeast and Midwest, respectively. In addition, the lowest mortality rates were found in cities with 20.-100 thousand inhabitants. The highest mortality rates belong both to the big cities, with over 500 thousand inhabitants, as to the small ones, where the population does not reach 5 thousand. The trend analysis showed that Brazilian regions could have reduced their respective mortality rates if other phenomena (such as income growth, increased life expectancy and declining fertility rate) had not happened in Brazil. Finally, the compilation of data on breast cancer still showed a lower level of coverage of this neoplasm in the North, Midwest and Northeast and a higher level in the Southeast and South. However, this situation has improved over the considered period. Moreover, the reduction of deaths coming from ill-defined causes, verified along 1990, 2000 and 2010, appears to have reduced the effect of this problem on mortality from breast cancer.