Mortalidade por câncer de mama e câncer de colo do útero no município de Juiz de Fora

Abstract

The aim of this study was to analyze the trends in mortality from breast cancer and cancer of the uterine cervix in women of the municipality of Juiz de Fora, Minas Gerais, Brazil. The death time-series of the Mortality Information System (Sistema de Informação Sobre Mortalidade – SIM) of the Brazilian Ministry of Health was used. Deaths having as the basic cause breast cancer and cancer of the uterine cervix, including uterus, part unspecified, occurring during the period 1980-2006, were identified. Age-related annual specific mortality rates were calculated and standardized according to the world population. Regression models, in which mortality rates were considered dependent variables and the years independent variables, were used for analysis of mortality trends. Polynomial regression and segmented linear regression (joinpoint) models were applied. Trends in mortality rate were considered significant when the polynomial regression model reached the 5% significance level (p < 0.05). For segmented linear regression, log-transformed mortality rates and permutation tested statistical analysis with description of the respective confidence intervals were used. Breast cancer was the main cause of death among malignancies in the population of women living in the municipality of Juiz de Fora, with the lowest mortality rate in 1997 (10/100,000) and the highest mortality rate in 1999 (19.6/100,000). During the same period, the mortality rates for cancer of the uterine cervix ranged from 3.6/100,000 in 2003 to 12.5/100,000 in 1982. Trend analysis by the polynomial regression model showed a decrease of mortality due to cancer of the uterine cervix (p=0.001) and an increase of mortality due to breast cancer (p=0.035) throughout the years of the series. On the other hand, segmented linear regression analysis showed a decrease in mortality due to cancer of the uterine cervix until 2001 (APC -4.2%; CI 95% -6.2: -2.1), with stabilization of the rates in the last years of the series, there being no variation in the mortality due to breast cancer. The behavior of the mortality due to breast cancer and cancer of the uterine cervix in the municipality of Juiz de Fora suggests an ongoing process of epidemiological transition, with significant mortality rates due to diseases associated with better socioeconomic conditions, such as breast cancer, and the persistence of high rates of tumors related to poverty, such as cancer of the uterine cervix.