Unequal burden of mortality from gastric cancer in Brazil and its regions, 2000–2015
- 39 Downloads
Gastric cancer (GC) is an important cause of morbidity and mortality worldwide. However, population-based data on GC mortality dynamics in low and middle income countries are scarce.
We analyzed GC mortality in Brazil based on all GC-related deaths registered 2000–2015.
A total of 17,374,134 deaths were recorded, with GC identified in 214,808 (1.24%) cases—203,941 (94.9%) as underlying cause, and 10,867 (5.1%) as associated cause of death. Adjusted rates for age and sex was 6.85 deaths/100,000 inhabitants [95% confidence interval (CI) 6.73–6.97]. The highest mortality rates were found in males [10.00; rate ratio (RR) 1.85; 95% CI 1.78–1.91; p < 0.0001] and patients ≥ 45 years of age (24.98; RR 3.79; 95% CI 3.55–4.05; p < 0.0001). The South (7.56; RR 1.62; 95% CI 1.50–1.76; p < 0.0001) and Southeast (7.36; RR 1.59; 95% CI 1.48–1.71; p < 0.0001) regions had the highest regional rates. Spatial and spatiotemporal high-risk mortality areas in 2004–2007 were located mainly in the South, Southeast, and Central-West regions. After 2008, the Northeast region became a high-risk area, especially Ceará State.
GC remains a significant public health problem with high mortality burden and unequal distribution in Brazilian states. The new patterns in poorer regions and the high risk in some specific populations show a clear process of epidemiological transition over time. There is a need to strengthen nationwide epidemiological monitoring, surveillance, prevention, and control for GC in the country.
KeywordsGastric cancer Mortality Spatial analysis Brazil
JH and DMMQ are class 1 research fellows at National Council for Scientific and Technological Development/Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq/Brazil). AFF is a master fellow at CNPq/Brazil.
LLBCB, ANR Jr, and JH conceived and designed the study. ANR Jr, AFF, and CHA contributed to data collection and analysis. LLBCB, ANR Jr, MBBN, and JH wrote the manuscript. DMMQ, AFF, and DCM revised the manuscript. All authors contributed to the interpretation of data and approved the final manuscript.
Compliance with ethical standards
Conflict of interest
We declare that we have no conflicts of interest.
- 1.Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Allen C, Barber RM, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol 2017;3:524–48.CrossRefGoogle Scholar
- 8.Instituto Nacional de. Câncer José Alencar Gomes da Silva. Coordenação de Prevenção e Vigilância. Estimate/2018—Cancer Incidence in Brazil. Rio de Janeiro: INCA; 2017.p. 128. http://www.inca.gov.br/estimativa/2018/estimativa-2018.pdf. Accessed 5 June 2018.