Gastric Cancer

, Volume 22, Issue 4, pp 675–683 | Cite as

Unequal burden of mortality from gastric cancer in Brazil and its regions, 2000–2015

  • Lucia Libanez Bessa Campelo BragaEmail author
  • Alberto Novaes RamosJr.
  • Manuel Bonfim Braga Neto
  • Anderson Fuentes Ferreira
  • Dulciene Maria Magalhães Queiroz
  • Danielle Calheiros Campelo Maia
  • Carlos Henrique Alencar
  • Jorg Heukelbach
Original Article



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.


Gastric 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.

Author contributions

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.


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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2019

Authors and Affiliations

  • Lucia Libanez Bessa Campelo Braga
    • 1
    Email author
  • Alberto Novaes RamosJr.
    • 2
  • Manuel Bonfim Braga Neto
    • 1
  • Anderson Fuentes Ferreira
    • 2
  • Dulciene Maria Magalhães Queiroz
    • 3
  • Danielle Calheiros Campelo Maia
    • 1
  • Carlos Henrique Alencar
    • 2
  • Jorg Heukelbach
    • 2
    • 4
  1. 1.Clinical Research Unit/Biomedicine Institute, Department of Internal Medicine, School of MedicineFederal UniversityFortalezaBrazil
  2. 2.Department of Community Health, School of MedicineFederal University of CearáFortalezaBrazil
  3. 3.Laboratory of Research in Bacteriology, School of MedicineFederal University of Minas GeraisBelo HorizonteBrazil
  4. 4.Division of Tropical Health and Medicine, College of Public Health, Medical and Veterinary SciencesJames Cook UniversityTownsvilleAustralia

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