Modeling of Mortality in Elderly by Lung Cancer in the Northeast of Brazil

Abstract

In 2015, for the elderly (60 and over), lung cancer was the second leading cause of cancer death in Brazil (14%) and in the Northeast of the country (12.5%). With a population of 56 million inhabitants, the Northeastern Brazil is considered one of the less developed regions of the country and Latin America. The main goal was to identify sociodemographic and socioeconomic determinants of mortality by lung cancer in older people applying the Confirmatory Factorial Analysis (CFA). Using micro-data information from the 2010 census, a cross-sectional ecological study was adopted in 188 micro regions of the Northeast to cause-specific mortality by lung cancer and by sex. These results are compared to projected population for 2015 and to registered data for lung cancer. The following steps were performed: (1) The death data distribution by age was corrected; (2) Age-standardized corrected mortality rates were computed; (3) The CFA was applied. The outcome mortality rates due to lung cancer were observed directly, and a set of indicators regarding health, education, income and environmental conditions were used indirectly as latent variables. The CFA proved to be highly sensitive with significance in the measurement model for some relevant latent variables that can subsidize political planning. Rates were higher in micro regions with lower percentages of illiterate elderly, lower dependency ratio and higher percentage of elderly people living in households with running water. The levels were higher in elderly men and increased with age. In view of the high rates observed, and an aging process and life expectancy rising in the Northeast, it is expected that these levels should increase even more in the near future.