Disparities in female breast cancer mortality rates between urban centers and rural areas of Brazil: Ecological time-series study

• Published in: Breast (Edinburgh) Vol. 23; no. 2; pp. 180 - 187
• Main Authors: Gonzaga, Carolina M.R, Freitas-Junior, Ruffo, Souza, Marta R, Curado, Maria Paula, Freitas, Nilceana M.A
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.04.2014
• Subjects: Brazil; Breast cancer; Breast Neoplasms - mortality; Female; Healthcare Disparities; Hematology, Oncology and Palliative Medicine; Humans; Mortality; Rural Population - statistics & numerical data; Survival Rate - trends; Trends; Urban Population - statistics & numerical data; Brazil; Brazil; Breast cancer; Trends; Mortality
• ISSN: 0960-9776; 1532-3080
• DOI: 10.1016/j.breast.2014.01.006

Abstract Objectives To evaluate trends in breast cancer mortality in urban centers and rural areas of Brazil. Methods Ecological time-series study using data on breast cancer deaths and census. Mortality trends were analyzed using change-point regression: 1980–2010. Results A declining trend was found in five urban centers: São Paulo (APC = −1.7%), Porto Alegre (APC = −1.6%), Belo Horizonte (APC = −1.2%), Rio de Janeiro and Recife (APC = −0.9%). An increasing was found in: Porto Velho (APC = 9.0%), Teresina (APC = 4.6%), João Pessoa (APC = 1.6%), Belém (APC = 0.8%) and Fortaleza (APC = 0.5%). In the majority of rural areas, mortality continues to rise, with the exception of some areas in the southern. Conclusion Disparities in breast cancer mortality were found across the country, with increasing trends occurring predominantly in the north and northeastern regions. One of the reasons for this disparity may be that access to treatment is more difficult for patients living in rural areas and in the north of Brazil.