Trend and magnitude of Cancer mortality in Brazil and its relationship with socioeconomic conditions and health care provision

Abstract

The World Health Organization estimates 8.8 million deaths due to Cancer in 2015, totaling 15% of all causes of death worldwide. However, 70% of these deaths occur in low- and middle-income regions. Inequalities in Cancer mortality may be related to the socioeconomic determinants of disease incidence, as well as to the effectiveness of health services. Objectives: a) to describe the trend and magnitude of mortality for seven types of Cancer (lung, breast, pancreas, uterus, colon and rectum, prostate and head and neck) in 137 mesoregions of Brazil. b) to analyze the relationship of these outcomes with socioeconomic indices and health service provision. Methods: official mortality data will be gathered from the Mortality Information System, maintained by the Ministry of Health, with stratification by sex, age, year (1996-2015), place of residence and underlying cause. Population data will be informed by the general census conducted in 1991, 2000 and 2010, with estimates for the inter-census years provided by the Brazilian Institute of Geography and Statistics Foundation. Mortality will be adjusted for sex and age by the direct method and taking the standard of population proposed by the World Health Organization. The trend of mortality will be estimated using Prais-Winsten regression. The analysis of mortality distribution in the 137 mesoregions will use generalized regression models, which adjust for spatial autocorrelation. Prospective results: different factors can influence Cancer mortality. Understanding how these factors interrelate helps to create public health policies that aim to reduce the burden of disease in the population. It is expected that worst socioeconomic conditions are inversely correlated with mortality. Furthermore, it is expected that regions with a higher provision of health services exhibit lower magnitude and decreasing trends of Cancer mortality. (AU)