Spatial and spatio-temporal analysis of deaths from breast and cervical cancer, municipality of São Paulo, 2000 to 2016

Introduction - Breast and uterine cervical cancers are important causes of morbidity and mortality in the Brazilian female population. Therefore, it is important to look at deaths from these cancers in the municipality of São Paulo, from the spatial and temporal point of view, considering their distinct patterns in this territory. Objectives - to describe and analyze, in space and time, deaths from breast and cervical cancer, comparing these two cancers considering the distribution of socioeconomic status in the city, in women aged 20 years and over, living in the city of São Paulo, Brazil. 2000 to 2016. Methods - Ecological study, in which all deaths from breast cancer and uterine cervical cancer that occurred in the female population, in the age group, period and municipality of study, were considered. The following analysis modalities were developed: exploratory descriptive analysis; analysis by scan statistics to detect spatial, spatiotemporal clusters and spatial variation in temporal trends; bivariate analysis of spatial correlation between mortality rates and socioeconomic conditions in the municipality; and stratified analysis for breast cancer mortality among women up to 59 years of age and women aged 60 and over. Results - The success rate of georeferencing of deaths was 98.9%. Mortality from breast cancer declines at the end of the period, and the highest rates are located in central regions, with better socioeconomic conditions. However, it presents a change in spatial pattern over time, with increased mortality in the peripheral regions and reduction in the central regions. Mortality from cervical cancer did not change in pattern over time, with higher rates in peripheral regions, with worse socioeconomic conditions. As for the temporal trend, mortality from this cancer decreased, except in the 20-39 year old age group, with an increase. In the stratified analysis for breast cancer, differences in the spatial pattern were observed. In the elderly, the pattern is similar to the analysis without stratification. However, in the younger ones, the high concentration of rates in the central region is no longer so evident. Conclusion - the knowledge of spatial and temporal patterns allows the best allocation of resources for the prevention, health promotion, control and surveillance of cancers in the territories. (AU)