EVOLUTION OF MORTALITY FOR COLORECTAL CANCER IN BRAZIL AND REGIONS, BY SEX, 1996-2015

DUTRA, Viviane Gomes Parreira; PARREIRA, Virgilio Augusto Gomes; GUIMARÃES, Raphael Mendonça

doi:10.1590/S0004-2803.201800000-12

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ORIGINAL ARTICLE • Arq. Gastroenterol. 55 (01) • Jan-Mar 2018 • https://doi.org/10.1590/S0004-2803.201800000-12 copy

EVOLUTION OF MORTALITY FOR COLORECTAL CANCER IN BRAZIL AND REGIONS, BY SEX, 1996-2015

Evolução da mortalidade por câncer de cólon e reto no Brasil e regiões, 1995 a 2015

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND:

Colorectal cancer is among the three most frequent neoplasms in Brazil, being a public health problem.

OBJECTIVE:

To describe distribution pattern of colorectal cancer mortality in Brazil and regions, according to sex, between 1996 and 2015.

METHODS:

Values of standardized and stratified mortality rates by sex between 1996 and 2015 were used, through polynomial regression models and joinpoint analysis.

RESULTS:

It was observed that, for linear trends in mortality rates, for both sexes, there is a statistically significant trend increasing in both models, with rates and trends, and higher for men than for women, respectively, 7.3% per year (R²=0.95, P<0.001) and 6.5% per year (R²=0.87, P<0.001). It is observed a difference in magnitude and behavior of trend between the regions.

CONCLUSION:

It is understood that it is important to know the trend of rates in order to define priority populations for early interventions that increase survival and reduce mortality.

HEADINGS:
Colorectal neoplasms, mortality; Men; Women; Regression analysis; Colonic neoplasms; Time series studies

Local	R	n₀	n₁	n	E (R)	Var (R)	SD (R)	Z	P value
Brazil
Male	2	8	10	18	9.89	4.11	2.04	-3.88	<0.001
Female	2	7	11	18	9.56	3.9	1.93	-3.87	<0.001
Total	2	7	11	18	9.56	3.8	1.95	-3.87	<0.001
Midwest
Male	2	8	10	18	9.89	4.11	2.03	-3.88	<0.001
Female	2	7	11	18	9.56	3.79	1.95	-3.87	<0.001
Total	2	8	10	18	9.89	4.13	2.03	-3.88	<0.001
North
Male	2	9	9	18	10	4.28	2.05	-3.89	0.001
Female	2	10	8	18	9.89	4.16	2.03	-3.88	<0.001
Total	2	10	8	18	9.89	4.17	2.04	-3.88	<0.001
Northeast
Male	2	9	9	18	10	4.26	2.06	-3.89	<0.001
Female	2	8	10	18	9.89	4.15	2.03	-3.88	<0.001
Total	2	8	10	18	9.89	4.19	2.03	-3.88	<0.001
South
Male	4	10	8	18	9.89	4.10	2.03	-2.9	0.002
Female	4	9	9	18	10	4.23	2.06	-2.92	0.002
Total	4	8	10	18	9.89	4.14	2.03	-2.9	0.002
Southeast
Male	2	7	11	18	9.56	3.87	1.95	-3.87	<0.001
Female	4	8	10	18	9.89	4.15	2.03	-2.9	0.002
Total	4	8	10	18	9.89	4.11	2.03	-2.9	0.002

Local	β₀	β₁	SE_res	df	R²	F	Trend	P value*
Brazil
Male	5.64	0.16	0.15	16	0.97	484.5	increase	<0.001
Female	5.73	0.11	0.20	16	0.85	94.2	increase	0.002
Total	5.69	0.12	0.18	16	0.92	205.2	increase	0.001
Midwest
Male	4.24	0.22	0.20	16	0.96	442.2	increase	<0.001
Female	4.48	0.2	0.38	16	0.84	91.6	increase	0.003
Total	4.37	0.19	0.27	16	0.93	211.5	increase	<0.001
North
Male	1.30	0.15	0.16	16	0.95	330.7	increase	<0.001
Female	2.40	0.1	0.24	16	0.68	36.9	increase	0.01
Total	1.84	0.17	0.15	16	0.93	210.6	increase	<0.001
Northeast
Male	1.51	0.2	0.10	16	0.99	1186.0	increase	<0.001
Female	2.00	0.17	0.10	16	0.98	723.8	increase	<0.001
Total	1.77	0.17	0.09	16	0.99	1191.0	increase	<0.001
South
Male	7.95	0.19	0.36	16	0.87	116.2	increase	0.001
Female	7.62	0.1	0.39	16	0.53	20.0	increase	0.03
Total	7.77	0.13	0.36	16	0.76	55.5	increase	0.002
Southeast
Male	8.08	0.18	0.20	16	0.94	248.0	increase	<0.001
Female	7.42	0.13	0.24	16	0.73	47.0	increase	0.008
Total	7.56	0.17	0.22	16	0.87	114.5	increase	0.005

Sex/Region	Model	R²	P value	Trend
Midwest
Male	y= 6.09 + 0.18x	0.96	<0.001	increase
Female	y= 6.04 + 0.15x	0.84	<0.001	increase
Total	y= 6.07 + 0.16x	0.93	<0.001	increase
Northeast
Male	Y= 2.95 + 0.14X	0.99	<0.001	increase
Female	Y= 3.19 + 0.12X	0.98	<0.001	increase
Total	Y= 3.08 + 0.13X	0.98	<0.001	increase
North
Male	y= 2.54 + 0.12X	0.94	<0.001	increase
Female	y= 3.03 + 0.06X	0.73	<0.001	increase
Total	y= 2.78 + 0.09X	0.92	<0.001	increase
Southeast
Male	y= 9.46 + 0.13x	0.93	<0.001	increase
Female	y= 8.14 + 0.08x	0.76	<0.001	increase
Total	y= 8.57 + 0.12x	0.89	<0.001	increase
South
Male	y= 9.62 + 0.16x	0.85	<0.001	increase
Female	y= 8.38 + 0.09x	0.58	0.001	increase
Total	y= 8.94 + 0.13x	0.77	<0.001	increase
Brazil
Male	y= 7.04 + 0.14x	0.96	<0.001	increase
Female	y= 6.56 + 0.08x	0.84	<0.001	increase
Total	y= 6.77 + 0.11x	0.91	<0.001	increase

Region	Sex	Period	APC	95% CI		P value
Region	Sex	Period	APC	LL	UL	P value
North	Total	1996-2015	3.61	3.12	4.09	<0.001
	Male	1996-2015	5.41	4.85	5.96	<0.001
	Female	1996-2015	2.83	1.39	3.03	<0.001
Northeast	Total	1996-2015	4.65	4.37	4.95	<0.001
	Male	1996-2015	5.41	5.04	5.78	<0.001
	Female	1996-2015	4.09	3.77	4.38	<0.001
Southeast	Total	1996-2015	1.26	1.02	1.50	0.020
	Male	1996-2015	1.57	1.34	1.79	0.005
	Female	1996-2015	0.95	0.66	1.24	0.01
South	Total	1996-2015	1.42	1.03	1.78	0.003
	Male	1996-2015	1.86	1.49	2.24	0.001
	Female	1996-2015	0.98	0.53	1.42	0.008
Midwest	Total	1996-2015	3.07	2.59	3.56	<0.001
	Male	1996-2015	3.31	2.95	3.68	<0.001
	Female	1996-2015	2.87	2.21	3.53	<0.001
Brazil	Total	1996-2015	1.71	1.45	1.97	0.002
	Male	1996-2015	2.14	1.93	2.36	<0.001
	Female	1996-2015	1.35	1.05	1.65	<0.001

Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. Rua Dr. Seng, 320, 01331-020 São Paulo - SP Brasil, Tel./Fax: +55 11 3147-6227 - São Paulo - SP - Brazil
E-mail: secretariaarqgastr@hospitaligesp.com.br

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[1] Correspondence: Raphael Mendonça Guimarães. Av. Brasil, 4365, Manguinhos - EPSJV/Fiocruz. CEP: 21040-360 - Rio de Janeiro, RJ, Brasil. E-mail: raphael.guimaraes@fiocruz.br