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      EVOLUTION OF MORTALITY FOR COLORECTAL CANCER IN BRAZIL AND REGIONS, BY SEX, 1996-2015 Translated title: Evolução da mortalidade por câncer de cólon e reto no Brasil e regiões, 1995 a 2015

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      Arquivos de Gastroenterologia
      Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE; Colégio Brasileiro de Cirurgia Digestiva - CBCD; Sociedade Brasileira de Motilidade Digestiva e Neurogastroenterologia - SBMDN; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED
      Neoplasias colorretais, mortalidade, Homens, Mulheres, Análise de regressão, Neoplasia do colo, Estudos de séries temporais, Colorectal neoplasms, mortality, Men, Women, Regression analysis, Colonic neoplasms, Time series studies

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          Abstract

          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.

          Translated abstract

          RESUMO CONTEXTO: O câncer de cólon e reto está entre as três neoplasias mais frequentes no Brasil, sendo um problema de saúde pública. OBJETIVO: Descrever o padrão de distribuição da mortalidade por câncer de cólon e reto no Brasil e regiões, por sexo, no período de 1996 a 2015. MÉTODOS: Utilizou-se os valores de taxas de mortalidade padronizadas e estratificadas por sexo entre 1996 e 2015, através dos modelos de regressão polinomial e análise por joinpoints. RESULTADOS: Foi observado que, para as tendências lineares das taxas de mortalidade, para ambos os sexos, há tendência de aumento linear estatisticamente significativa em ambos os modelos, sendo as taxas e as tendências maiores para homens do que para mulheres, respectivamente, 7,3% ao ano (R2=0,95; P<0,001) e 6,5% ao ano (R2=0,87; P<0,001). Observa-se diferença na magnitude e comportamento da tendência entre as regiões. CONCLUSÃO: Entende-se que é importante conhecer a tendência das taxas de forma a definir populações prioritárias para intervenções precoces que aumentem a sobrevida e reduzam a mortalidade.

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          Cancer Disparities by Race/Ethnicity and Socioeconomic Status

          This article highlights disparities in cancer incidence, mortality, and survival in relation to race/ethnicity, and census data on poverty in the county or census tract of residence. The incidence and survival data derive from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) Program; mortality data are from the National Center for Health Statistics (NCHS); data on the prevalence of major cancer risk factors and cancer screening are from the National Health Interview Survey (NHIS) conducted by NCHS. For all cancer sites combined, residents of poorer counties (those with greater than or equal to 20% of the population below the poverty line) have 13% higher death rates from cancer in men and 3% higher rates in women compared with more affluent counties (less than 10% below the poverty line). Differences in cancer survival account for part of this disparity. Among both men and women, five-year survival for all cancers combined is 10 percentage points lower among persons who live in poorer than in more affluent census tracts. Even when census tract poverty rate is accounted for, however, African American, American Indian/Alaskan Native, and Asian/Pacific Islander men and African American and American Indian/Alaskan Native women have lower five-year survival than non-Hispanic Whites. More detailed analyses of selected cancers show large variations in cancer survival by race and ethnicity. Opportunities to reduce cancer disparities exist in prevention (reductions in tobacco use, physical inactivity, and obesity), early detection (mammography, colorectal screening, Pap tests), treatment, and palliative care.
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            Recent trends of cancer in Europe: a combined approach of incidence, survival and mortality for 17 cancer sites since the 1990s.

            We present a comprehensive overview of most recent European trends in population-based incidence of, mortality from and relative survival for patients with cancer since the mid 1990s. Data on incidence, mortality and 5-year relative survival from the mid 1990s to early 2000 for the cancers of the oral cavity and pharynx, oesophagus, stomach, colorectum, pancreas, larynx, lung, skin melanoma, breast, cervix, corpus uteri, ovary, prostate, testis, kidney, bladder, and Hodgkin's disease were obtained from cancer registries from 21 European countries. Estimated annual percentages change in incidence and mortality were calculated. Survival trends were analyzed by calculating the relative difference in 5-year relative survival between 1990-1994 and 2000-2002 using data from EUROCARE-3 and -4. Trends in incidence were generally favorable in the more prosperous countries from Northern and Western Europe, except for obesity related cancers. Whereas incidence of and mortality from tobacco-related cancers decreased for males in Northern, Western and Southern Europe, they increased for both sexes in Central Europe and for females nearly everywhere in Europe. Survival rates generally improved, mostly due to better access to specialized diagnostics, staging and treatment. Marked effects of organised or opportunistic screening became visible for breast, prostate and melanoma in the wealthier countries. Mortality trends were generally favourable, except for smoking related cancers. Cancer prevention and management in Europe is moving in the right direction. Survival increased and mortality decreased through the combination of earlier detection, better access to care and improved treatment. Still, cancer prevention efforts have much to attain, especially in the domain of female smoking prevalence and the emerging obesity epidemic.
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              Young-onset colorectal cancer: is it time to pay attention?

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                ag
                Arquivos de Gastroenterologia
                Arq. Gastroenterol.
                Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE; Colégio Brasileiro de Cirurgia Digestiva - CBCD; Sociedade Brasileira de Motilidade Digestiva e Neurogastroenterologia - SBMDN; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED (São Paulo, SP, Brazil )
                0004-2803
                1678-4219
                March 2018
                : 55
                : 1
                : 61-65
                Affiliations
                [3] Rio de Janeiro orgnameFundação Oswaldo Cruz Brazil
                [1] Rio de Janeiro orgnameFundação Oswaldo Cruz orgdiv1Instituto Nacional de Infectologia Evandro Chagas Brazil
                [2] Rio de Janeiro Rio de Janeiro orgnameInstituto Nacional do Câncer Brazil
                Article
                S0004-28032018000100061
                10.1590/s0004-2803.201800000-12
                9db072d5-df28-46ed-8bd8-c7e77a22adf4

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 13 September 2017
                : 17 July 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 36, Pages: 5
                Product

                SciELO Brazil


                Time series studies,Neoplasias colorretais, mortalidade,Homens,Mulheres,Análise de regressão,Neoplasia do colo,Estudos de séries temporais,Colorectal neoplasms, mortality,Men,Women,Regression analysis,Colonic neoplasms

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