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      Critical review of cancer mortality using hospital records and potential years of life lost Translated title: Revisão crítica da mortalidade por câncer usando registros hospitalares e anos potenciais de vida perdidos

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          ABSTRACT

          Objective

          To determine and discuss cancer mortality rates in southern Brazil between 1988 and 2012.

          Methods

          This was a critical review of literature based on analysis of data concerning incidence and mortality of prostate cancer, breast cancer, bronchial and lung cancer, and uterine and ovarian cancer. Data were collected from the online database of the Brazil Instituto Nacional de Câncer José Alencar Gomes da Silva.

          Results

          The southern Brazil is the leading region of cancer incidence and mortality. Data on the cancer profile of this population are scarce especially in the States of Santa Catarina and Paraná. We observed inconsistency between data from hospital registers and death recorded.

          Conclusion

          Both cancer incidence and the mortality are high in Brazil. In addition, Brazil has great numbers of registers and deaths for cancer compared to worldwide rates. Regional risk factors might explain the high cancer rates.

          RESUMO

          Objetivo

          Investigar e discutir os indicadores de mortalidade por câncer na Região Sul do Brasil entre 1988 e 2012.

          Métodos

          Revisão crítica da literatura baseada na análise de dados referentes às estimativas de incidência e mortalidade dos cânceres de próstata, mama feminina, brônquios e pulmões, colo de útero e ovário, realizada por meio de consulta na base de dados online do Instituto Nacional de Câncer José Alencar Gomes da Silva.

          Resultados

          A Região Sul lidera no país a incidência e a mortalidade das neoplasias estudadas. Há escassez de dados sobre o perfil do câncer nesta população, especialmente nos Estados de Santa Catarina e Paraná. Notou-se, ainda, incoerência entre os dados de registros hospitalares e registros de óbito no período estudado.

          Conclusão

          Tanto a incidência quanto a mortalidade decorrentes dos cânceres estudados ainda são muito elevadas no Brasil, com significante número de registros da doença e de óbitos, quando comparado às taxas mundiais. Fatores de risco regionais podem explicar as elevadas taxas.

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          Most cited references22

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          Patterns and trends in prostate cancer incidence, survival, prevalence and mortality. Part I: international comparisons.

          Andrew Quinn, P Babb (2002)
          The international patterns and trends in prostate cancer incidence, survival, prevalence and mortality were examined. Age-standardized incidence and death rates among men in a variety of countries worldwide were obtained from various sources, survival rates from European sources and elsewhere, and prevalence estimates from the EUROPREVAL study. Results from many published studies were summarized. The incidence of prostate cancer varies widely around the world, with by far the highest rates in the USA and Canada. There has been a gradual increase in the incidence of prostate cancer since the 1960s in many countries and in most continents; there were large increases in the late 1980s and early 1990s in the USA, but increases have also occurred in countries with comparatively low incidence, e.g. India. Survival from prostate cancer improved during the 1970s and 1980s; further increases in the 1990s may be largely a result of earlier diagnosis. There were wide differences in survival across Europe, with rates in the UK well below the average, but all European rates were far below those in the USA. There was wide variation in the prevalence of prostate cancer in Europe; in some countries with high incidence and high life-expectancy, prostate cancers formed approximately 15% of all prevalent cancers in men. Mortality from prostate cancer has also increased in many countries, but to a lesser extent than incidence; this is consistent with the observed trends in survival. Mortality decreased slightly in the mid to late 1990s in several countries, including the USA, Canada, England, France and Austria. Part of the apparent increases in the incidence of prostate cancer has been associated with diagnostic artefacts (particularly detecting preclinical tumours through the increased use of transurethral resection) which may also have had an effect on death certification through the incorrect attribution of prostate cancer as the underlying cause of death. However, the greatest effect on the registration of new cases of prostate cancer has been the increased availability of prostate specific antigen testing during the early- to mid-1990s. Possibly, in addition to the effect of attribution bias, the earlier diagnosis of prostate cancers has contributed to the recent slight decreases in mortality. However, this is unlikely to account for much of the reduction, given the slow development of the disease from onset to death. Changes in disease management are probably more important. There are many strong arguments against introducing population-based screening for prostate cancer.
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            Disparities in cervical and breast cancer mortality in Brazil

            Vania Reis Girianelli, Carmen Gamarra, Gulnar Silva (2014)
            OBJECTIVE To analyze cervical and breast cancer mortality in Brazil according to socioeconomic and welfare indicators. METHODS Data on breast and cervical cancer mortality covering a 30-year period (1980-2010) were analyzed. The data were obtained from the National Mortality Database, population data from the Brazilian Institute of Geography and Statistics database, and socioeconomic and welfare information from the Institute of Applied Economic Research. Moving averages were calculated, disaggregated by capital city and municipality. The annual percent change in mortality rates was estimated by segmented linear regression using the joinpoint method. Pearson’s correlation coefficients were conducted between average mortality rate at the end of the three-year period and selected indicators in the state capital and each Brazilian state. RESULTS There was a decline in cervical cancer mortality rates throughout the period studied, except in municipalities outside of the capitals in the North and Northeast. There was a decrease in breast cancer mortality in the capitals from the end of the 1990s onwards. Favorable socioeconomic indicators were inversely correlated with cervical cancer mortality. A strong direct correlation was found with favorable indicators and an inverse correlation with fertility rate and breast cancer mortality in inner cities. CONCLUSIONS There is an ongoing dynamic process of increased risk of cervical and breast cancer and attenuation of mortality because of increased, albeit unequal, access to and provision of screening, diagnosis and treatment. 
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              Tendências da mortalidade por câncer nas capitais dos estados do Brasil, 1980-2004

              Luiz Fonseca, José Eluf Neto, Victor Wünsch-Filho (2010)
              OBJETIVO: A mortalidade por câncer iniciou declínio nos países desenvolvidos nos anos 90, mas seu comportamento nos países em desenvolvimento é menos conhecido. Estudo anterior abordando a mortalidade por câncer no Brasil mostrou queda na mortalidade pelo conjunto dos cânceres, mas a qualidade dos dados suscitou críticas quanto à validade dos resultados. As informações de mortalidade das capitais dos estados do Brasil são de melhor qualidade que aquelas para o país como um todo, possibilitando análise mais acurada das tendências. MÉTODOS: Os dados de mortalidade e população foram obtidos das bases de dados do Ministério da Saúde e do IBGE. Calcularam-se taxas ajustadas por idade e taxas específicas por idade, para ambos os sexos. Empregou-se regressão linear para avaliar a significância das mudanças de tendência. RESULTADOS: As taxas de mortalidade pelo conjunto dos cânceres declinaram, (-4,6% para os homens e -10,5% para as mulheres). O câncer de estômago mostrou queda de taxas nos dois sexos, assim como o câncer de pulmão entre os homens, enquanto as taxas do câncer de próstata aumentaram. No sexo feminino, “câncer do útero não especificado" apresentou redução e o câncer de pulmão, aumento de taxas. O câncer de mama mostrou-se estável, e o câncer do colo do útero aumentou suas taxas ao final do período. CONCLUSÃO: Conforme já registrado em países desenvolvidos, a mortalidade pelo conjunto dos cânceres nas capitais de estados brasileiros mostrou tendência de queda entre 1980 e 2004, o que se deveu fundamentalmente ao declínio da mortalidade por câncer de estômago.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Einstein (Sao Paulo)
                Journal ID (iso-abbrev): Einstein (Sao Paulo)
                Journal ID (publisher-id): eins
                Title: Einstein
                Publisher: Instituto Israelita de Ensino e Pesquisa Albert Einstein
                ISSN (Print): 1679-4508
                ISSN (Electronic): 2317-6385
                Publication date Collection: 2018
                Publication date (Electronic): 06 April 2018
                Volume: 16
                Issue: 1
                Electronic Location Identifier: eAO4018
                Affiliations
                [1 ]Group of Advanced Studies in Health Applied Sciences, Universidade Estadual do Oeste do Paraná, Francisco Beltrão, PR, Brazil
                Author notes
                Corresponding author: Carolina Panis, Universidade Estadual do Oeste do Paraná, Centro de Ciências da Saúde Rodovia PR 180, Km 02 − Água Branca − Zip code: 85601-970, Francisco Beltrão, PR, Brazil, Phone: (55 46) 3520-4886 E-mail: carolpanis@ 123456hotmail.com

                Conflict of interest:

                none.

                Article
                DOI: 10.1590/S1679-45082018AO4018
                PMC ID: 5968795
                PubMed ID: 29694620
                SO-VID: f591e405-9cde-4212-b3af-83e4c2efca0c
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 13 February 2017
                Date accepted : 04 August 2017
                Page count
                Figures: 6, Tables: 4, Equations: 0, References: 30, Pages: 7
                Categories
                Subject: Original Article

                Keywords: neoplasms/mortality,hospital records,potential years of life lost,brazil,neoplasias/mortalidade,registros hospitalares,anos potenciais de vida perdidos,brasil
                Data availability:
                Keywords: neoplasms/mortality, hospital records, potential years of life lost, brazil, neoplasias/mortalidade, registros hospitalares, anos potenciais de vida perdidos, brasil

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