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Recent changes in trends of mortality from cervical cancer in Southeastern Brazil

OBJECTIVE: To analyze the trends of cervical cancer mortality in Brazilian Southeastern states, and to compare them to Brazil and other regions between 1980 and 2020. METHODS: Time series study based on data from the Sistema de Informações de Mortalidade (Brazilian Mortality Information System). Dea...

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Autores principales: Luizaga, Carolina Terra de Moraes, Jardim, Beatriz Cordeiro, Wünsch, Victor, Eluf, José, Silva, Gulnar Azevedo e
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Faculdade de Saúde Pública da Universidade de São Paulo 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10118416/
https://www.ncbi.nlm.nih.gov/pubmed/37075421
http://dx.doi.org/10.11606/s1518-8787.2023057004709
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author Luizaga, Carolina Terra de Moraes
Jardim, Beatriz Cordeiro
Wünsch, Victor
Eluf, José
Silva, Gulnar Azevedo e
author_facet Luizaga, Carolina Terra de Moraes
Jardim, Beatriz Cordeiro
Wünsch, Victor
Eluf, José
Silva, Gulnar Azevedo e
author_sort Luizaga, Carolina Terra de Moraes
collection PubMed
description OBJECTIVE: To analyze the trends of cervical cancer mortality in Brazilian Southeastern states, and to compare them to Brazil and other regions between 1980 and 2020. METHODS: Time series study based on data from the Sistema de Informações de Mortalidade (Brazilian Mortality Information System). Death data were corrected by proportional redistribution of deaths from ill-defined causes and cervical cancer of unspecified portion. Age-standardized and age-specific rates were calculated by screening target (25–39 years; 40–64 years) and non-target (65 years or older) age groups. Annual percentage changes (APC) were estimated by linear regression model with breakpoints. The coverage of Pap Smear exam in the Unified Health System (SUS) was evaluated between 2009 and 2020 according to age group and locality. RESULTS: There were increases in corrected mortality rates both in 1980 and in 2020 in all regions, with most evident increments at the beginning of the series. There was a decrease in mortality nationwide between 1980–2020; however, the state of São Paulo showed a discrete upward trend in 2014–2020 (APC=1.237; 95%CI 0.046–2.443). Noteworthy is the trend increment in the 25–39 year-old group in all study localities, being sharper in the Southeast region in 2013–2020 (APC=5.072; 95%CI 3.971–6.185). Screening coverage rates were highest in São Paulo and lowest in Rio de Janeiro, with a consistent decline from 2012 onwards at all ages. CONCLUSIONS: São Paulo is the first Brazilian state to show a reversal trend in mortality from cervical cancer. The changes in mortality patterns identified in this study point to the need for reorganization of the current screening program, which should be improved to ensure high coverage, quality, and adequate follow-up of all women with altered test results.
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spelling pubmed-101184162023-08-28 Recent changes in trends of mortality from cervical cancer in Southeastern Brazil Luizaga, Carolina Terra de Moraes Jardim, Beatriz Cordeiro Wünsch, Victor Eluf, José Silva, Gulnar Azevedo e Rev Saude Publica Original Article OBJECTIVE: To analyze the trends of cervical cancer mortality in Brazilian Southeastern states, and to compare them to Brazil and other regions between 1980 and 2020. METHODS: Time series study based on data from the Sistema de Informações de Mortalidade (Brazilian Mortality Information System). Death data were corrected by proportional redistribution of deaths from ill-defined causes and cervical cancer of unspecified portion. Age-standardized and age-specific rates were calculated by screening target (25–39 years; 40–64 years) and non-target (65 years or older) age groups. Annual percentage changes (APC) were estimated by linear regression model with breakpoints. The coverage of Pap Smear exam in the Unified Health System (SUS) was evaluated between 2009 and 2020 according to age group and locality. RESULTS: There were increases in corrected mortality rates both in 1980 and in 2020 in all regions, with most evident increments at the beginning of the series. There was a decrease in mortality nationwide between 1980–2020; however, the state of São Paulo showed a discrete upward trend in 2014–2020 (APC=1.237; 95%CI 0.046–2.443). Noteworthy is the trend increment in the 25–39 year-old group in all study localities, being sharper in the Southeast region in 2013–2020 (APC=5.072; 95%CI 3.971–6.185). Screening coverage rates were highest in São Paulo and lowest in Rio de Janeiro, with a consistent decline from 2012 onwards at all ages. CONCLUSIONS: São Paulo is the first Brazilian state to show a reversal trend in mortality from cervical cancer. The changes in mortality patterns identified in this study point to the need for reorganization of the current screening program, which should be improved to ensure high coverage, quality, and adequate follow-up of all women with altered test results. Faculdade de Saúde Pública da Universidade de São Paulo 2023-08-28 /pmc/articles/PMC10118416/ /pubmed/37075421 http://dx.doi.org/10.11606/s1518-8787.2023057004709 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Luizaga, Carolina Terra de Moraes
Jardim, Beatriz Cordeiro
Wünsch, Victor
Eluf, José
Silva, Gulnar Azevedo e
Recent changes in trends of mortality from cervical cancer in Southeastern Brazil
title Recent changes in trends of mortality from cervical cancer in Southeastern Brazil
title_full Recent changes in trends of mortality from cervical cancer in Southeastern Brazil
title_fullStr Recent changes in trends of mortality from cervical cancer in Southeastern Brazil
title_full_unstemmed Recent changes in trends of mortality from cervical cancer in Southeastern Brazil
title_short Recent changes in trends of mortality from cervical cancer in Southeastern Brazil
title_sort recent changes in trends of mortality from cervical cancer in southeastern brazil
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10118416/
https://www.ncbi.nlm.nih.gov/pubmed/37075421
http://dx.doi.org/10.11606/s1518-8787.2023057004709
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