Comportamento da mortalidade por câncer de mama nos municípios brasileiros e fatores associados

OBJECTIVE. To analyze breast cancer mortality trends in Brazilian municipalities and assess the influence of socioeconomic and demographic factors on mortality rates. METHODS. Age-adjusted mortality rates were calculated for the periods centered in 1990, 2000, and 2010 and corrected for ill-defined causes of death. After that, panel data regression models were developed for analysis of the association between the factors of interest and the mortality rate from breast cancer in Brazilian municipalities RESULTS. A growing trend was detected in breast cancer mortality in Brazil. However, the models showed that the mortality could have decreased (negative trend), especially in the Southeast and South regions, if some associated factors (such as income, education, longevity, fertility rate, health spending, and infrastructure, among others) had remained constant during the study period. Breast cancer mortality was positively/significantly associated with longevity and negatively/significantly associated with public health spending. Mortality was higher in the South and Southeast, in municipalities with more than 500 000 inhabitants and in those with population below 5 000. CONCLUSIONS. The growth in per capita income, the increase in life expectancy, and the decrease in fertility rates may be associated with high breast cancer mortality and a trend towards increased mortality from this cancer in Brazilian municipalities.