Disparities in female breast cancer mortality rates between urban centers and rural areas of Brazil: Ecological time-series study

Background: Living at moderate altitude may be associated with health benefits, including reduced mortality from male colorectal and female breast cancer. We aimed to determine altitude-dependent incidence and mortality rates of those cancers and put them in the context of altitude-associated lifestyle differences. Methods: Incidence cases and deaths of male colorectal cancer (n = 17,712 and 7462) and female breast cancer (n = 33,803 and 9147) from altitude categories between 250 to about 2000 m were extracted from official Austrian registries across 10 years (2008–2017). Altitude-associated differences in health determinants were derived from the Austrian Health Interview Survey (2014). Results: The age-standardized incidence and mortality rates of male colorectal cancer decreased by 24.0% and 44.2%, and that of female breast cancer by 6.5% and 26.2%, respectively, from the lowest to the highest altitude level. Higher physical activity levels and lower body mass index for both sexes living at higher altitudes were found. Conclusions: Living at a moderate altitude was associated with a reduced incidence and (more pronounced) mortality from colorectal and breast cancer. Our results suggest a complex interaction between specific climate conditions and lifestyle behaviours. These observations may, in certain cases, support decision making when changing residence.

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Female breast cancer mortality in Brazil and its regions

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.60.04.019 ◽

2014 ◽

Vol 60 (4) ◽

pp. 387-393 ◽

Cited By ~ 12

Author(s):

Ana Claudia Garabeli Cavalli Kluthcovsky ◽

Thaisa Nogueira Palozi Faria ◽

Fabio Henrique Carneiro ◽

Robson Strona

Keyword(s):

Breast Cancer ◽

Cancer Mortality ◽

Breast Cancer Mortality ◽

Mortality Rates ◽

Female Breast Cancer ◽

Mortality Data ◽

Mortality Trends ◽

Female Breast ◽

Its Regions ◽

Proportional Mortality

Objective: to analyze female breast cancer mortality trends in Brazil and its regions. Methods: female breast cancer mortality in Brazil and its regions was analyzed using mortality data from the Ministry of Health's Mortality Information System and the National Cancer Institute between 1991 and 2010. The variables analyzed were. proportional mortality from female breast cancer in relation to total deaths in women, mortality rates of the five primary locations of the neoplasms most common in women, and mortality rates for female breast cancer: Linear regression models were estimated to analyze mortality trends: Results: a growth in proportional mortality due to female breast cancer in Brazil and its regions was observed: In relation to the mortality rates for the five primary types of cancer, breast cancer persisted in first place in Brazil and its regions, except the North region, where cervical cancer was the most frequent: Rising female breast cancer mortality rates were observed for Brazil (p = 0.017), Northeastern (p < 0.001), North (p < 0.001) and the Mid-West (p = 0.001), regions, and declining rates for the Southeast region (p = 0.047), and stable rates for the South region. Conclusion: the results emphasize the importance of the disease in terms of public health in the country, reinforcing the need for early detection and appropriate treatment.

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Effects of county-level attributes on geographic variation in female breast cancer mortality rates across counties in United States.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e13093 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e13093-e13093

Author(s):

Hari Krishna Raju Sagiraju ◽

Ismail Jatoi ◽

Melissa Valerio ◽

Lung-Chang Chien ◽

David Gimeno

Keyword(s):

Breast Cancer ◽

Cancer Mortality ◽

Breast Cancer Mortality ◽

Mortality Rates ◽

Female Breast Cancer ◽

County Level ◽

Female Breast ◽

Midwest Region ◽

Black Unemployment ◽

Hispanic White

e13093 Background: Though studies have examined geographic disparities in breast cancer mortality among United States (U.S.) counties, county-level risk factors were not accounted for. The aim of this study is to efficiently map the spatial association between female breast cancer mortality rates & socioeconomic attributes across U.S. counties for identifying high risk geographical clusters in terms of socioeconomic attributes. Methods: County-specific age standardized breast cancer mortality rates for women ≥20 years in the U.S. were obtained for 3,109 counties in 48 contiguous states from Surveillance Epidemiology and End Results program from 1990-2012. County-level attributes such as percentages of Hispanic white, Non-Hispanic white, Non-Hispanic black, < high school education, below 200% poverty, urban, foreign born, language isolation, women aged ≥ 40 years with mammography within last 2 years, and median household income were gathered from U.S. decennial census. Factor analysis condensed county attributes into three factor covariates namely Hispanic immigrants, health care access among urban high socioeconomic population, and non-Hispanic black unemployment. Spatiotemporal analysis was carried out by structured additive regression model to incorporate spatial functions & Markov chain Monte Carlo simulation techniques. Results: Moran’s index suggested existence of spatial dependence for breast cancer mortality among U.S. counties. As mammography screening, %urban population, % with high socioeconomic status and non-Hispanic black unemployment increased in counties of the Southwest region, Rocky mountain region and those in the western border of Midwest region of U.S, risk of breast cancer mortality increased significantly above the national average. As the Hispanic immigrant culture increased, counties of Midwest region of U.S had significantly higher mortality rates compared to national average. Conclusions: These initial results describe socio-economic, cultural, and healthcare access factors for observed geographic variations in female breast cancer mortality, and in turn, could support a stronger theoretical basis for public health policy.

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Race Disparities in Mortality By Breast Cancer From 2000 to 2017 in São Paulo, Brazil: A Time-Series Study

10.21203/rs.3.rs-420370/v1 ◽

2021 ◽

Author(s):

Ana Cláudia Marcelino ◽

Bruno Gozzi ◽

Cássio Cardoso-Filho ◽

Helymar Machado ◽

Luiz Carlos Zeferino ◽

...

Keyword(s):

Breast Cancer ◽

Time Series ◽

Black Women ◽

Causes Of Death ◽

White Women ◽

Mortality Rates ◽

Sao Paulo ◽

São Paulo ◽

Time Series Study ◽

Series Study

Abstract Background In Brazil, inequalities in access to care are present. This study aimed to evaluate the influence of race on breast cancer mortality in the state of São Paulo, from 2000 to 2017, contextualizing with other causes of death. Methods A retrospective cross-sectional time-series study using age and race as variables. Information on deaths was collected from the Ministry of Health Information System. Only white and black/brown categories were used. Mortality rates were age-adjusted by the standard method. For statistical analysis, trend-tests were carried out. Results: There were 60,940 deaths registered as breast cancer deaths, 46,365 in white and 10,588 in black women. The mortality rates for 100,000 women in 2017 were 16.46 in white and 9.57 in black women, a trend to reduction in white (p=0.002), and to increase in black women (p=0.010). This effect was more significant for white women (p<0.001). The trend to reduction was consistent in all age groups in white women, and the trend to increase was observed only in the 40-49 years group in black women. For 'all-cancer causes', the trend was to a reduction in white (p=0.031) and to increase in black women (p<0.001). For 'ill-defined causes' and 'external causes', the trend was to reduce both races (p<0.001). Conclusion The declared race influenced mortality rates due to breast cancer in São Paulo. The divergences observed between white and black women also were evident in all cancer causes of death, which may indicate inequities in access to highly complex health care in our setting.

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