Inequalities in Temporal Effects on Cervical Cancer Mortality in States in Different Geographic Regions of Brazil: An Ecological Study

Karina Cardoso Meira, Carinne Magnago, Angelo Braga Mendonça, Stephane Fernanda Soares Duarte, Pedro Henrique Oliveira de Freitas, Juliano dos Santos, Dyego Leandro Bezerra de Souza and Taynãna César Simões
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Karina Cardoso Meira: Health School, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
Carinne Magnago: School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
Angelo Braga Mendonça: Brazilian National Cancer Institute, Rio de Janeiro 20230-130, Brazil
Stephane Fernanda Soares Duarte: Department of Demography and Actuarial Sciences, Federal University of Rio Grande Norte, Natal 59078-970, Brazil
Pedro Henrique Oliveira de Freitas: Department of Demography and Actuarial Sciences, Federal University of Rio Grande Norte, Natal 59078-970, Brazil
Juliano dos Santos: Brazilian National Cancer Institute, Rio de Janeiro 20230-130, Brazil
Dyego Leandro Bezerra de Souza: Public Health Department, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
Taynãna César Simões: René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte 30190-002, Brazil

IJERPH, 2022, vol. 19, issue 9, 1-22

Abstract: Cervical cancer is a public health issue with high disease burden and mortality in Brazil. The objectives of the present study were, firstly, to analyze age, period, and cohort effects on cervical cancer mortality in women 20 years old or older from 1980 to 2019 in the North, South, and Southeast Regions of Brazil; and secondly, to evaluate whether the implementation of a national screening program and the expansion of access to public health services impacted the examined period and reduced the risk of death compared with previous years and among younger cohorts. The effects were estimated by applying Poisson regression models with estimable functions. The highest mortality rate per 100,000 women was found in Amazonas (24.13), and the lowest in São Paulo (10.56). A positive gradient was obtained for death rates as women’s age increased. The states in the most developed regions (South and Southeast) showed a reduction in the risk of death in the period that followed the implementation of the screening program and in the cohort from the 1960s onwards. The North Region showed a decreased risk of death only in Amapá (2000–2004) and Tocantins (1995–2004; 2010–2019). The findings indicate that health inequities remain in Brazil and suggest that the health system has limitations in terms of decreasing mortality associated with this type of cancer in regions of lower socioeconomic development.

Keywords: uterine cervical neoplasms; mortality; age–period–cohort analysis; forecasting; Brazil (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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Citations: View citations in EconPapers (1)

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