Exploring regional disparities in lung cancer mortality in a Brazilian state: A cross-sectional ecological study

Vlaudimir Dias Marques, Miyoko Massago, Mariana Teixeira da Silva, Igor Roskowski, Daniel Augusto Nunes de Lima, Lander dos Santos, Estela Louro, Simone Tomás Gonçalves, Raissa Bocchi Pedroso, Armstrong Mbi Obale, Sandra Marisa Pelloso, João Ricardo Nickenig Vissoci, Catherine Ann Staton, Oscar Kenji Nihei, Maria Dalva de Barros Carvalho, Amanda de Carvalho Dutra and Luciano de Andrade

PLOS ONE, 2023, vol. 18, issue 6, 1-12

Abstract: Background: Lung cancer (LC) is one of the main causes of mortality in Brazil; geographic, cultural, socioeconomic and health access factors can affect the development of the disease. We explored the geospatial distribution of LC mortality, and associated factors, between 2015 and 2019, in Parana state, Brazil. Methods and findings: We obtained mortality (from the Brazilian Health Informatics Department) and population rates (from the Brazilian Institute of Geography and Statistics [IBGE]) in people over 40 years old, accessibility of oncology centers by municipality, disease diagnosis rate (from Brazilian Ministry of Health), the tobacco production rate (IBGE) and Parana Municipal Performance Index (IPDM) (from Parana Institute for Economic and Social Development). Global Moran’s Index and Local Indicators of Spatial Association were performed to evaluate the spatial distribution of LC mortality in Parana state. Ordinary Least Squares Regression and Geographically Weighted Regression were used to verify spatial association between LC mortality and socioeconomic indicators and health service coverage. A strong spatial autocorrelation of LC mortality was observed, with the detection of a large cluster of high LC mortality in the South of Parana state. Spatial regression analysis showed that all independent variables analyzed were directly related to LC mortality by municipality in Paraná. Conclusions: There is a disparity in the LC mortality in Parana state, and inequality of socioeconomic and accessibility to health care services could be associated with it. Our findings may help health managers to intensify actions in regions with vulnerability in the detection and treatment of LC.

Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0287371

DOI: 10.1371/journal.pone.0287371

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