Magnitude e variação da carga da mortalidade por câncer no Brasil e Unidades da Federação, 1990 e 2015

Maximiliano Ribeiro Guerra, Maria Teresa Bustamante-Teixeira, Camila Soares Lima Corrêa, Daisy Maria Xavier de Abreu, Maria Paula Curado, Meghan Mooney, Mohsen Naghavi, Renato Teixeira, Elisabeth Barboza França, Deborah Carvalho Malta

To analyze the mortality rates from malignant neoplasia in Brazil and Federal Units (FU) in the years 1990 and 2015, according to sex and main types of cancer. Using estimates of global disease burden for Brazil made by the GBD 2015 study, age-adjusted cancer mortality rates and respective 95% uncertainty intervals were calculated for Brazil and FU in 1990 and 2015, as well as their percentage variation in the period. The main causes of cancer mortality by sex were analyzed, considering the five highest rates in the country and for each state. The cancer mortality rate for male and female population remained stable between the two years in the country. The same behavior pattern was observed in almost all the FU, and the majority of states in the northeast region and half of the north region showed a non-significant increase in mortality rates. Regarding the types of cancer, there was a drop in mortality rates for stomach cancers in both sexes (women: -38.9%, men: -37.3%), cervical cancer in women (-33.9%), and lung and esophagus cancer in men (-12.0% and -14.1%, respectively); in contrast, there was an increase in lung cancers in women (+20.7%) and colon and rectum cancers in men (+29.5%). Differences in the behavior of major cancers, with a decrease mainly in the more developed regions and an increase in the less developed regions of the country, seem to reflect the socioeconomic inequalities as well as difficulties in access to health services by the Brazilian population.