Projeções e tendências da mortalidade por melanoma no Brasil, de 1998 a 2032
INTRODUCTION: Malignant skin melanoma is one of the main types of skin cancer, with low incidence but high lethality. OBJECTIVE: Carry out projections and analyze mortality trends for melanoma, in the period 1998-2032, in Brazil and its geographic regions. METHODOLOGY: An ecological study is present...
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| Formato: | Dissertação |
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Brasil
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| Endereço do item: | https://repositorio.ufrn.br/jspui/handle/123456789/21521 |
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| Resumo: | INTRODUCTION: Malignant skin melanoma is one of the main types of skin cancer, with low incidence but high lethality. OBJECTIVE: Carry out projections and analyze mortality trends for melanoma, in the period 1998-2032, in Brazil and its geographic regions. METHODOLOGY: An ecological study is presented herein, with mortality data for malignant skin melanoma obtained from the Mortality Information System (MIS) and from the Brazilian Institute of Geography and Statistics (BIGS). Death analysis comprehended the period 1998-2012. For data projection, the Nordpred software was utilized, within the R program, considering the model age-period-cohort. It was verified whether the modifications throughout time were a result of population changes or of death risk for the disease. Joinpoint regression and standardized rates based on the world population were utilized to estimate the annual percentage change, with a 95% confidence interval. RESULTS: Evaluation of mortality trends for melanoma enabled the identification of regional similarities and differences regarding the patterns encountered. In all regions, there was a higher number of deaths in men. In the period 1998-2012, there were 21,705 deaths by melanoma (12,436 men and 9270 women). The projections for future periods have revealed, between 2013 and 2032, an increase to 46,245 deaths (27,112 men and 19,133 women), with standardized rates of 1.03 deaths/100,000 inhabitants for men and 0.62 deaths/100,000 inhabitants for women in the last observed period. For the last projected period, the standardized rates were 0.92 deaths/100,000 inhabitants for men and 0.51 deaths/100,000 inhabitants for women. Mortality trend analysis resulted, in Brazil, in reductions for men (APC = -0.4; CI95%= -0.6; -0.1; p<0.01) and women (APC = -0.8; CI95%= -0.9; -0.7; p<0.01). The Midwest region presented increases for both sexes, in opposition to the Southeast, which presented reductions for both sexes. The North region presented stability for men and increases for women, while the South region presented reductions for men and stability for women. Finally, the Northeast region revealed one joinpoint for each sex: in men, there was initially an increasing period followed by stable rates, and in women, the initial stability period was followed by decreasing rates. CONCLUSIONS: The results obtained revealed the existence of regions with higher mortality rates, which could be associated with individual determinants, such as phenotype and behavior, as well as with the environment, regarding the exposure to risk factors. The findings were in line with scientific literature, which evidenced higher rates in locations with higher purchasing power, in this case, the South and Southeast regions, accompanied by reducing trends throughout time. Also, higher mortality rates in men deserve better attention of health policies, as normally the diagnosis occurs in more advances stages of the disease for this sex. For such, actions to promote health are essential. Also, special attention should be given to the creation of preventive policies to fight the disease, mainly related to health education, directed to prevention through the reduction of the exposure to risk factors, besides the adoption of healthy life habits. |
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