Bastos Joana, Barros Henrique, Lunet Nuno
Serviço de Higiene e Epidemiologia, Faculdade de Medicina da Universidade do Porto, Porto, Brazil.
Acta Med Port. 2007 Mar-Apr;20(2):139-44. Epub 2007 Jun 11.
In the last decade there were significant changes in breast cancer mortality that is declining since the 90 s in several countries. The aim of this study was to quantify the variation of the female breast cancer mortality rates, in Portugal and in different regions of the country, considering the changes in the trends.
Breast cancer mortality rates and the number of deaths were obtained from the World Health Organization, for the years from 1955 to 2002, and the number of deaths and population in each region were obtained from the publication Risco de Morrer em Portugal. Age-standardized rates were computed by the direct method, using the European standard population. Joinpoint regression analyses were performed to identify the years in which changes in trends have occurred, and to estimate the annual percent changes in each period, for the age groups 35-74, 35-44, 45-54, 55-64 and 65-74 years. The annual variation was computed for each Portuguese region from 1990 to 2002.
Breast cancer mortality rates increased 1.55%/year (95% Confidence Interval (CI): 1.43 to 1.68) between 1955 and 1992 and changed -2.02%/year (95%CI: -2.81 to -1.31) from 1992 to 2002 in women aged 35 to 74 years. No significant differences were observed in the joinpoints or the estimated annual percent changes across age strata. At a regional level, the mortality trends between 1990 and 2002 were inversely associated with the rates at the beginning of this period (r= -0.74, p <0.001), the larger decline being observed in Lisbon, with rates varying -3.58%/ year (95% CI: -5.30 to -1.48).
A decrease in breast cancer mortality has been observed in Portugal in the early 90 s, with an estimated annual percent change of -2%/year in the last decade. The decline in mortality correlated positively with the rates at the beginning of the period.
在过去十年中，乳腺癌死亡率发生了显著变化，自20世纪90年代以来，一些国家的乳腺癌死亡率一直在下降。本研究的目的是考虑到趋势变化，量化葡萄牙及其不同地区女性乳腺癌死亡率的变化情况。
乳腺癌死亡率和死亡人数数据来自世界卫生组织，时间跨度为1955年至2002年，各地区的死亡人数和人口数据来自《葡萄牙的死亡风险》出版物。采用直接法，以欧洲标准人口为基础计算年龄标准化率。进行连接点回归分析，以确定趋势发生变化的年份，并估计各年龄组（35 - 74岁、35 - 44岁、45 - 54岁、55 - 64岁和65 - 74岁）在每个时期的年变化百分比。计算了1990年至2002年葡萄牙各地区的年变化情况。
1955年至1992年间，35至74岁女性的乳腺癌死亡率以每年1.55%的速度上升（95%置信区间（CI）：1.43至1.68），而1992年至2002年则以每年 - 2.02%的速度变化（95%CI： - 2.81至 - 1.31）。在连接点或各年龄层估计的年变化百分比方面未观察到显著差异。在区域层面，1990年至2002年的死亡率趋势与该时期开始时的死亡率呈负相关（r = - 0.74，p <0.001），在里斯本观察到的下降幅度更大，死亡率变化为每年 - 3.58%（95%CI： - 5.30至 - 1.48）。
20世纪90年代初，葡萄牙乳腺癌死亡率有所下降，在过去十年中估计年变化百分比为 - 2%/年。死亡率的下降与该时期开始时的死亡率呈正相关。
