Moi Gisele Pedroso, Silva Ageo Mário Cândido, Galvão Noemi Dreyer, de Castro Meneghim Marcelo, Pereira Antonio Carlos
Piracicaba Dental School, Campinas State University - FOP.UNICAMP, Piracicaba, Brazil.
University Center of Várzea Grande - UNIVAG, Várzea Grande, Brazil.
BMC Oral Health. 2018 Jan 23;18(1):14. doi: 10.1186/s12903-018-0473-y.
Oral cancer (OC) is among the ten most common cancers and the seventh most frequent cause of death worldwide. It has been reported that these incidence rates are higher in developed country and these mortality rates are higher in less developed areas. So, the objective of the present study was to analyze the spatial joint distribution and to explore possible associations of the epidemiological aspects with mortality rates due to OC in the Brazil.
An exploratory ecological study investigated the global spatial autocorrelation of epidemiological aspects with mortality rates due to OC from the Brazilian Federative Units (FUs) (n = 27) in the period 2005-2014, using the "global" and "local" Moran statistic method and a multiple spatial regression, having as variables of exposure the habits and lifestyle, sociodemographic indicators, the consumption of pesticides, the presence of comorbidities, the use of health services and food consumption; and, as a variable response, mortality rates due to OC. The software used was Stata 11.0, SPSS 18.0 and GeoDa 0.95-i.
The spatial distribution of OC mortality rates to age-standard was not random and showed high spatial autocorrelation and predominance of significant spatial groupings in the Central-South region of Brazil. In the multiple regression, statistically negative associations were observed between the Human Development Index (HDI) and OC age-standardized in the studied period (p < 0.05) and positive associations among the proportion of the population with dental appointment within last year, percentage of consumption of oils and fats, percentage of consumption of ready-to-eat foods and industrial mixtures and percentage of overweight adults with this type of cancer (p < 0.05).
This is the first study that analyzed the factors associated to the spatial clusters of mortality due to oral cancer in the Brazilian FUs. A fairly unequal distribution of OC mortality rates was found, being that these rates presented inverse association with HDI and direct association with dental appointment, consumption of oils and fats, ready-to-eat foods and industrial mixtures consumption and overweight these rates. It suggests the need to redirect Brazilian public policies aimed at combating them so that they cease to be temporary and become permanent.
口腔癌（OC）是全球十大常见癌症之一，也是第七大常见死因。据报道，发达国家的发病率较高，而欠发达地区的死亡率较高。因此，本研究的目的是分析空间联合分布，并探讨巴西口腔癌死亡率的流行病学因素之间的可能关联。
一项探索性生态研究，使用“全局”和“局部”莫兰统计方法以及多元空间回归，调查了2005 - 2014年期间巴西联邦单位（FUs，n = 27）口腔癌死亡率与流行病学因素的全局空间自相关性，将习惯和生活方式、社会人口统计学指标、农药消费、合并症的存在、卫生服务的使用和食物消费作为暴露变量；将口腔癌死亡率作为反应变量。使用的软件是Stata 11.0、SPSS 18.0和GeoDa 0.95 - i。
按年龄标准化的口腔癌死亡率的空间分布并非随机，显示出高度的空间自相关性，且在巴西中南部地区存在显著的空间聚集优势。在多元回归中，观察到在研究期间人类发展指数（HDI）与年龄标准化口腔癌之间存在统计学上的负相关（p < 0.05），以及在去年进行过牙科检查的人口比例、油脂消费百分比、即食食品和工业混合物消费百分比与超重成年人患这种癌症的百分比之间存在正相关（p < 0.05）。
这是第一项分析巴西联邦单位口腔癌死亡空间聚集相关因素的研究。发现口腔癌死亡率分布相当不均衡，这些死亡率与HDI呈负相关，与牙科检查、油脂消费、即食食品和工业混合物消费以及超重呈正相关。这表明需要重新调整巴西旨在对抗这些疾病的公共政策，使其不再是临时性的，而是永久性的。
