Braga Lucia Libanez Bessa Campelo, Ferreira Anderson Fuentes, Pinheiro Fernando Antônio Siqueira, Benigno Tiago Gomes da Silva, Heukelbach Jorg, de Castro Daniel Barros, Queiroz Dulciene Maria Magalhães, Miyajima Fábio, Ramos Alberto Novaes
Department of Internal Medicine School of Medicine Federal University of Ceará Fortaleza Brazil Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Brazil.
Postgraduate Program of Public Health School of Medicine Federal University of Ceará Fortaleza Brazil Postgraduate Program of Public Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil.
Rev Panam Salud Publica. 2022 Aug 18;46:e101. doi: 10.26633/RPSP.2022.101. eCollection 2022.
To identify nationwide temporal trends and spatial patterns of gastric cancer-related mortality in Brazil.
An ecological study was performed using death certificates registered from 2000 to 2019 in which gastric cancer was recorded as any cause of death (an underlying or associated cause). Trends over time were assessed using joinpoint regression models. Spatial and spatiotemporal clusters were identified by Kulldorff's space-time scan statistics to identify high-risk areas.
In 276 897/22 663 091 (1.22%) death certificates gastric cancer was recorded as any cause of death. Age-adjusted gastric cancer-related mortality increased significantly over time (annual percentage change [APC]: 0.7, 95% confidence interval [CI]: 0.5 to 0.8). The increase in mortality was more pronounced in the less-developed North and Northeast Regions (North Region, APC: 3.1, 95% CI: 2.7 to 3.5; Northeast Region, APC: 3.1, 95% CI: 2.5 to 3.7). Eight spatiotemporally associated high-risk clusters of gastric cancer-related mortality were identified in the North, South, Northeast and Central-West Regions, as well as a major cluster covering a wide geographical range in the South and Southeast Regions of Brazil during the first years of the study period (2000 to 2009).
More recently, during 2010 to 2019, clusters of gastric cancer have been identified in the Northeast Region. The nationwide increase in mortality in this analysis of 20 years of data highlights the persistently high burden of gastric cancer in Brazil, especially in socioeconomically disadvantaged regions. The identification of these areas where the population is at high risk for gastric cancer-related mortality emphasizes the need to develop effective and intersectoral control measures.
确定巴西全国范围内胃癌相关死亡率的时间趋势和空间模式。
采用生态研究方法，使用2000年至2019年登记的死亡证明，其中胃癌被记录为任何死亡原因（潜在或相关原因）。使用连接点回归模型评估随时间的趋势。通过Kulldorff时空扫描统计识别空间和时空聚类，以确定高风险区域。
在276897/22663091（1.22%）份死亡证明中，胃癌被记录为任何死亡原因。经年龄调整的胃癌相关死亡率随时间显著增加（年百分比变化[APC]：0.7，95%置信区间[CI]：0.5至0.8）。死亡率的增加在欠发达的北部和东北部地区更为明显（北部地区，APC：3.1，95%CI：2.7至3.5；东北部地区，APC：3.1，95%CI：2.5至3.7）。在研究期间的头几年（2000年至2009年），在北部、南部、东北部和中西部地区确定了8个与胃癌相关死亡率时空相关的高风险聚类，以及一个覆盖巴西南部和东南部广大地理区域的主要聚类。
最近，在2010年至2019年期间，在东北部地区发现了胃癌聚类。在这项对20年数据的分析中，全国范围内死亡率的增加凸显了巴西胃癌负担持续居高不下，特别是在社会经济弱势地区。确定这些人群面临胃癌相关死亡高风险的地区强调了制定有效和跨部门控制措施的必要性。
