Bermudi P M M, Pellini A C G, Diniz C S G, Ribeiro A G, de Aguiar B S, Failla M A, Chiaravalloti Neto F
School of Public Health of University of São Paulo, São Paulo, Brazil.
Nove de Julho University - UNINOVE, São Paulo, Brazil and Sao Caetano do Sul Municipal University Sao Caetano do Sul, Brazil.
Ann Epidemiol. 2023 Feb;78:61-67. doi: 10.1016/j.annepidem.2022.12.009. Epub 2022 Dec 29.
Studying breast and cervical cancers in space and time and verifying divergences of different territorially established socioeconomic profiles.
Ecological study using spatial scanning (with socioeconomic characterization), space-time, and spatial variation of temporal trends, in order to identify significant clusters of high- and low-risk or temporal trends, of deaths from breast cancer and cervical cancer, in the city of São Paulo, Brazil, during 2000-2016.
High-risk spatial clusters were identified in the central areas, and low-risk clusters were identified in the peripheral areas, which were associated with better and worse socioeconomic conditions, respectively. As for cervical cancer, the pattern was the opposite. High-risk space-time clusters occurred in the early years of the study, whereas low-risk clusters occurred in the most recent years. For breast cancer, the central areas showed a temporal trend of decreasing mortality and the peripheral areas showed an increasing trend. While for cervical cancer, in general, the temporal trend was for the identified clusters to fall.
It is expected that this study will provide insights for the formulation of public policies to implement prevention and control measures, in order to reduce mortality and inequalities related to breast and cervical cancers.
研究乳腺癌和宫颈癌在空间和时间上的分布情况，并验证不同地区所确立的社会经济状况差异。
采用空间扫描（结合社会经济特征）、时空分析以及时间趋势的空间变异进行生态学研究，以确定2000 - 2016年期间巴西圣保罗市乳腺癌和宫颈癌死亡的高风险和低风险显著聚集区或时间趋势。
在市中心区域发现了高风险空间聚集区，而在周边区域发现了低风险聚集区，分别与较好和较差的社会经济状况相关。至于宫颈癌，情况则相反。高风险时空聚集区出现在研究初期，而低风险聚集区出现在最近几年。对于乳腺癌，市中心区域死亡率呈下降趋势，周边区域呈上升趋势。而对于宫颈癌，总体而言，所确定聚集区的时间趋势是下降。
预计本研究将为制定实施预防和控制措施的公共政策提供见解，以降低与乳腺癌和宫颈癌相关的死亡率和不平等现象。
