Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
Educational and Research Institute, Barretos Cancer Hospital, Barretos, Brazil.
Cancer Med. 2023 Aug;12(15):16615-16625. doi: 10.1002/cam4.6259. Epub 2023 Jun 22.
Cancer disparities exist between and within countries; we sought to compare cancer-specific incidence and mortality according to area-level socioeconomic status (SES) in the State of São Paulo, Brazil.
Cancer cases diagnosed 2003-2017 in the Barretos region and 2001-2015 in the municipality of São Paulo were obtained from the respective cancer registries. Corresponding cancer deaths were obtained from a Brazilian public government database. Age-standardized rates for all cancer combined and the six most common cancers were calculated by SES quartiles.
There were 14,628 cancer cases and 7513 cancer deaths in Barretos, and 472,712 corresponding cases and 194,705 deaths in São Paulo. A clear SES-cancer gradient was seen in São Paulo, with rates varying from 188.4 to 333.1 in low to high SES areas, respectively. There was a lesser social gradient for mortality, with rates in low to high SES areas ranging from 86.4 to 98.0 in Barretos, and from 99.2 to 100.1 in São Paulo. The magnitude of the incidence rates rose markedly with increasing SES in São Paulo city for colorectal, lung, female breast, and prostate cancer. Conversely, both cervical cancer incidence and mortality rose with lower levels of SES in both regions.
A clear SES association was seen for cancers of the prostate, female breast, colorectum, and lung for São Paulo. This study offers a better understanding of the cancer incidence and mortality profile according to SES within a highly populated Brazilian state.
癌症在国家之间和国家内部存在差异；我们试图根据巴西圣保罗州的地区社会经济地位（SES）比较癌症的特定发病率和死亡率。
从各自的癌症登记处获得了 2003 年至 2017 年在巴雷托斯地区和 2001 年至 2015 年在圣保罗市诊断的癌症病例。从巴西公共政府数据库中获得了相应的癌症死亡人数。按 SES 四分位数计算了所有癌症和六种最常见癌症的年龄标准化率。
巴雷托斯有 14628 例癌症病例和 7513 例癌症死亡病例，圣保罗有 472712 例相应病例和 194705 例死亡病例。在圣保罗，SES 与癌症之间存在明显的梯度，低 SES 地区的发病率从 188.4 到 333.1 不等，高 SES 地区的发病率从 188.4 到 333.1 不等。死亡率的社会梯度较小，低 SES 地区的死亡率从 86.4 到 98.0 不等，高 SES 地区的死亡率从 99.2 到 100.1 不等。在圣保罗市，随着 SES 的增加，结直肠癌、肺癌、女性乳腺癌和前列腺癌的发病率显著上升。相反，在两个地区，宫颈癌的发病率和死亡率都随着 SES 的降低而上升。
对于圣保罗的前列腺癌、女性乳腺癌、结直肠癌和肺癌，SES 之间存在明显的关联。本研究更好地了解了巴西人口众多的州内 SES 与癌症发病率和死亡率之间的关系。
