de Melo Neto João Simão, Miguez Sâmia Feitosa, Rabelo Amanda Lia Rebelo, Silva Amanda Marinho da, Sacramento Daniel Souza, das Neves Dária Barroso Serrão, Rego Iana Nogueira, Garcia Riter Lucas Miranda, Galhardo Deizyane Dos Reis, Neves André Luiz Machado das
Institute of Health Sciences, Federal University of Pará (UFPA), Belém 66075-110, PA, Brazil.
School of Health Sciences, University of the state of Amazonas (UEA), Manaus 69005-010, AM, Brazil.
Cancers (Basel). 2024 Aug 31;16(17):3038. doi: 10.3390/cancers16173038.
Bladder cancer is one of the most economically costly types of cancer, but few studies have evaluated its mortality considering the factors that impact this outcome. This study aimed to investigate the impact of sociodemographic factors, period, cohort, and health services on bladder cancer mortality. This ecological study analyzed bladder cancer mortality data in Brazil from 2000 to 2022 and evaluated sociodemographic variables (race, region of residence), socioeconomic variables (gross domestic product per capita, Gini index of household income per capita, number of health professionals per inhabitant, expenditure on public health services, and consultations per inhabitant), and bladder cancer diagnosis and treatment procedures. These data were subjected to statistical analysis, which revealed that after the age of 50, there was a progressive increase in the risk of bladder cancer. Indigenous people had the lowest mortality rate, while white people had a significantly greater mortality rate than black and brown people. The North Region and Northeast Region presented the lowest mortality rates, whereas the South Region presented the highest mortality rates. In the South and Southeast Regions, a higher GDP was related to lower mortality. In the South, higher mortality was associated with a lower number of consultations per inhabitant per region. Fewer bladder punctures/aspirations and bladder biopsies were associated with higher mortality rates. In oncology, more procedures, such as total cystectomy, cystoenteroplasty, and total cystectomy with a single shunt, do not reduce the mortality rate. These results can serve as guidelines for adjusting public health policies.
膀胱癌是最具经济成本的癌症类型之一，但很少有研究在考虑影响这一结果的因素的情况下评估其死亡率。本研究旨在调查社会人口学因素、时期、队列和卫生服务对膀胱癌死亡率的影响。这项生态学研究分析了巴西2000年至2022年的膀胱癌死亡率数据，并评估了社会人口学变量（种族、居住地区）、社会经济变量（人均国内生产总值、人均家庭收入基尼系数、每居民卫生专业人员数量、公共卫生服务支出和每居民会诊次数）以及膀胱癌诊断和治疗程序。这些数据经过统计分析，结果显示50岁以后，膀胱癌风险逐渐增加。原住民的死亡率最低，而白人的死亡率明显高于黑人和棕色人种。北部地区和东北地区的死亡率最低，而南部地区的死亡率最高。在南部和东南部地区，较高的国内生产总值与较低的死亡率相关。在南部，较高的死亡率与每个地区每居民会诊次数较少有关。较少的膀胱穿刺/抽吸和膀胱活检与较高的死亡率相关。在肿瘤学方面，更多的手术程序，如全膀胱切除术、膀胱肠成形术和单分流全膀胱切除术，并不能降低死亡率。这些结果可作为调整公共卫生政策的指导方针。
