Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Brazilian Ministry of Health, Leopoldo Bulhões Street, 1480, Manguinhos, Rio de Janeiro, Brazil.
National Cancer Institute, Brazilian Ministry of Health, Rio de Janeiro, Brazil.
Sci Rep. 2024 Nov 15;14(1):28178. doi: 10.1038/s41598-024-79921-y.
Colorectal cancer in Brazil is among the main public health concern. The burden of disease can be related to unhealthy lifestyle behavior and inequality in access to health services. The aim of this study was to identify the main factors associated with colorectal cancer mortality in Brazil. This is an ecological study that had the Brazilian Federal Units as the primary units of analysis. Colorectal cancer mortality data (ICD C18-C21) were obtained from Brazilian national mortality system to the year 2020. Prevalence of overweight, food consumption (fiber, whole grains and red meat), physical inactivity, smoke, alcohol consumption, the median of household income, years of study, rates of cancer treatment units and oncologist by Brazilian Federal Units were considered as factor associated to the colorectal cancer mortality. Quasipoisson Generalized Linear Models were used to associate CRC mortality and variables related to dietary intake, risk behavior, and access to health services. In 2020, there were 21,501 deaths by colorectal cancer (51% among women). Prevalence of overweight (men: IRR 1.03; CI: 1.01-1.04; women IRR 1.05; CI 1.02-1.08) and the density of oncologist (men: IRR 1.02; CI: 1.01-1.03; women IRR 1.02; CI 1.01-1.03) were the main factors associated with colorectal cancer mortality. Sociodemographic and food consumption characteristics were not statistically associated with CRC. Prevalence of overweight was the strongest factor associated with mortality from colorectal cancer in Brazil in 2020. Therefore, current public policies to reduce overweight and obesity should be prioritized and strengthened in Brazil.
巴西的结直肠癌是主要的公共卫生关注点之一。疾病负担可能与不健康的生活方式行为和获得卫生服务的不平等有关。本研究旨在确定与巴西结直肠癌死亡率相关的主要因素。这是一项生态研究，以巴西联邦单位为主要分析单位。结直肠癌死亡率数据（ICD C18-C21）来自巴西国家死亡率系统，时间跨度为 2020 年。超重患病率、食物消费（纤维、全谷物和红肉）、身体活动不足、吸烟、饮酒、家庭收入中位数、受教育年限、巴西联邦单位的癌症治疗单位和肿瘤学家比例被视为与结直肠癌死亡率相关的因素。使用准泊松广义线性模型将 CRC 死亡率与与饮食摄入、风险行为和获得卫生服务相关的变量相关联。2020 年，结直肠癌死亡人数为 21501 人（女性占 51%）。超重患病率（男性：IRR 1.03；95%CI：1.01-1.04；女性 IRR 1.05；95%CI 1.02-1.08）和肿瘤学家密度（男性：IRR 1.02；95%CI：1.01-1.03；女性 IRR 1.02；95%CI 1.01-1.03）是与结直肠癌死亡率相关的主要因素。社会人口统计学和食物消费特征与 CRC 无统计学关联。超重患病率是 2020 年巴西结直肠癌死亡的最强相关因素。因此，巴西应优先和加强当前旨在减少超重和肥胖的公共政策。
