Desigualdades na epidemiologia do câncer colorretal no Brasil
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2023-06-07
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Universidade Federal de Goiás
Resumo
Colorectal cancer (CRC) is among the most common cancers worldwide, affecting over 1,931,590 people
annually. Social determinants of health related to the incidence and mortality of colorectal cancer have been analyzed,
revealing higher incidence rates in socioeconomically favorable regions, while mortality rates are higher in low- and
middle-income regions. Objective: To analyze the incidence, prevalence, mortality, and Disability-Adjusted Life Years
(DALY) of colorectal cancer in Brazil and its Federative Units, correlating them with socioeconomic indicators.Methodology: This is an ecological study, with a time series analysis of incidence, mortality, DALY, and prevalence
rates of CRC in individuals aged 30 years and older. The corrected and estimated data from the Global Burden of
Diseases Study 19 (GBD19) for Brazil, by Federative Unit (FU) and sex, from 1990 to 2019, were used. Agestandardized rates were calculated using the GBD19 standard population. Indicator trends were estimated using the
average annual percent change and 95% confidence interval (95% CI) by joinpoint regression. Pearson's correlation was
used to correlate the indicators with the Human Development Index, using the Socio-Demographic Index (SDI) obtained
from GBD19. Results: The analysis of age-standardized rates per 100,000 inhabitants showed an increase in all states,
regardless of sex, from 1990 to 2019, with the following changes: incidence from 23.8 (1990) to 35.48 (2019),
prevalence from 167.7 (1990) to 319.98 (2019), mortality from 41.74 (1990) to 49.14 (2019), and DALY from 934.4
(1990) to 1,109.35 (2019). The highest incidence and prevalence trends were observed in the North and Northeast macroregions and among males. Mortality and DALY trends showed predominantly higher rates among men in all Federative
Units (except the Federal District) and remained stable among women. Correlation analysis between SDI and CRC
showed a positive association with incidence and a negative association with mortality and Disability-Adjusted Life
Years. Conclusion: The incidence, prevalence, mortality, and DALY rates of colorectal cancer were found to be high
throughout the country, which can be explained by Brazil being a developing nation with increasing urbanization and
greater access to risk factors. Rates are predominantly higher in more developed Federative Units where Westernized
diets are already prevalent in the food routines of these groups. The high incidence trends in less favored regions may
be due to the urbanization process, which is making previously absent risk factors more accessible over the years.
Another reason could be the amplification of healthcare assistance in these regions, resulting in an increase in the
reporting of new cases. The elevated mortality and DALY trends in socioeconomically disadvantaged regions may be
related to the lack of public policies for prevention, screening, and treatment in these specific populations. Based on
these findings, this study reinforces the importance of creating and implementing public health policies targeting highrisk groups for prevention and screening. Relevance and Impact: Colorectal cancer is a current public health issue
worldwide. This study contributes to the epidemiological update of this cancer in Brazil, highlighting its relevance within
the Brazilian context. The findings can contribute to prioritizing public health policies aimed at cancer prevention and
control.
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Citação
SCHAEDLER, A. C. Desigualdades na epidemiologia do câncer colorretal no Brasil. 2023. 63 f. Dissertação (Mestrado em Medicina Tropical e Saúde Pública) - Instituo de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, 2023.