Evolução temporal da incidência do câncer de mama na cidade de Goiânia de acordo com o grupo etário e análise geoespacial
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2010-09-24
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Universidade Federal de Goiás
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OBJECTIVE: To study the behavior of breast cancer incidence in the city of
Goiania/Goias, during the specified period of years, according to the age group
and geospatial distribution.
METHODS: In order to achieve our objectives, we conducted three distinctive
studies, as described below: Study I: This study sought to verify the Average
Annual Percentage Change (AAPC) of breast cancer incidence in Goiania, per
decade of life. It used the database of the Population Based Cancer Registries of
Goiania (RCBPGo), between 1988 and 2003. During this period, it was registered
3,310 new cases of female breast cancer. The incidence of both crude and
standardized rates, this is adjusted by Segi’s World population, were calculated
per age groups at each 10 years. Poisson Regression was used to calculate the
AAPC for these age groups. Study II: Studied breast cancer incidence trends in
young women, in Goiania, during the same period of time (1988 to 2003). The
women were divided in three age groups: young women, younger than 39 years
old;; women between 40 and 59 years old;; and women above 60 years old. To
conduct this study, the annual incidence was calculated by the respective age
groups. It was calculated the AAPC and the linear regression. The latter was used
to obtain the correlation coefficient and the determination coefficient. Study III:
The database of the Population Based Cancer Registries of Goiania (RCBPGo)
was updated in this study until 2006;; therefore, this analysis covered a period of 19 years, in which there were 4,155 new cases of breast cancer. Each incident
case was distributed geospatially, and the truncated incidences of women above
30 years old was calculated in each sanitary district. It was also calculated the
AAPC for the districts and the change in the female population growth in each
district.
RESULTS: In Study I, it was observed that the AAPC of the total crude rate
incidence was of 7.18% per year (IC 95% = 6.1 – 8.3;; p < 0.001), from 1988 to
2003;; and that the AAPC of the standardized incidence was of 4.86% per year (IC
95% = 3.8 – 5.9;; p < 0.001). The age group which presented the highest growth
was the group of women between the age of 50 and 59 (6.3%;; IC 95% = 4.5 – 8.0;;
p < 0.001). There was a significant raise of the AAPC breast cancer incidence for
all age groups, except the age group of 20 to 29 year old women (p = 0.13). In
Study II the AACP of the women until 39 years old (the group of young women)
was of 5.22% (IC 95% = 2.91 – 7.54), and it was lower than the one observed
in women above 40 years old. The coefficient of determination of young women
incidence was R2 = 0.52 (p < 0.003). The Study III demonstrated that the total
truncated incidence during the 19 year period of study was of 86/100,000 cases.
Campinas Centre was the district with the highest incidence with 118/100,000
cases of breast cancer. The Northwest district presented the highest AAPC of
20% (IC 95% = 7.2 – 36.4;; p = 0.02). In spite of that, the highest population growth
happened in the West district with rates of 71%.
CONCLUSION: Within the period studied, the incidence of breast cancer in
Goiania increased significantly in all age groups. Such growth, however, happened
in an uneven way in the different sanitary districts. The highest incidences were observed in the Centre and South districts. The raise of breast cancer incidence
presented low correlation with the female population growth in all the districts of
Goiania. This founding, therefore, indicates that the causes of such raise should
be further studied in this population.
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FREITAS, Nilceana Maya Aires. Evolução temporal da incidência do câncer de mama na cidade de Goiânia de acordo com o grupo etário e análise geoespacial. 2010. 163 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2010.