Padrões espaço-temporais da mortalidade por câncer de mama em mulheres no Estado do Espírito Santo - um estudo ecológico
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Data
2011-01-01
Autores
Felix, Janaina Daumas
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Universidade Federal do Espírito Santo
Resumo
Breast cancer is the leading cancer affecting females in Brazil. Breast cancer is now a disease of extreme importance for the national public health, encouraging a broad discussion of the measures to promote its early diagnosis, a reduction in morbidity and mortality. This research has three goals and the results are organized into articles. The first objective was to examine the completeness of the data from the Mortality Information on deaths from breast cancer in women in Espirito Santo, the southeast and Brazil (1998 a 2007). This was a descriptive analytic study based on secondary data, where we analyzed the absolute number and percentage of non-compliance of the variables on death certificates. Score was adopted to evaluate the degree of non-completion. The results for sex and age were excellent equally for Espirito Santo, the Southeast and Brazil. The filling of the variables race, education level and marital status presented problems in Espirito Santo. While in the Southeast and Brazil the variables race or education have a decreasing trend for non-fulfillment, inEspirito Santo the trend is stable. For the variable marital status, the no fulfillment has a growing trend in the state of Espirito Santo. The second objective was to analyze the evolution of mortality rates from breast cancer in women in Espirito Santo during the period 1980 to 2007. Study temporal series, whose data on deaths were obtained from the Mortality Information System, and population estimates by age and calendar years, from the Brazilian Institute of Geography and Statistics. The specific mortality rates, by age group were calculated annually. A trend analysis was performed by using standardized mortality rates by the direct method, where the 12 population's sense IBGE-2000, was considered standard. During the study period, there were 2,736 deaths from breast cancer. The mortality rate for this period ranged from 3.41 to 10.99 per 100,000 women. The results indicate that there is a trend in mortality from breast cancer over the serie. (p=0,001 with growing of 75,42%). All ages from 30 years showed a increased trend from mortality was statistically significant (p=0,001). The percentages of growth were increasing, according to the older age groups, with 48.4% aged 40 to 49 years, reaching to 92.3%, range 80 years and over. The third objective was to conduct spatial analysis of deaths in women from breast cancer in Espirito Santo, during the years 2003 to 2007, with analysis of the spatial correlations of mortality and components of the municipality. The scenario was the state of Espirito Santo, composed of 78 municipalities. For data analysis, we used the Bayesian approach (methods Ebest Global and Local Ebest) for correction of epidemiological rates. We calculated the Moran I index for spatial dependence in the global level and the local Moran statistic. The highest rates are concentrated in 19 cities from the Microregions: Metropolitan (Fundão, Vitória, Vila Velha, Viana, and Cariacica Guarapari), Expanded Southern Metropolis(Anchieta, Alfredo Chaves), Pólo Cachoeiro (Vargem Alta, Rio Novo do Sul, Mimoso do Sul, Cachoeiro de Itapemirim, Castelo, Jerônimo Monteiro, Bom Jesus do Norte, Apiacá e Muqui) e Caparaó (Alegre e São José do Calçado). The results of Bayesian estimation (the Moran index) of deaths from breast cancer in women occurred in the state of Espirito Santo, according to the raw and adjusted data indicated the existence of significant spatial correlation for the location map (I = 0.573, p = 0.001 ) and Global (I = 0.118, p = 0.039). The raw data do not show spatial correlation (R = 0.075, p = 0.142).
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Breast cancer , Information system , Mortality , Temporal series studies , Spatial analysis , Câncer de mama , Sistema de informação , Mortalidade , Estudos de séries temporais , Análise espacial