MORTALITY FROM ORAL CANCER IN BRAZIL: TIME TREND ANALYSIS AND THE EFFECT OF SOCIOECONOMIC VARIABLES
Mouth Cancer; Public health; Mortality
Introduction: Oral cancer is a public health issue in Brazil and around the world. In addition to presenting significant incidence and mortality rates, the costs of its treatments substantially burden the public health service. Objective: To study the time trend in mortality rates from oral cancer in Brazil, between 2000 and 2020, and the relationship with demographic and socioeconomic characteristics. Method: This is an ecological study carried out with official mortality data from the Mortality Information System (SIM) of the Brazilian Ministry of Health, available on the website of the SUS Information Technology Department (DATASUS). Mortality data by sex, color/race, education were obtained for each municipality in Brazil and the rates were calculated based on the estimated population for the year equivalent to the midpoint of each period, using the base of 100 thousand inhabitants. For the aggregate calculation, as in the case of regions for example, population-weighted averages were calculated. For trend analysis, joinpoint regression was applied, with the calculation of APC and AAPC and respective confidence intervals (95%). Distribution in the territory was carried out using the QGis program and analyzed visually. The relationship with socioeconomic factors was made by comparing the mortality ratio with tertiles of income, education and inequality indicators. Results: Higher mortality was observed among men and black people, with different growth rates between regions. Higher growth rates were found for the group with higher education. The distribution in the territory showed a different distribution pattern for the analyzed variables. The association with socioeconomic indicators showed a significant “dose-response” effect, where the disparity in cancer mortality between black and white people is more pronounced in regions with unfavorable socioeconomic conditions. Conclusions: It is imperative that public policies are directed not only to prevention, but also to assistance for oral cancer, especially in more vulnerable populations. Prevention and control strategies must be adapted to the specific needs of each region and consider existing socioeconomic and racial disparities.