Bessa Campelo Braga, Lucia Libanez, Ramos, Alberto Novaes, Braga Neto, Manuel Bonfim, Ferreira, Anderson Fuentes, Magalhaes Queiroz, Dulciene Maria, Campelo Maia, Danielle Calheiros, Alencar, Carlos Henrique, and Heukelbach, Jorg (2019) Unequal burden of mortality from gastric cancer in Brazil and its regions, 2000-2015. Gastric Cancer, 22 (4). pp. 675-683.

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Abstract

Background: Gastric cancer (GC) is an important cause of morbidity and mortality worldwide. However, population-based data on GC mortality dynamics in low and middle income countries are scarce.

Methods: We analyzed GC mortality in Brazil based on all GC-related deaths registered 2000-2015.

Results: A total of 17,374,134 deaths were recorded, with GC identified in 214,808 (1.24%) cases203,941 (94.9%) as underlying cause, and 10,867 (5.1%) as associated cause of death. Adjusted rates for age and sex was 6.85 deaths/100,000 inhabitants [95% confidence interval (CI) 6.73-6.97]. The highest mortality rates were found in males [10.00; rate ratio (RR) 1.85; 95% CI 1.78-1.91; p<0.0001] and patients 45years of age (24.98; RR 3.79; 95% CI 3.55-4.05; p<0.0001). The South (7.56; RR 1.62; 95% CI 1.50-1.76; p<0.0001) and Southeast (7.36; RR 1.59; 95% CI 1.48-1.71; p<0.0001) regions had the highest regional rates. Spatial and spatiotemporal high-risk mortality areas in 2004-2007 were located mainly in the South, Southeast, and Central-West regions. After 2008, the Northeast region became a high-risk area, especially Ceara State.

Conclusion: GC remains a significant public health problem with high mortality burden and unequal distribution in Brazilian states. The new patterns in poorer regions and the high risk in some specific populations show a clear process of epidemiological transition over time. There is a need to strengthen nationwide epidemiological monitoring, surveillance, prevention, and control for GC in the country.

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