Transition towards cancer mortality predominance over cardiovascular disease mortality in Brazil, 2000–2019: a population-based study

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas Pub Date : 2024-10-04 DOI:10.1016/j.lana.2024.100904

Beatriz Rache , Rudi Rocha , Luciana Alves de Medeiros , Letícia Martins Okada , Gerson Ferrari , Hongmei Zeng , Alessandro Bigoni , Maria Paula Curado , Catarina M. Azeredo , Leandro F.M. Rezende

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引用次数: 0

Abstract

Background

Cardiovascular disease (CVD) and cancer are the first and second leading causes of death in Brazil and worldwide. However, an ongoing epidemiological transition in which cancer surpasses CVD has been observed in many high and middle-income countries. In this study, we provided a nationwide analysis of the transition towards cancer mortality predominance over CVD mortality in Brazil.

Methods

We leveraged data from 5570 municipalities using the Mortality Information System and classified the causes of death using ICD-10 codes. Age-standardized CVD and cancer mortality rates were calculated annually between 2000 and 2019. Mortality rate ratios (MRRs = CVD rates divided by cancer rates) described the predominance of cancer or CVD mortality across municipalities and states. Choropleth maps displayed state-specific MRRs and the transition in the predominant cause of death over time.

Findings

From 2000 to 2019, CVD mortality rates declined in 25 out of 27 states, whereas cancer mortality increased in 15 states, indicating a shift towards cancer predominance. While in 2000 cancer mortality was lower than CVD in all states and only exceeded the latter in 7% of the municipalities, by 2019 the gap narrowed considerably, with 13% of municipalities displaying higher cancer mortality rates vs CVD mortality rates. Additionally, higher household income correlated with higher mortality from cancer vs CVD.

Interpretation

An ongoing epidemiological transition in which cancer mortality surpasses CVD mortality is occurring in Brazil, particularly in municipalities with higher household incomes. Our findings may provide important information for policymakers and public health practitioners in Brazil.

Funding

National Council for Scientific and Technological Development (CNPq).

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2000-2019 年巴西癌症死亡率超过心血管疾病死亡率的转变：基于人口的研究

背景心血管疾病（CVD）和癌症是巴西乃至全球的第一和第二大死因。然而，在许多中高收入国家，癌症超过心血管疾病的流行病学转型正在进行中。在这项研究中，我们在全国范围内分析了巴西癌症死亡率超过心血管疾病死亡率的过渡情况。方法我们利用死亡率信息系统从 5570 个城市获得的数据，并使用 ICD-10 编码对死因进行分类。我们计算了 2000 年至 2019 年期间每年的年龄标准化心血管疾病和癌症死亡率。死亡率比（MRRs = 心血管疾病死亡率除以癌症死亡率）描述了癌症或心血管疾病死亡率在各市和各州的主导地位。研究结果从 2000 年到 2019 年，27 个州中有 25 个州的心血管疾病死亡率有所下降，而 15 个州的癌症死亡率有所上升，这表明癌症已成为主要死因。2000 年，各州的癌症死亡率均低于心血管疾病死亡率，仅有 7% 的城市癌症死亡率高于心血管疾病死亡率，而到 2019 年，这一差距大幅缩小，13% 的城市癌症死亡率高于心血管疾病死亡率。此外，家庭收入越高，癌症死亡率与心血管疾病死亡率之间的相关性也越高。解释：在巴西，癌症死亡率超过心血管疾病死亡率的流行病学转变正在发生，尤其是在家庭收入较高的城市。我们的研究结果可为巴西的政策制定者和公共卫生从业人员提供重要信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Regional Health-Americas Multiple-

CiteScore

8.00

自引率

0.00%

发文量

期刊介绍： The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.