Mortality from malignant neoplasms at home and in hospitals in Brazil, 2002-2022: sociodemographic characteristics and temporal trends.

Objective: To analyze the sociodemographic characteristics and temporal trends of deaths due to malignant neoplasms in Brazil, according to whether they occurred at home or in a hospital, from 2002 to 2022.

Methods: This is a descriptive and ecological study analyzing data on cancer deaths from the Brazilian Mortality Information System. The analysis included descriptive measures, mortality rates, and trends based on joinpoint regression of sociodemographic variables, according to the place of death, as well as associations with the occurrence at home or in hospitals.

Results: We analyzed a total of 3,696,553 cancer deaths in Brazil, of which 82.5% occurred in hospitals. The variables positively associated with deaths at home were: men, age between 70 and 79 years and 80 years or older, mixed-race and Indigenous ethnicity, no formal education and one to three years of formal education, and widowed or other marital status. The Northeast and South regions had the highest rates of home mortality, while the Southeast and South regions led in hospital mortality. There was an increasing trend for both deaths occurring at home and those in hospitals nationwide. In the evaluation of home deaths, an increasing trend was observed in nine states and in the Federal District. Regarding hospital deaths, all Brazilian states showed an increasing trend.

Conclusion: The factors that influence the place of death for cancer patients are complex and include support network, access, culture, and the use of healthcare services. Targeted actions for more vulnerable populations and locations are necessary to reverse the growing trend of this condition.