Magnitude da mortalidade por câncer do colo do útero no Brasil, 1996-2005

Abstract

This study aimed to correct the magnitude of registered deaths from cancer of the cervix in Brazil, and analyze the magnitude of mortality from this cancer and its association with social indicators in the states of the Northeast region, Brazil, in the period 1996 to 2005. For correction of under-registration, we used the factors created by the Global Burden of Disease Project in Brazil-1998. To redistribute the categories of diagnosis unknown, incomplete or poorly defined deaths, identified in the information system on mortality, was used the methodology of proportional redistribution, except the missing data of age, corrected by imputation. The corrections were applied to each state of the country, by sex and age group, and the results presented for Brazil and each major region and their respective geographical areas (capital, other cities and metropolitan areas of the interior). Temporal trends of mortality were analyzed using simple linear regression for each state of the region. Index percentage change was used to determine the variability of the magnitude of the rates before and after correction of the deaths. By linear regression, we analyzed the behavior of the correction and the correlations between the socio-economic indicators and mortality rates for cervical cancer with and without correction. After the correction, the mortality rates for cervical cancer in Brazil showed a percentile increment of 103.4%, with variation of 35% for capitals of South region, 339% for the interior of Northeastern region. Positive correlations between some socioeconomic indices and non -corrected rates, and negative association the same indices and fixed rates were evidenced. With others socioeconomic indices, the opposite behavior was observed. The results showed consistency in geographical terms and in relation to findings in the literature, allowing concluding that the proposed methodology was appropriate to correct the magnitude of the mortality rates for cervical cancer in the country. If comparative analysis on the socio-economic conditions and the behavior of this cancer are estimated without any knowledge about the quality and coverage of registration of deaths, wrong conclusions could be obtained. Considering the corrected magnitude of this disease we can affirm that cervical cancer in Northeastern region of Brazil is a problem bigger than the stated in the official reports. However, the results suggest that control and early detection programs developed in this country has shown positive results.