Mortalidade por câncer de pulmão e poluição atmosférica em regiões metropolitanas do Brasil.

Abstract

Malignant neoplasm of the lung is the leading cause of cancer death in both sexes in Brazil and its death burden remains elevated. The first aim of this study is to evaluate the lung cancer mortality trends, according to sex, in age group 30 and over, for the 19 metropolitan areas (MAs) and inner states, from 2000-2015. The second is to estimate the effects of air pollution indicators on lung cancer mortality of the most populous MAs in Brazil. Initially, data on lung cancer deaths was corrected based on the redistribution of ill-defined causes and nonspecific ICD-10 codes. Next, age-adjusted annual mortality rates were calculated and stratified by sex and units of analysis. Environmental indicators were defined to estimate the effects of air pollution associated with these rates. Temporal trends of lung cancer mortality were analyzed and correlated with environmental health indicators, considering potential confounding variables in the investigated relationship. The rates magnitude was higher in men than women. Declined trends was predominantly observed in men, whereas pattern of increase predominated in females. Pronounced decline was observed for men in Porto Alegre MA (-2.55; 95% CI: -2.79; -2.31). In women, higher increase was observed in the inner municipalities of Ceará (0.86, 95% CI: 0.79, 0.92). The motorization rate (1.33%; 95% CI: 0.82%; 1.84%) and the potential energy of thermoelectric power plants (21.91%, 95% CI: 1.05%, 47.09%) were correlated with mortality from lung cancer in men from North, Northeast and Central West MAs. Positive correlation was also verified for the motorization rate in men (0.64%; 95% CI: 0.49%; 0.79%) and women (0.32%; 95% CI: 0.12%; 0.52%) from MAs in interior of São Paulo State. The level of industrialization showed a small but significant association with lung cancer mortality in males for all MAs evaluated (0.28%, CI 95%: 0.02%, 0.53%) and MAs in interior of São Paulo State (0.73%, 95% CI: 0.20%, 1.27%). Air pollution indicators showed a positive correlation on increasing mortality lung cancer from large urban areas of the country in the period evaluated, which emphasizes the need for effective measures of air quality control in these areas.