Exploring disparities in incidence and mortality rates of breast and gynecologic cancers according to the Human Development Index in the Pan-American region

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7
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article
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2017
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W B SAUNDERS CO LTD
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PubMed
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MARTINEZ-MESA, J.
WERUTSKY, G.
MICHIELS, S.
PEREIRA FILHO, C. A. S.
DUENAS-GONZALEZ, A.
ZARBA, J. J.
VILLARREAL-GARZA, C.
GOMEZ, H.
BARRIOS, C. H.
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PUBLIC HEALTH, v.149, p.81-88, 2017
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Objective: To evaluate whether a country's Human Development Index (HDI) can help explain the differences in the country's breast cancer and gynecological cancer incidence and mortality rates in the Pan-American region. Study design: Ecological analysis. Methods: Pan-American region countries with publicly available data both in GLOBOCAN 2012 and the United Nations Development Report 2012 were included (n = 28). Incidence and mortality rates age-standardized per 100,000 were natural log-transformed for breast cancer, ovarian cancer, corpus uteri cancer, and cervical cancer. The mortality-to-incidence ratio (MIR) was calculated for each site. Pearson's correlation test and a simple linear regression were performed. Results: The HDI showed a positive correlation with breast cancer and ovarian cancer incidence and mortality rates, respectively, and a negative correlation with cervical cancer incidence and mortality rates. The HDI and corpus uteri cancer showed no association. MIR and the HDI showed a negative correlation for all tumor types except ovarian cancer. An increment in 1 HDI unit leads to changes in cancer rates: in breast cancer incidence beta = 4.03 (95% confidence interval [CI] 2.61; 5.45) P < 0.001, breast cancer mortality beta = 1.76 (95% CI 0.32; 3.21) P = 0.019, and breast cancer-MIR beta = -0.705 (95% CI 0.704; 0.706) P < 0.001; in cervical cancer incidence beta = -3.28 (95% CI -4.78; -1.78) P < 0.001, cervical cancer mortality beta = -4.63 (95% CI -6.10; -3.17) P < 0.001, and cervical cancer-MIR beta = -1.35 (95% CI -1.83; -0.87) P < 0.001; in ovarian cancer incidence beta = 3.26 (95% CI 1.78; 4.75) P < 0.001, ovarian cancer mortality beta = 1.82 (95% CI.0.44; 3.20) P = 0.012, and ovarian cancer-MIR beta = 5.10 (95% CI 3.22; 6.97) P < 0.001; in corpus uteri cancer incidence beta = 2.37 (95% CI -0.33; 5.06) P = 0.83, corpus uteri cancer mortality beta = 0.68 (95% CI -2.68; 2.82) P = 0.96, and corpus uteri cancer-MIR beta = -2.30 (95% CI -3.19; -1.40) P < 0.001. Conclusions: A country's HDI should be considered to understand disparities in breast cancer and gynecological cancer in the Pan-American region.
Palavras-chave
Breast neoplasms, Genital neoplasm, Female, Epidemiology, Gynecology, Incidence, Mortality, Human Development Index
URI
https://observatorio.fm.usp.br/handle/OPI/21867
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MDR
Artigos e Materiais de Revistas Científicas - LIM/24
Artigos e Materiais de Revistas Científicas - ODS/03