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Spatial pattern of mortality from breast and cervical cancer in the city of São Paulo

Authors
  • Bermudi, Patricia Marques Moralejo1
  • Pellini, Alessandra Cristina Guedes2, 3
  • Rebolledo, Elizabeth Angélica Salinas4
  • Diniz, Carmen Simone Grilo5
  • de Aguiar, Breno Souza3
  • Ribeiro, Adeylson Guimarães6
  • Failla, Marcelo Antunes3
  • Baquero, Oswaldo Santos7
  • Chiaravalloti, Francisco Neto1
  • 1 Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil, São Paulo SP , (Brazil)
  • 2 Universidade Nove de Julho. Faculdade de Medicina. Diretoria de Ciências Médicas. São Paulo, SP, Brasil, São Paulo SP , (Brazil)
  • 3 Secretaria Municipal de Saúde de São Paulo. Coordenação de Epidemiologia e Informação. Gerência de Geoprocessamento e Informações Socioambientais. São Paulo, SP, Brasil, São Paulo, SP , (Brazil)
  • 4 Universidade de São Paulo. Faculdade de Saúde Pública. Programa de Pós-Graduação em Saúde Pública. São Paulo, SP, Brasil, São Paulo SP , (Brazil)
  • 5 Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Saúde, Ciclos de Vida e Sociedade. São Paulo, SP, Brasil, São Paulo SP , (Brazil)
  • 6 Hospital de Câncer de Barretos. Instituto de Ensino e Pesquisa. Barretos, SP, Brasil, Barretos SP , (Brazil)
  • 7 Universidade de São Paulo. Faculdade de Medicina Veterinária e Zootecnia. Departamento de Medicina Veterinária Preventiva e Saúde Animal. São Paulo, SP, Brasil, São Paulo SP , (Brazil)
Type
Published Article
Journal
Revista de Saúde Pública
Publisher
Universidade de Sao Paulo Sistema Integrado de Bibliotecas - SIBiUSP
Publication Date
Dec 04, 2020
Volume
54
Identifiers
DOI: 10.11606/s1518-8787.2020054002447
PMID: 33331488
PMCID: PMC7726920
Source
PubMed Central
Keywords
License
Green

Abstract

OBJECTIVE To verify the spatial pattern of mortality from breast and cervical cancer in areas of primary health care, considering socioeconomic conditions. METHODS This is an ecological study, from January 2000 to December 2016. The study area is the municipality of São Paulo, Brazil, and its 456 coverage areas of primary health units. Information on deaths of women aged 20 years or over were geocoded according to residence address. We calculated mortality rates, standardized by age, and smoothed by the local empirical Bayesian method, and grouped into three or two years to reduce the random fluctuation of the data. In addition, bivariate global and local Moran indexes were calculated to verify the existence of spatial agglomeration of standardized mortality rates with a domain of socioeconomic condition, elaborated based on the Índice Paulista de Vulnerabilidade Social (IPVS – São Paulo Index of Social Vulnerability). RESULTS The success rate of geocoding was 98.9%. Mortality from breast cancer, without stratification by time, showed a pattern with higher rates located in central regions with better socioeconomic conditions. It showed a decrease at the end of the period and a change in spatial pattern, with increased mortality in peripheral regions. On the other hand, mortality from cervical cancer remained with the highest rates in peripheral regions with worse socioeconomic conditions, despite being reduced over time. CONCLUSION The spatial pattern of mortality from the studied cancers, over time, suggests association with the best socioeconomic conditions of the municipality, either as protection (cervical) or risk (breast). This knowledge may direct resources to prevent and promote health in the territories.

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