Exploring cervical cancer mortality in Brazil: an ecological study on socioeconomic and healthcare factors.

Autor:	Silva Filho ALD; Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil agnaldo.ufmg@gmail.com.; Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Reis Romualdo G; Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Pinhati MES; Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Neves GL; Medical School, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil., Almeida Oliveira J; Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Moretti-Marques R; Department of Gynecologic Oncology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil., Nogueira-Rodrigues A; Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Tsunoda AT; Department of Gynecologic Oncology, Hospital Erasto Gaertner, Curitiba, Brazil., Cândido EB; Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.; Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Jazyk:	angličtina
Zdroj:	International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2024 Oct 04. Date of Electronic Publication: 2024 Oct 04.
DOI:	10.1136/ijgc-2024-005738
Abstrakt:	Objective: To evaluate the correlation between socioeconomic and healthcare factors and cervical cancer mortality rates, as well as the accessibility to prevention and treatment across Brazilian states and macroregions. The aim is to highlight the multifaceted challenge of addressing cervical cancer mortality, particularly in low- and middle-income countries. Methods: This cross-sectional study analyzed public data from the Brazilian National Institute of Cancer (INCA), the National Institute of Geography and Statistics (IBGE), and the Brazilian Ministry of Health. Data were collected on indicators such as the Human Development Index (HDI), physician density, average household income, human papillomavirus (HPV) vaccine coverage, Pap smear screening rates, radiotherapy machine density, and non-White population rates by state and macroregion across Brazil. Spearman's rank correlation test and simple linear regression analysis were employed. Results: Cervical cancer mortality rates are statistically lower in women with health insurance, positive self-perception of health, located in states with a higher HDI, per capita household income, density of physicians, and radiotherapy machines per 1000 inhabitants. In contrast, mortality rates proportionally increase according to poverty levels, as expected, and rates of non-White population. Considering public health, HDI scores significantly affected Pap smear test coverage, the number of radiotherapy machines, and HPV vaccine uptake. The North and the Southeast regions have, respectively, the lowest and the highest socioeconomic indicators, proportional to their mortality rates. No significant correlation was found between mortality rates and HPV vaccine or Pap smear coverage. Conclusions: Cervical cancer mortality in Brazil is significantly influenced by socioeconomic and healthcare disparities. This study provides a data-driven basis for public health strategies that address both medical and social determinants of health. Competing Interests: Competing interests: None declared. (© IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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