Spatial distribution of morbimortality from colorectal cancer in Brazil

To analyze the spatial distribution pattern of advanced-stage diagnosis and mortality from colorectal cancer (CRC) in Brazil and its relationship with population socioeconomic and healthcare service indicators. Ecological study conducted with cases of colorectal cancer (CCR) in individuals of both sexes from the 133 Intermediate Regions of Urban Articulation in the Brazilian territory in the period from 2015 to 2019. Staging, mortality, socioeconomic, and healthcare service availability data were collected from information systems. A spatial analysis was performed using the Global Moran's Index and Local Indicator of Spatial Association. In the multivariate analysis, models with global spatial effects, the Spatial Error, were utilized. The proportion of advanced-stage diagnosis of colorectal cancer for females was 64.7%, and for males, it was 65.9%. The adjusted mortality rate for colorectal cancer was 11.25 for females and 14.29 for males per 100,000 inhabitants. The adjusted mortality rates for colorectal cancer were associated with the social vulnerability index, general practitioner density, colorectal specialist density, and specialized oncology services. Social inequities and disparities in healthcare service provision are predictors of the spatial pattern for colorectal cancer mortality.

Keywords:
Mortality; Colon cancer; Rectal cancer; Social determinants of health; Spatial analysis