Leukemia mortality trends in children and adolescents in Brazilian state capitals: 1980-2015

Saraiva, Danúbia da Cunha Antunes; Santos, Sabrina da Silva; Monteiro, Gina Torres Rego

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Brasil

Epidemiologia e Serviços de Saúde

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Brasil

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Sumário

ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 27 (3) • 2018 • https://doi.org/10.5123/S1679-49742018000300004 copy

Leukemia mortality trends in children and adolescents in Brazilian state capitals: 1980-2015

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to analyze the temporal trend of leukemia mortality in children and adolescents under 20 years old, in Brazilian state capitals and Federal District, between 1980 and 2015.

Methods:

this was a descriptive time series study; age-standardized leukemia mortality rates were calculated; the Prais-Winsten regression model was used.

Results:

leukemia mortality rates fell from 2.73 to 1.58 per 100,000 inhabitants aged under 20 years in the period studied (annual percentage variation of -7.06%: 95%CI -8.61;5.49), with differences between capitals; there was a reduction in magnitude in all age groups - 0-4 years (9.17%: 95%CI -11.58;-6.69), 5-9 years (-9,27%: 95%CI -11.90;-6.56), 10-14 years (-4.86%: 95%CI -6.69;-3.00) and 15-19 years (-3.77%: 95%CI -5.22;-2.31).

Conclusion:

there was a falling trend in pediatric leukemia mortality rates, although it was unequal between the capitals, indicating the need for measures to minimize regional differences.

Keywords:
Child; Adolescent; Leukemia; Mortality; Ecological Studies; Time Series Studies

Variables	Annual percentage change (APC%)	95% Confidence Interval (95%CI)	P Value^a	Trend
Age (in years)
0-4	-9.17	(-11.58;-6.69)	<0.001	Decreasing
5-9	-9.27	(-11.90;-6.56)	<0.001	Decreasing
10-14	-4.86	(-6.69;-3.00)	<0.001	Decreasing
15-19	-3.77	(-5.22;-2.31)	<0.001	Decreasing
<20^b	-7.06	(-8.61;-5.49)	<0.001	Decreasing
Sex
Male (by age in years)
0-4	-10.23	(-14.18;-6.09)	<0.001	Decreasing
5-9	-8.39	(-11.95;-4.68)	<0.001	Decreasing
10-14	-5.74	(-7.62;-3.82)	<0.001	Decreasing
15-19	-5.14	(-7.57;-2.64)	<0.001	Decreasing
<20^b	-7.67	(-9.91;-5.37)	<0.001	Decreasing
Female (by age in years)
0-4	-8.33	(-9.58;-7.05)	<0.001	Decreasing
5-9	-10.12	(-12.85;-7.30)	<0.001	Decreasing
10-14	-4.00	(-6.66;-1.27)	0.006	Decreasing
15-19	-2.80	(-3.90;-1.68)	<0.001	Decreasing
<20^b	-6.56	(-7.69;-5.42)	<0.001	Decreasing
Type of leukemia (by age in years)
Lymphoid
0-4	-4.75	(-7.06;-2.38)	<0.001	Decreasing
5-9	-5.19	(-7.63;-2.69)	<0.001	Decreasing
10-14	-1.31	(-2.64;0.03)	0.056	Stationary
15-19	0.37	(-0.79;1.54)	0.521	Stationary
<20^b	-2.92	(-4.29;-1.53)	<0.001	Decreasing
Myeloid
0-4	-0.57	(-1.29;0.17)	0.125	Stationary
5-9	-1.42	(-2.27;-0.55)	0.002	Decreasing
10-14	-1.46	(-2.43;-0.47)	0.005	Decreasing
15-19	-1.84	(-2.86;-0.81)	0.001	Decreasing
<20^b	-1.27	(-1.77;-0.77)	<0.001	Decreasing
Others Leukemias
0-4	-4.11	(-4.80;-3.41)	<0.001	Decreasing
5-9	-2.76	(-3.53;-1.98)	<0.001	Decreasing
10-14	-2.17	(-2.78;-1.54)	<0.001	Decreasing
15-19	-2.38	(-3.20;-1.56)	<0.001	Decreasing
<20^b	-2.94	(-3.46;-2.42)	<0.001	Decreasing

Capitals, by region	1980/82	1983/85	1986/88	1989/91	1992/94	1995/97	1998/00	2001/03	2004/06	2007/09	2010/12	2013/15
Southeast
Rio de Janeiro	3.01	2.82	2.50	2.34	2.07	2.42	2.27	1.46	1.68	1.52	1.60	1.29
São Paulo	2.27	2.36	1.95	1.93	1.76	1.81	1.61	1.83	1.51	1.66	1.49	1.14
Belo Horizonte	2.61	3.27	2.73	3.16	2.47	2.10	1.59	1.75	1.33	1.48	1.74	1.68
Vitória	3.27	1.65	2.67	3.37	1.98	2.40	2.25	2.13	1.87	0.35	0.80	1.43
South
Porto Alegre	2.86	3.68	2.88	2.33	2.46	2.04	2.49	1.47	1.29	1.76	1.18	1.84
Florianopolis	1.19	2.41	2.57	2.31	3.33	3.48	1.90	1.56	0.68	0.29	2.06	0.84
Curitiba	2.70	2.91	2.42	3.11	2.25	1.73	2.13	2.05	1.71	1.70	1.05	1.46
Northeast
Maceió	2.18	1.84	1.79	1.25	2.69	1.02	2.41	1.47	1.81	1.91	1.54	1.35
Fortaleza	2.84	2.33	1.95	2.30	1.79	1.66	2.59	1.91	1.20	1.47	1.97	1.34
João Pessoa	1.46	2.52	2.82	2.51	3.36	1.99	1.03	2.58	0.45	1.62	1.60	0.76
Natal	1.66	3.69	1.37	1.29	1.91	2.78	2.47	2.10	1.44	1.51	2.19	1.48
Aracaju	2.66	1.28	1.20	2.41	2.79	1.46	1.32	1.08	1.83	1.84	2.06	1.65
Recife	2.83	1.96	2.24	1.95	2.29	1.28	1.47	1.01	1.06	1.47	1.03	1.01
Salvador	2.58	2.85	2.36	1.65	2.32	1.98	0.88	1.51	1.24	1.21	1.01	1.33
Teresina	1.43	1.82	1.75	1.92	2.86	1.21	2.47	2.31	1.81	2.17	2.96	1.59
São Luís	1.37	2.19	1.52	1.43	1.33	1.86	2.70	2.00	1.77	1.94	2.69	1.75
North
Belém	2.78	4.15	2.14	2.30	2.43	2.93	2.93	3.59	2.75	2.09	2.70	2.71
Boa Vista	1.94	2.37	2.52	1.56	0.00	0.40	1.08	1.67	0.86	0.30	0.60	2.64
Macapá	3.19	0.84	1.93	2.19	2.39	3.05	2.46	1.34	2.33	2.15	2.03	1.68
Manaus	2.83	2.29	2.13	1.93	2.54	1.90	2.51	3.33	2.24	2.60	2.88	3.07
Palmas ^a	-	-	-	-	0.00	0.00	1.06	1.33	2.00	2.47	1.51	2.73
Porto Velho	1.31	1.39	1.41	1.44	1.30	0.48	2.36	2.87	1.18	1.73	1.90	1.31
Rio Branco	2.41	2.64	2.32	1.40	3.35	1.41	2.69	1.96	1.23	1.98	2.70	3.13
Midwest
Brasília (FD)	2.84	2.25	2.04	2.04	1.76	1.84	1.34	1.38	1.01	1.18	1.23	1.54
Campo Grande	2.82	3.67	3.16	2.39	2.67	2.42	1.92	2.57	1.20	1.88	2.64	1.40
Cuiabá	2.59	2.99	3.94	2.86	2.47	2.39	2.36	1.93	2.20	2.36	2.18	1.36
Goiânia	4.53	2.99	2.52	2.43	3.03	2.34	2.27	2.08	1.99	3.29	2.38	1.96
Brazil	2.59	2.63	2.21	2.15	2.13	1.95	1.94	1.87	1.53	1.68	1.74	1.53

Capitals, by region	Annual percentage change (APC%)	95% Confidence Interval (95%CI)	P Value^a	Trend
Southeast
Rio de Janeiro	-10.78	-13.63;-7.85	<0.001	Decreasing
Male	-11.46	-15.23;-7.53	<0.001	Decreasing
Female	-10.04	-13.13;-6.85	<0.001	Decreasing
São Paulo	-6.42	-8.17;-4.63	<0.001	Decreasing
Male	-6.82	-9.34;-4.24	<0.001	Decreasing
Female	-6.06	-8.00;-4.07	<0.001	Decreasing
Belo Horizonte	-11.31	-14.87;-7.60	<0.001	Decreasing
Male	-9.67	-15.74;-3.15	0.005	Decreasing
Female	-12.60	-16.65;-8.34	<0.001	Decreasing
Vitória	-12.79	-19.25;-5.81	0.001	Decreasing
Male	-17.96	-32.26;-0.64	0.043	Decreasing
Female	-6.94	-18.58;6.37	0.282	Stationary
South
Porto Alegre	-12.26	-15.94;-8.42	<0.001	Decreasing
Male	-14.74	-19.82;-9.34	<0.001	Decreasing
Female	-9.79	-14.61;-4.69	0.001	Decreasing
Florianopolis	-9.31	-19.64;2.34	0.110	Stationary
Male	3.16	-15.59;26.07	0.755	Stationary
Female	-19.86	-26.19;-12.99	<0.001	Decreasing
Curitiba	-10.80	-13.72;-7.78	<0.001	Decreasing
Male	-15.92	-20.66;-10.89	<0.001	Decreasing
Female	-5.48	-10.88;0.24	0.059	Stationary
Northeast
Maceió	-2.96	-8.30;2.68	0.287	Stationary
Male	-1.98	-10.15;6.93	0.643	Stationary
Female	-4.54	-10.68;2.03	0.165	Stationary
Fortaleza	-7.27	-11.57;-2.76	0.003	Decreasing
Male	-4.28	-10.29;2.14	0.180	Stationary
Female	-10.31	-14.61;-5.79	<0.001	Decreasing
João Pessoa	-9.67	-17.63;-0.95	0.032	Decreasing
Male	-13.66	-23.86;-2.09	0.023	Decreasing
Female	-5.21	-16.86;8.07	0.413	Stationary
Natal	-3.30	-11.36;5.49	0.438	Stationary
Male	-4.00	-14.93;8.34	0.498	Stationary
Female	-3.13	-11.71;6.28	0.491	Stationary
Aracaju	-2.36	-10.70;6.76	0.590	Stationary
Male	-2.58	-12.30;8.22	0.617	Stationary
Female	-3.22	-13.24;7.96	0.547	Stationary
Recife	-10.69	-13.87;-7.38	<0.001	Decreasing
Male	-15.46	-20.70;-9.88	<0.001	Decreasing
Female	-5.96	-9.97;-1.77	0.007	Decreasing
Salvador	-11.25	-15.24;-7.07	<0.001	Decreasing
Male	-10.48	-16.72;-3.77	0.004	Decreasing
Female	-11.96	-15.30;-8.49	<0.001	Decreasing
Teresina	4.27	-1.56;10.44	0.149	Stationary
Male	4.34	-7.06;17.13	0.461	Stationary
Female	4.12	-5.52;14.75	0.404	Stationary
São Luís	5.44	-0.11;11.30	0.055	Stationary
Male	1.60	-6.04;9.87	0.682	Stationary
Female	8.28	2.57;14.30	0.005	Increasing
North
Belém	-1.77	-9.20;6.25	0.646	Stationary
Male	-0.30	-8.78;8.96	0.945	Stationary
Female	-4.43	-11.57;3.29	0.244	Stationary
Boa Vista	-4.01	-16.61;10.49	0.558	Stationary
Male	-6.21	-21.61;12.21	0.472	Stationary
Female	-4.51	-18.22;11.51	0.550	Stationary
Macapá	-1.47	-10.83;8.87	0.765	Stationary
Male	-5.73	-15.91;5.68	0.301	Stationary
Female	2.09	-8.96;14.48	0.716	Stationary
Manaus	4.25	-0.25;8.94	0.063	Stationary
Male	3.54	-4.13;11.83	0.365	Stationary
Female	5.38	0.42;10.58	0.034	Increasing
Palmas^b	33.54	16.36;53.26	<0.001	Increasing
Male	47.84	15.90;88.60	0.003	Increasing
Female	21.30	7.51;36.85	0.003	Increasing
Porto Velho	3.19	-4.62;11.64	0.423	Stationary
Male	1.67	-7.49;11.73	0.724	Stationary
Female	3.67	-10.16;19.63	0.612	Stationary
Rio Branco	0.80	-9.05;11.72	0.876	Stationary
Male	11.57	-5.00;31.03	0.176	Stationary
Female	-9.59	-21.48;4.10	0.155	Stationary
Midwest
Brasília (FD)	-8.27	-12.05;-4.32	<0.001	Decreasing
Male	-10.45	-14.59;-6.11	<0.001	Decreasing
Female	-5.63	-11.30;0.41	0.066	Stationary
Campo Grande	-10.32	-16.59;-3.57	0.004	Decreasing
Male	-14.95	-24.35;-4.38	0.008	Decreasing
Female	-5.91	-15.83;5.18	0.274	Stationary
Cuiabá	-10.36	-14.81;-5.68	<0.001	Decreasing
Male	-8.89	-16.66;-0.40	0.041	Decreasing
Female	-12.08	-19.98;-3.40	0.009	Decreasing
Goiânia	-8.44	-14.22;-2.27	0.009	Decreasing
Male	-9.14	-19.15; 2.12	0.105	Stationary
Female	-8.31	-12.08;-4.38	<0.001	Decreasing

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[1] Correspondence: Danúbia da Cunha Antunes Saraiva - Serviço de Nutrição e Dietética, Praça Cruz Vermelha, No. 23, 5º andar, Centro, Rio de Janeiro, RJ, Brazil. CEP: 20230-130. E-mail: danubia.saraiva@inca.gov.br