Mortality from oral and oropharyngeal cancer in Brazil, between 2000 and 2013: trends by sociodemographic strata

doi:10.1590/1413-81232020258.31282018

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ARTICLE • Ciênc. saúde coletiva 25 (8) • Aug 2020 • https://doi.org/10.1590/1413-81232020258.31282018 copy

Mortality from oral and oropharyngeal cancer in Brazil, between 2000 and 2013: trends by sociodemographic strata

About the SCIMAGO INSTITUTIONS RANKINGS

Abstract

Generalized observations of temporal trends in mortality could mask consistent specific patterns. This study aims to analyze the trend of oral and oropharyngeal cancer mortality rates in Brazil, from 2000 to 2013, considering the differences by gender, anatomical site, age group and ethnicity. Data on oral and oropharyngeal cancer mortality were retrieved from the Mortality Information System. The trend of historical series mortality rates by stratum was estimated through a generalized linear regression by the Prais-Winsten method. In total, 61,190 deaths from oral and oropharyngeal cancer were recorded in the 2000-2013 period (mean of coefficients: 3.50 deaths/100 thousand inhabitants/year). The trend of mortality rates was stable for males and increasing for females (1.31%/year). A growing pattern was identified for men aged 20-29 years (2.92%/year) and brown men (20.36%/year). The increasing pattern was also identified for white women (2.70%/year) and brown women (8.24%/year). We can conclude that surveillance of this condition should consider the sociodemographic differences of the population for equitable planning of care strategies because they reflected in different trends of oral and oropharyngeal cancer mortality rates in Brazil.

Key words
Mouth neoplasms; Oropharyngeal neoplasms; Mortality; Ethnicity and Health

Variable	Overall	Men (M)	Woman (W)	M/W Ratio
Anatomical Site
Lip	0.038	0.058	0.019	3.05
Base of the tongue	0.283	0.498	0.082	6.07
Other parts of the tongue	0.662	1.080	0.270	4.00
Gum	0.031	0.041	0.022	1.86
Floor of the mouth	0.126	0.213	0.046	4.63
Palate	0.169	0.248	0.095	2.61
Other parts of the mouth	0.760	1.146	0.399	2.87
Parotid gland	0.159	0.208	0.113	1.84
Other major salivary glands	0.051	0.060	0.042	1.43
Tonsil	0.112	0.195	0.034	5.74
Oropharynx	1.108	1.947	0.322	6.05
Age Group
15 - 19	0.003	0.003	0.002	1.37
20 - 29	0.014	0.018	0.011	1.60
30 - 39	0.076	0.122	0.033	3.70
40 - 49	0.493	0.889	0.121	7.35
50 - 59	1.021	1.845	0.250	7.38
60 - 69	0.874	1.493	0.295	5.06
70 - 79	0.596	0.873	0.337	2.59
80 and +	0.423	0.451	0.396	1.14
Ethnicity/Skin Color
White	3.355	5.632	1.221	4.61
Black	3.385	5.441	1.459	3.73
Brown	2.275	3.565	1.067	3.34
Yellow^* * Excluding age groups of 70-79 years and 80 years and over.	1.402	2.341	0.522	4.48
Indigenous^* * Excluding age groups of 70-79 years and 80 years and over.	0.883	1.355	0.442	3.07

Variable		95% CI
Variable	APC (%)	Lowest	Highest	P-value	Trend	R²
Anatomical Site
Lip	0.942	-1.405	3.345	0.402	Stable	0.997
Base of the tongue	1.507	0.398	2.629	0.012	Increasing	0.997
Other parts of the tongue	0.667	-0.447	1.794	0.217	Stable	0.960
Gum	-1.020	-2.811	0.804	0.245	Stable	0.999
Floor of the mouth	2.613	0.973	4.279	0.005	Increasing	0.997
Palate	0.958	-0.092	2.018	0.070	Stable	0.999
Other parts of the mouth	-0.244	-1.597	1.128	0.704	Stable	0.888
Parotid gland	0.797	-1.599	3.251	0.486	Stable	0.992
Other major salivary glands	-0.624	-2.690	1.487	0.529	Stable	0.998
Tonsil	-1.982	-3.327	-0.618	0.008	Decreasing	0.998
Oropharynx	0.188	-1.048	1.440	0.747	Stable	0.551
Gender
Women	1.307	0.121	2.507	0.033	Increasing	0.957
Men	0.175	-0.968	1.331	0.746	Stable	0.997
Overall	0.413	-0.722	1.561	0.445	Stable	0.995

Variable		95%CI
Variable	APC (%)	Lowest	Highest	P-value	Trend	^R2
Age Group
Women
15 - 19	3.733	-6.456	15.031	0.455	Stable	0.985
20 - 29	1.298	-1.867	4.565	0.394	Stable	0.998
30 - 39	1.961	0.145	3.810	0.036	Increasing	0.999
40 - 49	0.640	-1.349	2.669	0.500	Stable	0.997
50 - 59	0.493	-0.549	1.546	0.324	Stable	0.998
60 - 69	0.312	-0.616	1.249	0.480	Stable	0.998
70 - 79	1.390	-0.045	2.846	0.057	Stable	0.993
80 and +	2.821	0.467	5.230	0.023	Increasing	0.971
Men
15 - 19	1.805	-3.419	7.301	0.474	Stable	0.997
20 - 29	2.915	0.597	5.286	0.018	Increasing	0.999
30 - 39	-2.598	-4.047	-1.128	0.002	Decreasing	0.998
40 - 49	-1.807	-3.318	-0.272	0.025	Decreasing	0.651
50 - 59	0.428	-0.640	1.508	0.401	Stable	0.985
60 - 69	0.299	-0.734	1.342	0.542	Stable	0.968
70 - 79	0.462	-0.595	1.530	0.361	Stable	0.785
80 and +	1.517	-0.131	3.191	0.068	Stable	0.980
Ethnicity/Skin Color
Women
Yellow^* * Excluding age groups of 70-79 years and 80 years and over.	-3.649	-10.197	3.377	0.272	Stable	0.884
White	2.701	1.397	4.023	0.001	Increasing	0.999
Indigenous^* * Excluding age groups of 70-79 years and 80 years and over.	-4.339	-19.211	13.272	0.579	Stable	0.563
Brown	8.242	3.481	13.221	0.002	Increasing	0.986
Black	-5.789	-10.431	-0.907	0.024	Decreasing	0.992
Men
Yellow^* * Excluding age groups of 70-79 years and 80 years and over.	-40.386	-59.298	-12.688	0.012	Decreasing	0.846
White	-6.925	-17.223	4.655	0.207	Stable	0.996
Indigenous^* * Excluding age groups of 70-79 years and 80 years and over.	-43.994	-71.635	10.582	0.088	Stable	0.457
Brown	20.335	9.782	31.902	0.001	Increasing	0.993
Black	-13.903	-28.943	4.322	0.115	Stable	0.988

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[1] Collaborations

AR Cunha worked on the design of the project, the search, analysis and interpretation of data, the writing of the article and the approval of the final version to be published. TS Prass and FN Hugo collaborated in the design of the project, in the analysis and interpretation of the data, in the relevant critical review of the intellectual content and in the approval of the final version to be published.