Disparities in Epidemiological Profile of Gastric Adenocarcinoma in Selected Cities of Brazil

Abstract

Background: Despite decreasing global incidence trends, gastric cancer is still among the five most incident cancers<br />in the world and the third cancer-related cause of death. In Brazil, differences in incidence and mortality exist depending<br />on the geographic region studied. Objective: To describe the incidence, mortality, trends and age-period-cohort of<br />gastric cancer in three cities of Brazil (Sao Paulo, Belem and Fortaleza), in the period 1990-2012. Mortality for gastric<br />cancer in Brazil overall and by region was described. Methods: 33,462 incident cases of gastric cancer were identified<br />from the population-based cancer registries and 23,424 deaths from mortality information system in residents of<br />the three cities and in Brazil were included in the study. Data for incident cases were extracted from the Population<br />Based Cancer Registries from the National Cancer Institute (INCA). Mortality data on gastric cancer were extracted<br />from Information Technology Department of Brazilian Public Health Care System/Health Ministry (DATASUS/MS).<br />Mortality and incidence age standardized rates were calculated. For trends analysis the Joinpoint Regression and<br />age-period-cohort model were applied. Results: Belem presented the highest incidence rates for gastric adenocarcinoma.<br />Decreasing incidence trends were identified in Sao Paulo (-7.8% in men; -6.3% in women) and in Fortaleza (-1.2%<br />in men). Increasing incidence trends were observed for women in Belem (1.8%) and Fortaleza (1.1%). In Belem<br />(Amazon area), there was an increased risk for gastric cancer in women born after the 1960s. Overall in Brazil mortality<br />for gastric cancer is decreasing. Mortality trends showed significant reduction, for both sexes, in the three Brazilian<br />cities. Conclusion: Incidence of gastric cancer is increasing in women born in the sixties in Belem (Amazon region)<br />and Fortaleza (Northeast region). In Brazil there was increase in mortality in Northeast region and decrease in others<br />regions. More update data on incidence for Amazon and Northeast region is needed.