MORTALITY BY ORAL AND OROPHARYNGEAL CANCER IN BRAZIL BETWEEN 2000 AND 2013

Abstract

Oral and Oropharyngeal cancers are public health problems in Brazil and Worldwide. Incidence and mortality have changed in Brazil, but the last publication that evaluated time trends in Oral and Oropharyngeal cancer mortality analysed data between 1980 and 2003, prior to the reorganization and expansion in Brazils Public Oral Health network by the National Oral Health Policy of 2004.

Aim: To estimate coefficients and evaluate mortality trends by Oral and Oropharyngeal cancer between 2000 and 2013 in Brazil.

Method: Mortality coefficients were adjusted by sex and age using the direct method, using the Brazilian population of 2010. Mortality data were obtained from the Mortality Information System (SIM) of the Ministry of Health of Brazil and demographic data were extracted from demographic census and intercensal projections of the Brazilian Institute of Geography and Statistics (IBGE). Mortality trends were evaluated by sex, self-reported race/skin color, and age, by anatomical site of tumour and region of the country, using general linear regressions by Prais-Winsten method.

Results: There were 61,190 deaths by Oral and Oropharyngeal cancer in Brazil between 2000 and 2013, of which 48,301 (78.9%) were males. The male/female ratio was of 3.9:1. Oropharyngeal cancer was the most frequent cause of death at 31.7%. Trend analysis revealed that overall mortality by oral and oropharyngeal cancer was stable between 2000 and 2013 in Brazil, with an annual variation of 1.3% (95% CI: -2.6 to 5.3). Stratification by sex revealed a trend of significant increase for females, with an annual variation of 1.8% (95% CI: 0.1 to 3.5). Stratification by cancer site revealed that there was a trend of significant increase in the annual variation of mortality by cancer of the base of the tongue (0.4%, 95% CI: 0.1 to 0.7), and by cancer of the floor of the mouth (0.3%, 95% CI: 0.1 to 0.5). There was a trend of significant decrease in the annual variation of mortality by tonsil cancer (-0.2, 95% CI: -0.4 to -0.1). Stratification by sex and skin colour revealed a trend of significant increase in the annual variation of overall mortality by oral and oropharyngeal cancer for white women (1.2%, 95% CI: 0.6 to 1.7), for brown women (3.4%, 95% CI: 1.5 to 5.4), and for brown men (8.0%, 95% CI: 4.0 to 12.0). There was a trend of significant decrease for black women (-2.6%, 95% CI: -4.8 to -0.4) and yellow men (-26%, 95% CI: -47.6 to -4.4).

Conclusions: There was an important trend of increase in mortality by oral and oropharyngeal cancer for females in Brazil between 2000 and 2013. In addition, there was an increasing trend for base of the tongue and the floor of the mouth.