Inequalities in Mortality and Access to Hospital Care for Cervical Cancer—An Ecological Study

Abstract

Cervical cancer is the second most common form of cancer in the world among women, and it is estimated to be the third most frequent cancer in Brazil, as well as the fourth leading cause of death from cancer. There is a difference in cervical cancer mortality rates among different administrative regions in Brazil along with an inadequate distribution of cancer centers in certain Brazilian regions. Herein, we analyze the trends in hospital admission and mortality rates for CC between 2000 and 2012. This population-based ecological study evaluated the temporal trend in cervical cancer between the years 2000 and 2012, stratifying by Brazilian administrative regions. The North and Northeast regions had no reduction in mortality in all age groups studied (25 to 64 years); when analyzing hospitalization rates, only the age group of 50 to 64 years from the North Region did not present a reduction. During the years studied, in the South Region, the age group ranging from 50 to 54 years had the greatest reduction in mortality rates (β = −0.59, p = 0.001, r2 = 0.63), and the group ranging from 45 to 49 years had the greatest reduction in hospital admission rates (β = −8.87, p = 0.025, r2 = 0.37). Between the years 2000 and 2012, the greatest reduction in the incidence of UCC was in the South Region (β = −1.43, p = 0.236, r2 = 0.12) followed by the Central-West (β = −1, p < 0.001, r2 = 0.84), the Southeast (β = −0.95, p < 0.001, r2 = 0.88), the Northeast (β = −0.67, p = 0.080, r2 = 0.25), and, finally, by the North (β = −0.42, p = 0.157, r2 = 0.17). There was a greater reduction in mortality rates and global hospitalization rates for CC in Brazil than in the United States during the same period with exceptions only in Brazil’s North and Northeast regions.