Regional differentials in cancer mortality in a region of, Brazil, 1979-1981

A partir do fato de que os neoplasmas malignos foram a terceira causa de morte no Estado do Rio de Janeiro, Brasil, no ano de 1980, apresentando taxa bruta igual a 89,8 por 100.000 habitantes, foi analisada a mortalidade por câncer segundo suas principais localizações anatômicas, no período 1979-1981. Dividiu-se o Estado em três regiões distintas: Capital, Cinturão Metropolitano e Interior. Foram calculados coeficientes de mortalidade trienais, posteriormente padronizados pelo método direto utilizando-se, para tal, a população mundial. Para cumprir o objetivo de comparar diferentes regiões geográficas foram calculadas razões padronizadas de mortalidade. Observou-se que as principais localizações anatômicas foram pulmão, estômago, próstata, esôfago e fígado, nos homens; e mama, estômago, pulmão, cérvix uterino e útero (não especificado), nas mulheres. Encontrou-se que as maiores taxas para o total de tumores ocorreram na Capital e as menores no Interior, sendo as maiores razões padronizadas de mortalidade aquelas para mama (1,88), cólon (1,71) e pulmão (1,70). A mortalidade por neoplasmas malignos de esôfago e de fígado foi maior no Interior do que nas demais regiões, em ambos os sexos. Concluiu-se que existe comportamento distinto da mortalidade por câncer entre as diferentes regiões, apontando, mais uma vez, na direção da determinação ambiental de grande parte dos neoplasmas malignos.In 1980, malignant neoplasms ranked 3rd as a cause of death in the State of Rio de Janeiro, Brazil, with a crude mortality rate of 89.8 per 100,000. Cancer mortality data for 1979-1981 are presented for the State, with the objective of analyzing regional differentials. For the purpose of comparing mortality from the most important cancers, the State was divided into three regions: Capital, Metropolitan Belt and Interior, on the basis of the geographical structure of the State - which gave rise to the present urbanization patterns. Average annual age and sex-specific mortality rates per 100,000 were calculated for the period 1979-1981 for each cancer site and for 5-year age groups up to 79 years and for 80 years and above. Age standardized rates (ASR) were calculated by direct standardization to the world population and standardized mortality ratios (SMR) were also calculated with the objective of comparing different geographical areas. It was found that the most important malignant neoplasms among males were those of the lung (ASR 27.9), stomach (ASR 24.0), prostate, oesophagus and liver. The breast was the most important site for females (ASR 16.0), followed by the stomach (ASR 10.8), lung, cervix uteri and uterus (unspecified). The highest ASR were in the Capital (164.4 in males, 106.2 in females) and the lowest in the Interior (126.5 in males, and 91.3 in females). The highest SMR were found for breast (1.28), colon (1.71) and lung (1.70) cancers, the mortality rates for which were almost two-times higher in the Capital than in the Interior. Oesophagus and liver cancer mortality rates were higher in the Interior than in the other two regions, for both sexes. The highest gastric cancer mortality rates found in the State were two-times lower than those for Japan and 15.6 times higher than those for Nicaragua. The results confirm that there are important regional differences in cancer mortality within Rio de Janeiro State and that these are probably due to environmental factors