Banca de QUALIFICAÇÃO: KÁLYA YASMINE NUNES DE LIMA

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : KÁLYA YASMINE NUNES DE LIMA
DATE: 17/08/2020
TIME: 14:00
LOCAL: Departamento de Saúde Coletiva
TITLE:

Inequalities in lung cancer mortality and staging in Brazil

KEY WORDS:
PAGES: 100
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUBÁREA: Epidemiologia
SUMMARY:

Morbidity and mortality due to tracheal, lung and bronchial cancer reflects a scenario ofinequalities. Poorer populations have a higher risk of falling ill and dying from cancer,because in addition to being more exposed to the risk factors of the disease, they facedifficulties in accessing health care. The objective was to analyze the staging and mortalityfrom lung cancer and its relationship with socioeconomic factors and the provision of healthservices in Brazil. This is an observational, ecological and cross-sectional study. Mortalitydata (C33 and C34) were collected from the Mortality Information System (SIM) for theperiod from 2011 to 2015. Individual data related to cancer diagnosis and socioeconomicconditions were obtained from the Integrator of Cancer Hospital Records (RHC) for theperiod from 2006 to 2015. The contextual socioeconomic variables were collected in the Atlasof Human Development in Brazil and data on density of doctors and health services in theNational Register of Health Facilities (CNES). Mortality analysis was performed using theChi-squared test and Poisson Regression with robust variance for a 95% confidence level. Tocheck for the existence of spatial dependence on mortality rates and the proportion of latediagnosis, the Moran Global Index and the Local Spatial Association Indicator (LISA) wereused. The median age-standardized mortality rate between 2011 and 2015 was 12.8 deaths per100,000 inhabitants. For women, the adjusted rate was 8.44 (± 3.14) deaths per 100,000women and for men, 19.25 (± 13.83) deaths per 100,000 men. The high mortality rates due totracheal, bronchial and lung cancer were significantly associated with “Density of generalpractitioners” (RP = 1.68), “Establishments qualified in oncology” (RP = 1.49) and inverselyassociated with “ Proportion of poor ”(PR = 1.73) and, showed spatial autocorrelation (Moran= 0.5; p = 0.01). The multivariate spatial model was constituted by the variables"Establishments qualified in oncology", "Income" and "Coverage of health plans" and has anexplanatory power of 66% for lung cancer mortality. Between 2011 and 2015, the averageproportion of late diagnosis was 85.72% (± 10.26) for the population between 18 and 99 yearsold. For females, the average was 85.14% (± 12.43) and for males, 85.97% (± 12.86). Theproportions of late diagnosis showed a low spatial autocorrelation, however significant(Moran = 0.37; p = 0.01). The explanatory power of the final model, consisting of thevariables "Adjusted Mortality Rate", "HDI" and "Establishments qualified in oncology", was16% for the late diagnosis of lung cancer. The results show a scenario of inequalities that mayfavor the population's exposure to risk factors for lung cancer, but without the ability to meet the existing demand in a timely manner, which has reflected in the prevalence of latediagnosis and high rates of mortality from this neoplasm. 

BANKING MEMBERS:
Interno - 1149540 - ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
Interno - 3926907 - DYEGO LEANDRO BEZERRA DE SOUZA
Interna - 2305247 - ISABELLE RIBEIRO BARBOSA MIRABAL