Spatial assessment of advanced-stage diagnosis and lung cancer mortality in Brazil

Kálya Yasmine Nunes de Lima; Marianna de Camargo Cancela; Dyego Leandro Bezerra de Souza

doi:10.1371/journal.pone.0265321

Spatial assessment of advanced-stage diagnosis and lung cancer mortality in Brazil

PLoS One. 2022 Mar 18;17(3):e0265321. doi: 10.1371/journal.pone.0265321. eCollection 2022.

Authors

Kálya Yasmine Nunes de Lima¹, Marianna de Camargo Cancela², Dyego Leandro Bezerra de Souza^{3

4}

Affiliations

¹ Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte-UFRN, Natal, Rio Grande do Norte, Brazil.
² Division of Population Research, Division of Population Research, National Cancer Institute (INCA), Rio de Janeiro, Brazil.
³ Department of Collective Health, Postgraduate Programme in Collective Health, Federal University of Rio Grande do Norte-UFRN, Natal, Rio Grande do Norte, Brazil.
⁴ Faculty of Health Science and Welfare, Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences(M3O), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain.

Abstract

The high incidence and mortality rates make lung cancer a global public health issue. Socioeconomic conditions and the provision of health services may be associated with this reality. This study investigates the spatial distribution of advanced-stage diagnosis and mortality due to lung cancer and its association with the healthcare services supply and demographic and socioeconomic indicators in Brazil. This is an ecological study with 161 Intermediate Regions of Urban Articulation. Mortality data were extracted from the Mortality Information System, and the cases of lung cancer were obtained from the Integrator of Hospital-Based Cancer Registries from 2011 to 2015. Analyses employed Moran's I, local indicators of spatial association, and the multivariable model. The proportion of advanced-stage diagnosis was 85.28% (95% CI 83.31-87.10) and was positively associated with the aging rate (Moran's I 0.11; p = 0.02), per capita income (Moran's I 0.05; p = 0.01) and negatively associated with Gini Index (Moran's I -0.16; p = 0.01). The mean age-adjusted mortality rates was 12.82 deaths/100,000 inhabitants (SD 5.12). The age-adjusted mortality rates for lung cancer presented a positive and statistically significant spatial association with all demographic, socioeconomic and healthcare services supply indicators, except for the "density of family health teams" (Moran's I -0.02 p = 0.28). The multivariable model for the mortality rates was constituted by the variables "Density of facilities licensed in oncology", "Per capita income", and "Health plan coverage". The per capita income presented positive association and health plan coverage negative association with age-adjusted mortality rates. Both associations were statistically significant. The variable density of facilities licensed in oncology showed no significant association with age-adjusted mortality rates. There is a high proportion of advanced-stage diagnosis across the Brazilian territory and inequalities in lung cancer mortality, which are correlated with the most developed areas of the country.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brazil / epidemiology
Humans
Incidence
Income*
Lung Neoplasms* / diagnosis
Socioeconomic Factors
Spatial Analysis

Grants and funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.