Análise das tendências de incidência, mortalidade, sobrevida e a distribuição espacial do câncer colorretal em Sergipe

Abstract

Introduction: Colorectal cancer (CRC) has been gaining prominence among the most common types of cancer worldwide. Traditionally, evaluations of incidence, mortality, and survival are widely used in epidemiological studies, enabling comparisons between different regions. In Sergipe, an increase in these rates has been observed. Objective: To analyze the secular trends in incidence, mortality, survival, and spatial distribution of colorectal cancer in the state of Sergipe. Methods: A partially ecological study of aggregated time series was conducted for the periods from 1996 to 2017 for incidence and from 1996 to 2023 for mortality. Data from the Population-Based Cancer Registry of Aracaju were used for incidence calculations, and DATASUS data were used for mortality calculations. Trends in incidence and mortality were calculated using the Joinpoint Regression Program 4.8.0.1 from the National Cancer Institute. The 5- year relative survival was calculated by subtracting the mortality/incidence ratio from unity. For spatial statistics, TerraView 4.2.2 software was used, employing the local empirical Bayesian model for rate smoothing, and QGIS 3.10.7 software was used to create thematic maps. Municipality geocodes and the cartographic base were obtained from IBGE. Results: During the period, a total of 3,497 cases were diagnosed, with more than half occuring in female. For mortality, out of a total of 1,551 cases, 58% were female. The most common histological subtype was adenocarcinoma, with the rectum and left colon being the most affected sites in incident cases, while in mortality data, the highest proportions were found for "Unspecified colon." The estimated mean survival for males and females in Sergipe was 63.7% and 66.9%, respectively. In Aracaju, it was 62.9% and 65.2%, respectively. The highest age-standardized incidence rates for the world population for men and women in Sergipe were 12.6 per 100,000 men (2016) and 13.9 per 100,000 women (2017). In Aracaju, even higher rates were observed for both sexes. Regarding age-standardized mortality rates, 5.9 per 100,000 (2021) for men and 5.9 per 100,000 (2018) for women were found. In Aracaju, higher rates than the state average were also observed. In terms of spatial distribution, both for incidence and mortality, the areas with the highest clusters were found in regions considered to have high HDI or in neighboring municipalities. Conclusion: The incidence and mortality trends in Sergipe and Aracaju are increasing. Females are proportionally the most affected, with adenocarcinoma being the most common histological subtype. Topographically, the rectum and left colon were the most affected regions in incident cases, although for mortality, the highest proportions were found for "Unspecified colon." Clusters with municipalities with high incidence and mortality rates and their neighbors were also mainly distributed in regions/municipalities with higher HDI.