Regional differences in respiratory cancer in Brazil: a descriptive ecological study

Keywords

lung neoplasm - epidemiology - hospitalization - mortality

Introduction: Despite lung cancer being the most common and deadly type of respiratory cancer, trachea and bronchial cancer are also relevant types of respiratory cancers in Brazil. This highlights the importance of analyzing its data for Brazil's public health.

Objective: To analyze regional differences in trachea, bronchial, and lung cancer in Brazil and identify temporal trends.

Methods: This ecological and epidemiological study used data on malignant neoplasm of the trachea, bronchi, and lungs from Brazil's Hospital Information System (SIH/SUS) covering all regions (North, Northeast, Southeast, South, and Midwest) from 2014 to 2023. Simple linear regression, Kruskal-Wallis and ANOVA tests were conducted using Microsoft Excel and GraphPad Prism. The variables analyzed were hospitalization rate (per 100,000), mortality, and average hospital stay (days).

Results: Significant differences were observed between regions for all variables (p<0.05). The mean hospitalization rate in Brazil was 11,73, with the highest mean recorded in the South (22,51) and the lowest in the North (4,50). All regions showed significant growth trends in this variable (p<0,05), except the South (p = 0,74). Brazil's mean mortality was 26,49‰, with the North (32,89‰) being the only region to stand out in this variable. Significant temporal trends (p<0,05) were only observed in the Northeast (β=-0,46) and South (β=0,36) regions. The average hospital stay across the country was 7,42 days. The North (10,18) was the only region to stand out in this variable. All regions showed significant growth trends (p<0,05), but the highest was in the North (β=-0,47).

Conclusion: The results for the Southeast and midwest regions were similar to the country's average across all variables. The North, despite having the lowest hospitalization rate, exhibited the highest mortality, average hospital stays and hospital stay growth trend, which suggests that the public health strategies against this type of cancer may not be so effective in this region. The South had the highest hospitalization rate but presented mortality and average hospital stay similar to the country's mean rates. These data indicate that this region may have an effective public health strategy to track and treat these types of cancer. The Northeast was the only region to show a reduction trend on mortality. It is evident that further studies are needed to understand the highlighted regions, to guide future public health strategies

Corresponding author: Hugo Antunes Macedo (e-mail: [e-mail]).