Trends In Incidence And Mortality Of Colorectal Cancer In The Municipality Of São Paulo, São Paulo, Brazil, 1997-2012

Max OLIVEIRA, School of Public Health, University of São Paulo, Brazil
LATORRE M. 1,2 , LORIATO L. 1 , SANTOS A. 1 , SILVA F. 1 , TANAKA L. 1,2

1 Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
2 Population-based Cancer Registry of São Paulo, Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil

Purpose: Colorectal cancer (CRC) is one of the most incident worldwide. The risk for CRC development is influenced by genetic and environmental factors, such as tobacco smoking. We analyzed the trend of incidence and mortality from CRC by sex and age group, for the municipality of São Paulo from 1997 to 2012.
Methods: Ecological study using cancer and mortality records (C18-C20 codes of ICD-10). The incidence and mortality rates were calculated based on the population provided by IBGE and adjusted for the world population of SEGI, by sex and age group (40-49; 50-59; 60-69; ≥70 years). The annual percent change (APC) and Confidence Intervals 95% (95%CI) were estimated using the Joinpoint software.
Results: From 1997-2012, 47,297 incident cases (52.6% in women) and 19,854 deaths (53.4% ​​in women) occurred. The average incidence rate was 22.5 per 100,000 women and 29.1 per 100,000 men; and mortality rate was 9.9 and 13.1 per 100,000 in women and men, respectively. In women, incidence is significantly decreasing (APC:-1.5%; 95%CI:-2.3;-0.7), but mortality remains stable. In men, incidence is also decreasing (APC:-1.3%; 95%CI:-2.1;-0.5), whereas, mortality is increasing (APC:0.7%; 95%CI:0.2;1.2). By age group, there was a decrease in incidence rates in women aged 60-69 years (APC:-2.5%) and ≥70 years (APC:-2.9%) and in men aged 60-69 years (APC:-2.5%) and ≥70 years (APC:-2.1%); in other age groups the incidence rates were stable. For mortality, there was, in women, reduction to 60-69 (APC:-1.7%) and increase to 40-49 years (APC:1.6%) and 50-59 years (APC:1.9%); in men, also increase, except in 60-69 year age group.
Conclusions: The CRC rates in São Paulo are intermediate when compared to other countries. Differences in CRC burden across age groups maybe associated with differences prevalence exposure to risk factors. Since mortality may reflect both the incidence and the difficulties of access to health services.
Funding source: CAPES