Trends In Incidence And Mortality From Tobacco-Related Cancers, São Paulo, Brazil

Maria Do Rosário LATORRE, School of Public Health, University of São Paulo, Brazil

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

Purpose: Tobacco smoking is the most important modifiable risk factor for cancer. According to WHO, there is one billion smokers worldwide and half of them will die from tobacco-related illnesses. The aim of the present study was to assess trends in incidence and mortality of tobacco-related cancers in São Paulo, Brazil, between 1997 and 2012.
Methods: We selected topographies for which there is sufficient evidence, for their association with tobacco: head and neck (oral cavity, pharynx, nasal cavity and accessory sinuses, larynx), esophagus, stomach, colon-rectum, liver, pancreas, lung, cervix, ovary, urinary tract and myeloid leukemia. Incident cases were provided by the Population-based Cancer Registry of São Paulo and deaths were obtained from the Department of Informatics of the Unified Health System. The incidence and mortality rates were calculated based on the population provided by Brazilian Institute of Geography and adjusted for the world population of SEGI. The trend analyzes were carried out according to sex, using the Joinpoint software. The significance level was set at 5%.
Results: Some 195,332 newly (53.2% in men) diagnosed cases and 114,745 deaths (57.3% in men) occurred from tobacco-related cancers between 1997 and 2012. Incidence decreased for head and neck, esophageal, gastric, pancreatic, colorectal, lung, urinary tract (men only), cervical, ovarian cancer and myeloid leukemia and increased for liver in women. As for mortality, head and neck, esophageal, gastric, cervical, ovarian cancers and myeloid leukemia significantly decreased, whereas, liver and colorectal cancers in men and lung in women have shown increasing trends.
Conclusion: Important reductions in the burden of several tobacco-related cancers may reflect, to some extent, decreasing trends in tobacco-smoking prevalence in São Paulo, which in turn is a result of anti-tobacco efforts in Brazil. Increasing trends for some cancers indicate that other risk factors might be becoming gradually important in this context.