ArticleBMJ open2017
Breast cancer mortality and associated factors in São Paulo State, Brazil: an ecological analysis.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Linear regression in ecological studies involving space: methodology and an application example in public health.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2026Article
- Structural Characterization of Heat Shock Protein 90β and Molecular Interactions with Geldanamycin and Ritonavir: A Computational Study.International journal of molecular sciences · 2024Article
- Mortality trends of breast and cervical cancer in Passo Fundo, Rio Grande do Sul: an analysis by age and schooling, 1999-2019.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2023Article
- Intra-urban spatial variability of breast and cervical cancer mortality in the city of São Paulo: analysis of associated factors.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2023Article
- Challenge of Incorporating New Drugs for Breast Cancer in Brazil: A Proposed Framework for Improving Access to Innovative Therapies.JCO global oncology · 2021Review
- Spatial pattern of mortality from breast and cervical cancer in the city of São Paulo.Revista de saude publica · 2020Article
- Breast cancer in low-middle income countries: abnormality in splicing and lack of targeted treatment options.American journal of cancer research · 2020Review
- The Prefectural Participation Rates of Lung Cancer Screening Had a Negative Correlation with the Lung Cancer Mortality RatesAsian Pacific journal of cancer prevention : APJCP · 2019Article
- The Revised Champion's Health Belief Model Scale: Predictive Validity Among Brazilian Women.SAGE open nursingArticle
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIdentify the factors associated with the age-standardised breast cancer mortality rate in the municipalities of State of São Paulo (SSP), Brazil, in the period from 2006 to 2012.
designEcological study of the breast cancer mortality rate standardised by age, as the dependent variable, having each of the 645 municipalities in the SSP as the unit of analysis. SETTINGS: The female resident population aged 15 years or older, by age group and municipality, in 2009 (mid-term), obtained from public dataset (Informatics Department of the Unified Health System).
participantsWomen 15 years or older who died of breast cancer in the SSP were selected for the calculation of the breast cancer mortality rate, according to the municipality and age group, from 2006 to 2012.
main outcome measuresMortality rates for each municipality calculated by the direct standardisation method, using the age structure of the population of SSP in 2009 as the standard.
resultsIn the final linear regression model, breast cancer mortality, in the municipal level, was directly associated with rates of nulliparity (p<0.0001), mammography (p<0.0001) and private healthcare (p=0.006).
conclusionsThe findings that mammography ratio was associated, in the municipal level, with increased mortality add to the evidence of a probable overestimation of benefits and underestimation of risks associated with this form of screening. The same paradoxical trend of increased mortality with screening was found in recent individual-level studies, indicating the need to expand informed choice for patients, primary prevention actions and individualised screening. Additional studies should be conducted to explore if there is a causality link in this association.
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