Lung cancer mortality in Brazil from 2004 to 2023.

Abstract

e22578 Background: Lung cancer is one of the leading causes of death by cancer worldwide. An important risk factor is tobacco smoking. However, cases among non-smokers are increasing. Other risk factors are family history and environmental exposure to other carcinogens. In Brazil, lung cancer mortality is also important despite public policies for smoking. Therefore, it is crucial to better understand the epidemiology of lung cancer mortality in Brazil in recent years. Methods: This is a descriptive cross-sectional epidemiological study based on secondary data from the DATASUS Information System (Department of Information and Informatics of the Unified Health System) and IBGE (Brazilian Institute of Geography and Statistics) from 2004 to 2023. The variable analyzed was the number of deaths from CID-10 C34 (lung and bronchial neoplasias) in the Brazilian population per gender, race/color, years of education, state, and age. Results: From 2004 to 2023, mortality from malignant neoplasms of the bronchi and lungs increased by 54.7%, rising from 9.5 to 14.7 deaths per 100,000 inhabitants. The average mortality rate for men was higher, at 14.9 per 100,000 inhabitants, compared to 9.7 for women. However, the increase for women was more pronounced, rising from 6.1 in 2004 to 13.3 in 2023, a 7.2 per 100,000 inhabitants increase. For men, the rate changed from 13.0 in 2004 to 16.1 in 2023, a 3.1 per 100,000 inhabitants increase. Mortality rates were higher in older age groups, ranging from 45.8 (ages 60-64) to 121.8 (ages 80+). The most significant increases in mortality were observed in those aged 80+ (46.2 per 100,000 inhabitants, from 91.9 to 138.1) and those aged 75-79 (9.1 per 100,000 inhabitants, from 96.4 to 105.5). The Brazilian state with the highest increase in mortality was Paraíba, with an increase of 10.2 deaths per 100,000 inhabitants (2.9-13.1). Over the 20 years, Rio Grande do Sul had the highest average mortality rate at 28.5, followed by Santa Catarina with 17.7 and Rio de Janeiro with 15.4. The brown race/color increased by 14.1 percentage points (pp), the white race by 11 pp, and the black race by 1.7 pp. The population with 8-11 years of schooling increased by 7.5 percentage points. The number of individuals with unknown race/color and education level decreased. Conclusions: Lung cancer mortality increased significantly over the 20 years analyzed. While male mortality remains higher, female mortality doubled, possibly due to more smoking women and gender differences in tolerability and therapy response. The rise in mortality among individuals with 8-11 years of schooling may be linked to the increased population in this group. The reduction in “unknown” data suggests improved reporting. Factors like better monitoring, follow-up, the aging population, and more diagnostics may have contributed to the mortality increase. A public screening program would be beneficial; although Brazilian medical societies recommend it, the government has not yet approved it.