Epidemiological profile of cancer breast and cervical cancer-related mortality from 2010 to 2020 in Brazil

Epidemiological profile of cancer breast and cervical cancer-related mortality from 2010 to 2020 in Brazil | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Epidemiological profile of cancer breast and cervical cancer-related mortality from 2010 to 2020 in Brazil Thiffany Nayara Bento de Morais, Ketyllem Tayanne da Silva Costa, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2062282/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: There are several types of cancer that can affect different organs of the body, however, the one that most affects the female population worldwide and in Brazil is breast cancer. For this reason, it is necessary to conduct a study to evaluate the epidemiological behavior of breast and cervical cancer mortality for the years 2009-2021 in Brazil. Methods: The study in question is an ecological research of time series, carried out through data obtained from secondary sources. It is a research of Brazilian origin and its main approach is the number of deaths from 2009 to 2021 due to breast and cervical cancer, this being the dependent variable of the research. In addition, independent variables were also collected from DataSUS. The data was analyzed using the Join Point open source software version. Results: The results obtained indicate that cervical and breast cancers show a growth behavior in the period analyzed (2010-2020), although each region of Brazil has variations in certain periods. It is possible to observe that Brazil presents a linear growth curve, with a tendency to stabilize as of 2018 in both types of cancer. However, the Midwest region of Brazil shows a decreasing behavior between 2010 and 2012 in cervical cancer. The South region most closely resembles the graphical behavior of the country when looking at cervical cancer rates over the period studied (about 2.5 to 3.5 cases per 100,000 population). However, breast cancer rates are higher than those in Brazil (about 85 to 113 cases per 100,000 population) and have a perspective of gradual growth. Conclusions: Therefore, the two types of cancer studied cover the entire Brazilian territory, with a tendency to increase each year in the mortality rate, indicating that investments are not enough to control these data, since it is known that both types of cancer have a high chance when they present an effective and early investigation. Brazil epidemiology mortality rate breast cancer cervical cancer Figures Figure 1 Introduction The human body has cells, which in a physiological process form tissues through cell multiplication. The process occurs in such a way that most of these cells grow, multiply and die in an ordered way, however, still in the natural development, not all of them have this way of division, such as neurons, for example. However, it is necessary to understand that neoplasia does not occur only due to cell multiplication, but also due to disorder, because instead of dying, they continue dividing in a fast, aggressive and uncontrollable way, distributing themselves to several regions of the body and thus causing functional disorders[ 1 ]. There are several types of cancer that can affect different organs of the body, however, the one that most affects the female population worldwide and in Brazil is breast cancer. In developed and developing countries it is classified as one of the main causes of death. The incidence rate is higher in developed countries, as is the mortality rate. However, when tracked and investigated early, it has a high chance of cure[ 2 ]. Another type of cancer that affects the female public is cervical cancer, being the leading cause of death for women in Latin America and the Caribbean. It is a cancer with a high chance of being prevented, and yet 35,700 women die every year in the Americas, with more than 80% of these cases belonging to Latin America and the Caribbean, three times more than in North America. Thus, 51,500 deaths are estimated by 2030 due to the increase in population and life expectancy, 89% of which are in Latin America and the Caribbean[ 3 ]. Therefore, since it is a public health problem with a worldwide impact, with high mortality rates and a strong tendency to increase in the following years, besides being a problem that directly influences the well-being and quality of life of the ill and their caregivers, also contributing to an economic deficit by keeping the active public out of the workplace, it is important to encourage studies in this area in order to find ways to improve this context in the health field. For this reason, it is necessary to conduct a study to evaluate the epidemiological behavior of breast and cervical cancer mortality for the years 2009–2021 in Brazil. Metodology The study in question is an ecological research of time series, carried out through data obtained from secondary sources. It is a research of Brazilian origin and its main approach is the number of deaths from 2010 to 2020 due to breast and cervical cancer, this being the dependent variable of the research. The main purpose of analyzing the last twelve years of deaths from these neoplasms, is to identify how this variable has behaved over time, so the pattern of the period will be per year. Another factor is that the analysis of the territory will occur according to the regions of Brazil, because each one has its specificities that can cause unique impacts. For the behavior could be visualized and analyzed in a more simplified way, the mortality rate from breast and cervical cancer was calculated separately, so that the calculation was performed by dividing the number of deaths by the number of inhabitants (female) and then multiplied by 100,000. Therefore, as independent variable of the study will be the years under analysis, from 2010 to 2020. M = (Morbidity by COVID-19)/Population X 100,000 The data was obtained on May 30, 2022 in a digital platform idealized by the Ministry of Health, in order to compile data on several diseases that affect the health of Brazilian citizens, it is available and can be accessed through the site . Meanwhile, the information obtained is already downloaded in CSV format, therefore, soon after, it is already possible to clean the database in Microsoft Excel® software, and then, to make a more elaborate analysis in JoinPoint software, version 4.9.0.0 (Surveillance Research, National Cancer Institute, USA), provided by the National Cancer Institute of the United States ( http://surveillance.cancer.gov/joinpoint/ ). The JoinPoint software allows, through linear regression, the construction of junction points in a temporal series. Thus, it is possible to observe the formation of two outputs: the Annual Percentage Variation (APC) and the Average Annual Percentage Variation (AAPC), therefore, from these outputs it is possible to identify the most significant variations in the rate in question. To prove the significance of the tests, the Monte Carlo Permutation was performed, and the data are organized through epidemiological curves in order to have a better view of the behavior of the death rate from breast and cervical cancer in the last twelve years. The data collected for this research are of a secondary nature and belong to a public domain database, so there was no need to obtain personal data and thus did not need to be submitted to the Research Ethics Committee. Results The results obtained indicate that cervical and breast cancers show a growth behavior in the period analyzed (2010–2020), although each region of Brazil has variations in certain periods, as shown in Fig. 1. It is possible to observe that Brazil presents a linear growth curve, with a tendency to stabilize as of 2018 in both types of cancer. The curve for cervical cancer starts in 2010 with about 2.60 cases and rises to about 3.50 cases per 100,000 population in 2020. Breast cancer, on the other hand, affects about 67 people in 2010 and reaches about 95 per 100,000 population in 2020. However, the Midwest region of Brazil shows a decreasing behavior between 2010 and 2012 in cervical cancer. Then, the cases start to increase, reaching almost 4 cases per 100,000 inhabitants in 2020, a number higher than the national rate. Also noteworthy is the high annual variation in data points, which occurred most sharply between 2017 (3.3/100,000 population) and 2018 (3.9/100,000 population). With regard to breast cancer, the behavior of the graph is similar to that of Brazil, with a tendency to stabilize as of 2018, however, the midwest shows lower rates, ranging from approximately 53 to 85 cases per 100,000 inhabitants (2010–2020). The Northeast of Brazil follows the same pattern as the country, a gradual growth in both types of cancer, however, it is noticeable in the graphs that as of 2018 the annual growth is less expressive than in previous years. Regarding cervical cancer, the North region has higher rates than Brazil (approximately 2.8 to 3.9 cases per 100,000 inhabitants), but in breast cancer the rates in the North are lower than the country's (approximately 49 to 77 cases per 100,000 inhabitants). The South region most closely resembles the graphical behavior of the country when looking at cervical cancer rates over the period studied (about 2.5 to 3.5 cases per 100,000 population). However, breast cancer rates are higher than those in Brazil (about 85 to 113 cases per 100,000 population) and have a perspective of gradual growth. Lastly, the Southeast of Brazil is the region with the most unique behavior, since it presents a perspective of decline in the first years (2010 to 2014), but soon after undergoes an exacerbated growth in rates, which range from approximately 2.25 (2014) and peak at 2.75 (2020). Still, the proportion of cervical cancer cases in the Southeast is lower than the Brazilian average. In contrast, breast cancer rates are higher than the country's, ranging from approximately 82 to 112 cases per 100,000 population (2010–2020) and, unlike Brazil, there is an upward tendency. It is noteworthy that the behavior pattern of the regions of Brazil, in general, show a gradual increase in the morbidity rates of cervical and breast cancers, with a slight stabilization of the curve from 2017 and 2018 in some regions. It is important to note that the rate of cervical cancer in Brazil is being impacted mainly by the high rates presented especially in the North, but also in the Midwest and Northeast. In contrast, the high rates of breast cancer in the South and Southeast are causing the national average to rise. Tables 1 demonstrate the synthesis of data achieved through linear regression of cervical cancer mortality in Brazil organized by year, from 2010 and 2019. Thus, Table 1 shows the presence of two Joinpoints and one APCs with statistical relevance in Brazil and most of its regions. Brazil's AAPC was and 3.1, being the highest in the North region (4.1) and the lowest in the Southeast region (2.0). Table 1 Mortality rate due to cervical cancer in Brazil and regions in the period from 2010 to 2020. Brazil, 2022. Local Joinpoint 1 Period APC 2 Lower Upper AAPC 3 Lower Upper Brazil 2018 2010 to 2018 3.4* 2.5 4.2 3.1* 1.7 4.4 2018 to 2020 1.8 -5.6 9.7 North 2017 2010 to 2017 5.8* 4.4 7.2 4.1* 2.7 5.6 2017 to 2020 0.4 -4.4 5.4 Northeast 2018 2010 to 2018 3.6* 2.3 5.0 3.2* 1.1 5.3 2018 to 2020 1.3 -9.9 14.0 Midwest 2012 2010 to 2012 -1.6 17.0 -0.2 3.3* 0.2 6.5 2012 to 2020 4.5* 6.5 5.7 Southeast 2014 2010 to 2014 -0.3 -3.0 2.5 2.0* 0.8 3.1 2014 to 2020 3.5* 2.0 5.0 South 2018 2010 to 2018 4.6* 2.9 6.4 3.6* 0.9 6.4 2018 to 2020 -0.2 -14.3 16.1 1 by epidemiological week. 2 annual percentage change. 3 average annual percentage change. *p-value < 0.05. The linear regression of breast cancer mortality is demonstrated in Table 2 . Brazil presented two Joinpoints, as did the regions. In relation to the statistical relevance of the APC in Brazil, one was obtained, except the Northern region, which presented two APCs. The AAPC for Brazil was 3.6, with the North having the highest inconstancy and the South the lowest (2.9). Table 2 Mortality rate due to breast cancer in Brazil and regions in the period from 2010 to 2020. Brazil, 2022. Local Joinpoint 1 Period APC 2 Lower Upper AAPC 3 Lower Upper Brazil 2018 2010 to 2018 4.2* 3.9 4.5 3.6* 3.2 4.1 2018 to 2020 1.5 -0.8 3.8 North 2015 2010 to 2015 9.7* 5.3 14.3 7.0* 4.6 9.6 2015 to 2020 4.4* 0.2 8.8 Northeast 2018 2010 to 2018 5.0* 4.3 5.8 4.6* 3.4 5.9 2018 to 2020 2.9 -3.8 10.2 Midwest 2018 2010 to 2018 6.0* 5.2 6.8 4.7* 3.4 6.0 2018 to 2020 -0.3 -7.1 7.0 Southeast 2018 2010 to 2018 3.6* 3.2 3.9 3.1* 2.6 3.7 2018 to 2020 1.4 -1.7 4.6 South - 2010 to 2018 3.5* 2.9 4.1 2.9* 2.1 3.8 2018 to 2020 0.8 -4.0 5.8 1 by epidemiological week. 2 annual percentage change. 3 average annual percentage change. *p-value < 0.05. Discussion The natural history of cervical cancer consists of a complication arising from intraepithelial alterations that gradually appear between 10 and 20 years and may evolve to an invasive cancerous lesion[ 4 ]. It is important to emphasize that infection by Human Papilloma Virus is the main risk factor, which can be added to poor socioeconomic conditions, multiple sexual partners, smoking, early initiation of sexually active life, multiparity, use of oral contraceptives, and low intake of vitamin A and C[ 4 ]. When it comes to the female public, it is the most incident type of cancer in the world, holding the same position when it comes to mortality[ 5 ]. In 2018 there were about 311,365 deaths worldwide[ 5 ]. Regarding Brazil, after the cases of non-melanoma skin neoplasms, cervical cancer is in the third position as the most incident type of cancer among women. By the end of 2022, 16,710 new cases are estimated[[ 6 ]. It is known that the Human Papilloma Virus (HPV) is a sexually transmitted infection with a strong transmission rate, it is estimated that approximately 75% of people who start sexual life become infected at some point in their lives. In the 1990s, studies have shown that HPV infection is necessary for the development of cervical cancer, but most of these infections behave in an asymptomatic and self-resolving way, more specifically, 80% regress without major interventions[ 7 ]. Thus, in 2014 the Ministry of Health of Brazil began the policy of implementing free vaccination against HPV in the Unified Health System, being selected as target group, girls from 9 to 13 years, due to present high production of antibodies and for having more chances of not yet having been exposed to the virus through sexual intercourse. In 2017, the vaccine was applied to boys aged 9 to 14 and boys aged 11 to 14, in addition to including people with HIV/Aids, individuals undergoing solid organ/bone marrow transplants, and oncology patients up to 26 years old. In addition, in 2021 immunosuppressed women between the ages of 26 and 45 were also added as a target audience. It is worth noting that it is possible to vaccinate against HPV in private networks[ 8 ]. Even with the advance of vaccination, it is essential to continue and expand the cytopathological examinations, because the vaccine restricts the care to types 6, 11, 16, and 18 of HPV, but there are more than 18 that offer medium to high risk of infection[ 9 ]. Thus, from 1998 to 2020, 27 ordinances were made in the Brazilian legislative power in order to offer the expansion in screening and treatment with new resources and materials to assist more and more women[ 10 ]. Therefore, screening with the pap smear remains the most effective form of prevention against cervical cancer, but in developing countries this plan is still less effective due to the low supply and adherence of the public. It is recommended, according to the Brazilian guidelines for cervical cancer screening, to be performed among women aged 25 to 64 years with a three-year interval after two normal exams (performed annually)[ 9 ]. Between 2015 and 2020, the Unified Health System (SUS in portuguese) performed 41,448,399 cervico-vaginal cytopathological exams, maintaining a number close to 7 million every year, except in 2020 where it showed a reduction due to the COVID-19 pandemic and performed 3,942,427, always being about 80% of the exams performed by SUS[ 11 ]. When preventive actions are not effective and the case evolves to diagnosis, the initial treatment is based on clinical management, through the destruction of the lesion by physical or chemical mechanisms. Surgical treatment may also be necessary in order to have a local control, with minimal mutilation, besides obtaining more information regarding the biological aspect of the tumor and its prognosis. Finally, there is treatment with radiotherapy and chemotherapy, depending on the subtype of cervical cancer[ 4 ]. As a result of health policies and existing financial investments in Brazil directed to the prevention and treatment of this type of cancer, it is estimated that there will be an important change in the behavior of mortality rates by 2030[ 12 ]. Despite the expected advances, the socioeconomic particularities of each region result in differences in access to information, prevention, screening, and treatment, which is reflected in the forecast for the coming years, where it is estimated that the regions North and Northeast have the lowest rate of decrease in mortality. Meanwhile, it is assumed that the regions with better health systems, good equipment, and good distribution throughout the territory will have lower mortality rates, promoted by the more effective coverage of health policies. Breast cancer is the type of cancer that most kills women each year in Brazil since the first records of the SIM (Mortality Information System). When it comes to the Brazilian Northeast, this pattern is no different, since the mortality rates in this region have been gradually increasing for both types of cancer. Meanwhile, the recorded rates of deaths from cervical cancer in the North region is disproportionate to the rest of the country due to the low quality of early screening for this type of malignant neoplasm, in addition to the lack of guidance and adherence to preventive care in the lives of women in this region. It is known that some indicators are related to regional disparities regarding the high rates of death from breast and cervical cancer, as is the case in the Northeast region, such as income, education, living conditions, and housing. Thus, the rates were higher in micro-regions with lower percentages of illiterate and poor elderly women, lower dependency ratios, and higher percentages of elderly women living in households with running water. Moreover, the reality of the North region is directly related to its lower development when compared to other regions of the country, as well as its socioeconomic conditions, showing the need for a more effective articulation of health networks, aiming to offer better care for the neediest regions, this is what a study says about regional inequalities in mortality from malignant neoplasm of the uterine cervix [ 13 ]. Breast cancer consists of the increase in the unrestrained multiplication of cells with invasive potential that can be from genetic changes, which can be inherited or acquired. Breast cancer is subdivided into several types with different characteristics, so that some progress quickly and others do not. When, early, most of the time it has a good prognosis. The most common types are those that arise in the breast ducts, with about 80% of cases, in addition to lobular carcinoma, accounting for about 5–10% of diagnoses[ 14 ]. Breast cancer is the cause that most afflicts women, as it is the most common type of cancer in the world and the type of cancer that kills the Brazilian female population the most, causing 28% of new cases of cancer in this population[ 15 ]. Still in Brazil, it is estimated that for 2020–2022 there will be 66,280 new cases, which is 61 cases per 100,000 women. It is important to note that it also affects men, but at a minimum percentile, reaching less than 1% of all cases of the disease[ 16 ]. The causes of breast cancer are many and can be classified into: environmental, hormonal and genetic, with external causes (environmental and hormonal) responsible for 80–90% of cases[ 17 ]. Environmental causes are focused on body weight gain mainly after menopause, physical inactivity, alcohol consumption, exposure to ionizing radiation. Regarding risk factors of a hormonal nature, menarche before 12 years of age, nulliparous, first pregnancy after 30 years of age, women who have never breastfed, the presence of late menopause (after 55 years), post-menopausal hormone replacement can be listed. Finally, genetic causes, focused on a family history of breast cancer[ 18 ]. For the diagnosis of breast cancer, suspicions are first raised through physical and clinical examinations, the most complete being mammography, but to close the diagnosis it is essential to perform a biopsy. In 2021, for example, the SUS performed 3,497,439 mammograms, of which 3,145,930 were screening tests and 351,309 were diagnostic mammograms[ 19 ]. Treatment is performed according to the need and type of neoplasm, when it is local, surgery is usually performed followed by radiotherapy. In systemic cases, chemotherapy, hormone therapy and treatment with antibodies are recommended, which can be performed orally or intravenously[ 20 ]. In 2018, the SUS spent BRL 3.4 billion on cancer treatment, of which more than 40% were related to three cancers considered to be associated with excess weight, including breast cancer, evidencing the importance of preventive measures[ 21 ]. The Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA), as the auxiliary body of the Ministry of Health in the development and coordination of integrated actions for the prevention and control of cancer in Brazil, has some programs and actions aimed at breast cancer, for example, the mammography quality program, which aims, among others, to improve the quality of exam images, applying criteria, monitoring and implementing automation[ 22 ]. The Brazilian guidelines for breast cancer screening indicate that mammography should be offered to women aged 50 to 69 years, every two years, since early detection is one of the factors that impact on a better prognosis and survival[ 23 ]. In this aspect, with the results obtained in this study, it appears that the South and Southeast regions have high numbers of deaths from breast cancer, rates that exceed the national average. However, studies show that the two regions also have the highest rates of mammography performed by the year 2017, in addition to the diagnosis being performed primarily in the early stages of the disease. However, regarding the start of treatment after diagnosis, it is observed that both the Southeast and the South do not show satisfactory results, with an average above 60 days, while in other regions this average is 10 days shorter, which may be a strong indicator for the high mortality rates from breast cancer in the Southeast and South regions of Brazil[ 24 ]. The limitations of the study were the difficulty in accessing more up-to-date and specific data on breast and cervical cancer morbidity and mortality in Brazil, as well as the scarcity of information that could support the data obtained in the research in relation to national and loco-regional characteristics. Conclusions In view of the above, it was noticed that breast and cervical cancer had a growth behavior in the period studied in the research in question (2010–2020), but each Brazilian region has its particularities in relation to the development of cases during this period. time interval. The graphs for Brazil show a linear growth with a stabilization trend in 2018 in both types of cancer. With regard to uterine cancer, it is possible to observe in the central-west region a behavior of reduction between 2010 and 2012, followed by a growth reaching 4 cases per 100 thousand inhabitants in 2020. In addition, the northern region shows a rate higher than the national average. In the South region, in relation to breast cancer, it has the highest rates among the other regions with growth behavior. Therefore, the two types of cancer studied cover the entire Brazilian territory, with a tendency to increase each year in the mortality rate, indicating that investments are not enough to control these data, since it is known that both types of cancer have a high chance when they present an effective and early investigation. Therefore, it is necessary to expand more resources throughout the national territory in order to increase the number of preventive exams and health education to demonstrate the importance of good adherence to preventive actions and treatment to reduce the mortality rate in Brazil. Abbreviations CSV - Comma-separated values USA - United States of América APC - Annual Percentage Variation AAPC - Average Annual Percentage Variation HPV - Human Papilloma Virus HIV -Human Immunodeficiency Virus AIDS - Acquired Immunodeficiency Syndrome SUS - Unified Health System SIM - Mortality Information System Declarations Ethics approval and consent to participate Not applicable Consent for publication Not applicable Funding This work was supported by the Coordination for the Improvement of Higher Education Personnel - Brazil (CAPES) - Financial Code 001. Notes Role of the funder: The funding sources had no role in the study design, data collection and analysis, publication decision or preparation of the manuscript. Disclosures: The authors declare that there are no conflicts of interest. Author contributions: Conceptualization: (GNC, MDL, KTSC, TNBM); Methodology (GNC, KTSC, TNBM); Resources (GNC, MDL, KTSC, TNBM); Formal analysis (FBA); Writing—original draft (GNC, MDL, KTSC, TNBM); Writing—review and editing (All authors); Supervision (FBA). Data Availability The data that support the findings of this study are not publicly available. They can be made available by contacting the corresponding author by email. Acknowledgements The following was only allowed to be created thanks to funding from the Coordination for the Improvement of Higher Education Personnel - Brazil (CAPES) and support from the Federal University of Rio Grande do Norte References Brasil, Ministério da Saúde. ABC do Câncer. 2011. https://bvsms.saude.gov.br/bvs/publicacoes/abc_do_cancer.pdf Accessed on 2022 jun 10. Brasil, Ministério da Saúde. 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Available from: http://www1.inca.gov.br/inca/Arquivos/livro_deteccao_precoce_final.pdf . Accessed on 2022 jun 25. Instituto Nacional de Câncer José Alencar Gomes da Silva. A situação do câncer de mama no Brasil: Síntese de dados dos sistemas de informação. Rio de Janeiro, 2019. Available from: https://www.inca.gov.br/sites/ufu.sti.inca.local/files/media/document/a_situacao_ca_mama_brasil_2019.pdf . Accessed on 2022 jun 25. Additional Declarations No competing interests reported. Supplementary Files tablebreastandcervicalcancer1.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2062282","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":139509314,"identity":"a6e245cd-1234-4591-b0bf-ba3751407d1e","order_by":0,"name":"Thiffany Nayara Bento de Morais","email":"","orcid":"","institution":"Federal University of Rio Grande do Norte","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Thiffany","middleName":"Nayara Bento","lastName":"de Morais","suffix":""},{"id":139509315,"identity":"4866f8ce-2aea-4c35-a4aa-55d9f2158add","order_by":1,"name":"Ketyllem Tayanne da Silva Costa","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+ElEQVRIiWNgGAWjYBACCRDxoADGrQBiZuYGAlqYGRgSDMBsxgaGMyAtjKRoYWyDasUHJNv7j0kkGNhE87e3P3/wc14tkAHU8qNiG04t0jyH2YBa0nJnnDlj2Ni77XjujMNA23rO3MapRU4iGaTlcO4GiRzGBt5tx3IbgFqYGdvwaJF/DNLyH6gl/WHj3znHcucT0iItwQzScgCoJcGwmbehJncDIS2SPcnGFgkGyWC/zJY5diB3I1DLQXx+kTh+8OGNDxV2uf3t7Q8+vqmpy513/vDBBz8qcGsBAhYJJM5hMHkAn3ogYP6AxKkjoHgUjIJRMApGIgAA8g9dtYiHXfsAAAAASUVORK5CYII=","orcid":"","institution":"Federal University of Rio Grande do Norte","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Ketyllem","middleName":"Tayanne da Silva","lastName":"Costa","suffix":""},{"id":139509316,"identity":"3b14776c-2dca-4f49-807d-dda66ecd91b9","order_by":2,"name":"Gustavo Nepomuceno Capistrano","email":"","orcid":"","institution":"Federal University of Rio Grande do Norte","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Gustavo","middleName":"Nepomuceno","lastName":"Capistrano","suffix":""},{"id":139509317,"identity":"e5d8ec9c-5496-4871-b32d-6a047d764001","order_by":3,"name":"Maryanna Damasceno Leal","email":"","orcid":"","institution":"Federal University of Rio Grande do Norte","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Maryanna","middleName":"Damasceno","lastName":"Leal","suffix":""},{"id":139509318,"identity":"cfbf3d2f-9505-4767-85da-34bffebe03fd","order_by":4,"name":"Fábia Barbosa de Andrade","email":"","orcid":"","institution":"Federal University of Rio Grande do Norte","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Fábia","middleName":"Barbosa","lastName":"de Andrade","suffix":""}],"badges":[],"createdAt":"2022-09-13 19:14:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2062282/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2062282/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":27104810,"identity":"6a3bdf6a-05e5-48d7-a9b5-a93c6cf7d4d6","added_by":"auto","created_at":"2022-09-28 21:12:59","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":784038,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eMortality rate due to cervical and breast cancer in Brazil and regions in the period from 2010 to 2020. Brazil, 2022.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Fig1breastandcervicalcancer.png","url":"https://assets-eu.researchsquare.com/files/rs-2062282/v1/7344e093064af69493b6b07a.png"},{"id":27153179,"identity":"4ba7769e-3462-41f1-9b08-76b12fefa65a","added_by":"auto","created_at":"2022-09-29 20:14:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":493795,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2062282/v1/17dfc122-ebfc-4873-a686-517d2dd09e61.pdf"},{"id":27104811,"identity":"ccf37083-38d8-4099-931e-029039234964","added_by":"auto","created_at":"2022-09-28 21:12:59","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":14402,"visible":true,"origin":"","legend":"","description":"","filename":"tablebreastandcervicalcancer1.docx","url":"https://assets-eu.researchsquare.com/files/rs-2062282/v1/054cbe2ef70aae8f819d8302.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Epidemiological profile of cancer breast and cervical cancer-related mortality from 2010 to 2020 in Brazil","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe human body has cells, which in a physiological process form tissues through cell multiplication. The process occurs in such a way that most of these cells grow, multiply and die in an ordered way, however, still in the natural development, not all of them have this way of division, such as neurons, for example. However, it is necessary to understand that neoplasia does not occur only due to cell multiplication, but also due to disorder, because instead of dying, they continue dividing in a fast, aggressive and uncontrollable way, distributing themselves to several regions of the body and thus causing functional disorders[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThere are several types of cancer that can affect different organs of the body, however, the one that most affects the female population worldwide and in Brazil is breast cancer. In developed and developing countries it is classified as one of the main causes of death. The incidence rate is higher in developed countries, as is the mortality rate. However, when tracked and investigated early, it has a high chance of cure[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAnother type of cancer that affects the female public is cervical cancer, being the leading cause of death for women in Latin America and the Caribbean. It is a cancer with a high chance of being prevented, and yet 35,700 women die every year in the Americas, with more than 80% of these cases belonging to Latin America and the Caribbean, three times more than in North America. Thus, 51,500 deaths are estimated by 2030 due to the increase in population and life expectancy, 89% of which are in Latin America and the Caribbean[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTherefore, since it is a public health problem with a worldwide impact, with high mortality rates and a strong tendency to increase in the following years, besides being a problem that directly influences the well-being and quality of life of the ill and their caregivers, also contributing to an economic deficit by keeping the active public out of the workplace, it is important to encourage studies in this area in order to find ways to improve this context in the health field.\u003c/p\u003e \u003cp\u003eFor this reason, it is necessary to conduct a study to evaluate the epidemiological behavior of breast and cervical cancer mortality for the years 2009\u0026ndash;2021 in Brazil.\u003c/p\u003e"},{"header":"Metodology","content":"\u003cp\u003eThe study in question is an ecological research of time series, carried out through data obtained from secondary sources. It is a research of Brazilian origin and its main approach is the number of deaths from 2010 to 2020 due to breast and cervical cancer, this being the dependent variable of the research. The main purpose of analyzing the last twelve years of deaths from these neoplasms, is to identify how this variable has behaved over time, so the pattern of the period will be per year. Another factor is that the analysis of the territory will occur according to the regions of Brazil, because each one has its specificities that can cause unique impacts.\u003c/p\u003e \u003cp\u003eFor the behavior could be visualized and analyzed in a more simplified way, the mortality rate from breast and cervical cancer was calculated separately, so that the calculation was performed by dividing the number of deaths by the number of inhabitants (female) and then multiplied by 100,000. Therefore, as independent variable of the study will be the years under analysis, from 2010 to 2020.\u003c/p\u003e \u003cp\u003eM = (Morbidity by COVID-19)/Population X 100,000\u003c/p\u003e \u003cp\u003eThe data was obtained on May 30, 2022 in a digital platform idealized by the Ministry of Health, in order to compile data on several diseases that affect the health of Brazilian citizens, it is available and can be accessed through the site\u0026thinsp;\u0026lt;\u0026thinsp;\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://tabnet.datasus.gov.br/cgi/deftohtm.exe?sim/cnv/mat10uf.def\u0026gt;\u003c/span\u003e\u003cspan address=\"http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sim/cnv/mat10uf.def%3E\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eMeanwhile, the information obtained is already downloaded in CSV format, therefore, soon after, it is already possible to clean the database in Microsoft Excel\u0026reg; software, and then, to make a more elaborate analysis in JoinPoint software, version 4.9.0.0 (Surveillance Research, National Cancer Institute, USA), provided by the National Cancer Institute of the United States (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://surveillance.cancer.gov/joinpoint/\u003c/span\u003e\u003cspan address=\"http://surveillance.cancer.gov/joinpoint/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe JoinPoint software allows, through linear regression, the construction of junction points in a temporal series. Thus, it is possible to observe the formation of two outputs: the Annual Percentage Variation (APC) and the Average Annual Percentage Variation (AAPC), therefore, from these outputs it is possible to identify the most significant variations in the rate in question. To prove the significance of the tests, the Monte Carlo Permutation was performed, and the data are organized through epidemiological curves in order to have a better view of the behavior of the death rate from breast and cervical cancer in the last twelve years.\u003c/p\u003e \u003cp\u003eThe data collected for this research are of a secondary nature and belong to a public domain database, so there was no need to obtain personal data and thus did not need to be submitted to the Research Ethics Committee.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe results obtained indicate that cervical and breast cancers show a growth behavior in the period analyzed (2010\u0026ndash;2020), although each region of Brazil has variations in certain periods, as shown in Fig.\u0026nbsp;1. It is possible to observe that Brazil presents a linear growth curve, with a tendency to stabilize as of 2018 in both types of cancer. The curve for cervical cancer starts in 2010 with about 2.60 cases and rises to about 3.50 cases per 100,000 population in 2020. Breast cancer, on the other hand, affects about 67 people in 2010 and reaches about 95 per 100,000 population in 2020.\u003c/p\u003e\n\u003cp\u003eHowever, the Midwest region of Brazil shows a decreasing behavior between 2010 and 2012 in cervical cancer. Then, the cases start to increase, reaching almost 4 cases per 100,000 inhabitants in 2020, a number higher than the national rate. Also noteworthy is the high annual variation in data points, which occurred most sharply between 2017 (3.3/100,000 population) and 2018 (3.9/100,000 population). With regard to breast cancer, the behavior of the graph is similar to that of Brazil, with a tendency to stabilize as of 2018, however, the midwest shows lower rates, ranging from approximately 53 to 85 cases per 100,000 inhabitants (2010\u0026ndash;2020).\u003c/p\u003e\n\u003cp\u003eThe Northeast of Brazil follows the same pattern as the country, a gradual growth in both types of cancer, however, it is noticeable in the graphs that as of 2018 the annual growth is less expressive than in previous years. Regarding cervical cancer, the North region has higher rates than Brazil (approximately 2.8 to 3.9 cases per 100,000 inhabitants), but in breast cancer the rates in the North are lower than the country's (approximately 49 to 77 cases per 100,000 inhabitants).\u003c/p\u003e\n\u003cp\u003eThe South region most closely resembles the graphical behavior of the country when looking at cervical cancer rates over the period studied (about 2.5 to 3.5 cases per 100,000 population). However, breast cancer rates are higher than those in Brazil (about 85 to 113 cases per 100,000 population) and have a perspective of gradual growth.\u003c/p\u003e\n\u003cp\u003eLastly, the Southeast of Brazil is the region with the most unique behavior, since it presents a perspective of decline in the first years (2010 to 2014), but soon after undergoes an exacerbated growth in rates, which range from approximately 2.25 (2014) and peak at 2.75 (2020). Still, the proportion of cervical cancer cases in the Southeast is lower than the Brazilian average. In contrast, breast cancer rates are higher than the country's, ranging from approximately 82 to 112 cases per 100,000 population (2010\u0026ndash;2020) and, unlike Brazil, there is an upward tendency.\u003c/p\u003e\n\u003cp\u003eIt is noteworthy that the behavior pattern of the regions of Brazil, in general, show a gradual increase in the morbidity rates of cervical and breast cancers, with a slight stabilization of the curve from 2017 and 2018 in some regions. It is important to note that the rate of cervical cancer in Brazil is being impacted mainly by the high rates presented especially in the North, but also in the Midwest and Northeast. In contrast, the high rates of breast cancer in the South and Southeast are causing the national average to rise.\u003c/p\u003e\n\u003cp\u003eTables\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e demonstrate the synthesis of data achieved through linear regression of cervical cancer mortality in Brazil organized by year, from 2010 and 2019. Thus, Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e shows the presence of two Joinpoints and one APCs with statistical relevance in Brazil and most of its regions. Brazil's AAPC was and 3.1, being the highest in the North region (4.1) and the lowest in the Southeast region (2.0).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eMortality rate due to cervical cancer in Brazil and regions in the period from 2010 to 2020. Brazil, 2022.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eLocal\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eJoinpoint\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ePeriod\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eAPC\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eLower\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eUpper\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eAAPC\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eLower\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eUpper\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eBrazil\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2010 to 2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.4*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.1*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2018 to 2020\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-5.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e9.7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eNorth\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2017\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2010 to 2017\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.8*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.1*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2017 to 2020\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-4.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eNortheast\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2010 to 2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.6*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.2*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2018 to 2020\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-9.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e14.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eMidwest\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2012\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2010 to 2012\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-1.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-0.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.3*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e6.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2012 to 2020\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.5*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eSoutheast\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2014\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2010 to 2014\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-0.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-3.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.0*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2014 to 2020\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.5*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eSouth\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2010 to 2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.6*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.6*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e6.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2018 to 2020\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-0.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-14.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16.1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\"\u003e\u003csup\u003e1\u003c/sup\u003eby epidemiological week.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\"\u003e\u003csup\u003e2\u003c/sup\u003eannual percentage change.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\"\u003e\u003csup\u003e3\u003c/sup\u003eaverage annual percentage change.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\"\u003e*p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe linear regression of breast cancer mortality is demonstrated in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e. Brazil presented two Joinpoints, as did the regions. In relation to the statistical relevance of the APC in Brazil, one was obtained, except the Northern region, which presented two APCs. The AAPC for Brazil was 3.6, with the North having the highest inconstancy and the South the lowest (2.9).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eMortality rate due to breast cancer in Brazil and regions in the period from 2010 to 2020. Brazil, 2022.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eLocal\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eJoinpoint\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ePeriod\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eAPC\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eLower\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eUpper\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eAAPC\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eLower\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eUpper\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eBrazil\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2010 to 2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.2*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.6*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2018 to 2020\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-0.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eNorth\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e2015\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2010 to 2015\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e9.7*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e14.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e7.0*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e9.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2015 to 2020\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.4*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e8.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eNortheast\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2010 to 2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.0*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.6*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.9\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2018 to 2020\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-3.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e10.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eMidwest\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2010 to 2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6.0*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.7*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e6.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2018 to 2020\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-0.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-7.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eSoutheast\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2010 to 2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.6*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.1*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2018 to 2020\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-1.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eSouth\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2010 to 2018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.5*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.9*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2018 to 2020\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-4.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\"\u003e\u003csup\u003e1\u003c/sup\u003eby epidemiological week.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\"\u003e\u003csup\u003e2\u003c/sup\u003eannual percentage change.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\"\u003e\u003csup\u003e3\u003c/sup\u003eaverage annual percentage change.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\"\u003e*p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe natural history of cervical cancer consists of a complication arising from intraepithelial alterations that gradually appear between 10 and 20 years and may evolve to an invasive cancerous lesion[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. It is important to emphasize that infection by Human Papilloma Virus is the main risk factor, which can be added to poor socioeconomic conditions, multiple sexual partners, smoking, early initiation of sexually active life, multiparity, use of oral contraceptives, and low intake of vitamin A and C[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWhen it comes to the female public, it is the most incident type of cancer in the world, holding the same position when it comes to mortality[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In 2018 there were about 311,365 deaths worldwide[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Regarding Brazil, after the cases of non-melanoma skin neoplasms, cervical cancer is in the third position as the most incident type of cancer among women. By the end of 2022, 16,710 new cases are estimated[[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIt is known that the Human Papilloma Virus (HPV) is a sexually transmitted infection with a strong transmission rate, it is estimated that approximately 75% of people who start sexual life become infected at some point in their lives. In the 1990s, studies have shown that HPV infection is necessary for the development of cervical cancer, but most of these infections behave in an asymptomatic and self-resolving way, more specifically, 80% regress without major interventions[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThus, in 2014 the Ministry of Health of Brazil began the policy of implementing free vaccination against HPV in the Unified Health System, being selected as target group, girls from 9 to 13 years, due to present high production of antibodies and for having more chances of not yet having been exposed to the virus through sexual intercourse. In 2017, the vaccine was applied to boys aged 9 to 14 and boys aged 11 to 14, in addition to including people with HIV/Aids, individuals undergoing solid organ/bone marrow transplants, and oncology patients up to 26 years old. In addition, in 2021 immunosuppressed women between the ages of 26 and 45 were also added as a target audience. It is worth noting that it is possible to vaccinate against HPV in private networks[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eEven with the advance of vaccination, it is essential to continue and expand the cytopathological examinations, because the vaccine restricts the care to types 6, 11, 16, and 18 of HPV, but there are more than 18 that offer medium to high risk of infection[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Thus, from 1998 to 2020, 27 ordinances were made in the Brazilian legislative power in order to offer the expansion in screening and treatment with new resources and materials to assist more and more women[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTherefore, screening with the pap smear remains the most effective form of prevention against cervical cancer, but in developing countries this plan is still less effective due to the low supply and adherence of the public. It is recommended, according to the Brazilian guidelines for cervical cancer screening, to be performed among women aged 25 to 64 years with a three-year interval after two normal exams (performed annually)[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Between 2015 and 2020, the Unified Health System (SUS in portuguese) performed 41,448,399 cervico-vaginal cytopathological exams, maintaining a number close to 7\u0026nbsp;million every year, except in 2020 where it showed a reduction due to the COVID-19 pandemic and performed 3,942,427, always being about 80% of the exams performed by SUS[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWhen preventive actions are not effective and the case evolves to diagnosis, the initial treatment is based on clinical management, through the destruction of the lesion by physical or chemical mechanisms. Surgical treatment may also be necessary in order to have a local control, with minimal mutilation, besides obtaining more information regarding the biological aspect of the tumor and its prognosis. Finally, there is treatment with radiotherapy and chemotherapy, depending on the subtype of cervical cancer[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAs a result of health policies and existing financial investments in Brazil directed to the prevention and treatment of this type of cancer, it is estimated that there will be an important change in the behavior of mortality rates by 2030[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Despite the expected advances, the socioeconomic particularities of each region result in differences in access to information, prevention, screening, and treatment, which is reflected in the forecast for the coming years, where it is estimated that the regions North and Northeast have the lowest rate of decrease in mortality. Meanwhile, it is assumed that the regions with better health systems, good equipment, and good distribution throughout the territory will have lower mortality rates, promoted by the more effective coverage of health policies.\u003c/p\u003e \u003cp\u003eBreast cancer is the type of cancer that most kills women each year in Brazil since the first records of the SIM (Mortality Information System). When it comes to the Brazilian Northeast, this pattern is no different, since the mortality rates in this region have been gradually increasing for both types of cancer. Meanwhile, the recorded rates of deaths from cervical cancer in the North region is disproportionate to the rest of the country due to the low quality of early screening for this type of malignant neoplasm, in addition to the lack of guidance and adherence to preventive care in the lives of women in this region.\u003c/p\u003e \u003cp\u003eIt is known that some indicators are related to regional disparities regarding the high rates of death from breast and cervical cancer, as is the case in the Northeast region, such as income, education, living conditions, and housing. Thus, the rates were higher in micro-regions with lower percentages of illiterate and poor elderly women, lower dependency ratios, and higher percentages of elderly women living in households with running water. Moreover, the reality of the North region is directly related to its lower development when compared to other regions of the country, as well as its socioeconomic conditions, showing the need for a more effective articulation of health networks, aiming to offer better care for the neediest regions, this is what a study says about regional inequalities in mortality from malignant neoplasm of the uterine cervix [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBreast cancer consists of the increase in the unrestrained multiplication of cells with invasive potential that can be from genetic changes, which can be inherited or acquired. Breast cancer is subdivided into several types with different characteristics, so that some progress quickly and others do not. When, early, most of the time it has a good prognosis. The most common types are those that arise in the breast ducts, with about 80% of cases, in addition to lobular carcinoma, accounting for about 5\u0026ndash;10% of diagnoses[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBreast cancer is the cause that most afflicts women, as it is the most common type of cancer in the world and the type of cancer that kills the Brazilian female population the most, causing 28% of new cases of cancer in this population[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Still in Brazil, it is estimated that for 2020\u0026ndash;2022 there will be 66,280 new cases, which is 61 cases per 100,000 women. It is important to note that it also affects men, but at a minimum percentile, reaching less than 1% of all cases of the disease[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe causes of breast cancer are many and can be classified into: environmental, hormonal and genetic, with external causes (environmental and hormonal) responsible for 80\u0026ndash;90% of cases[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Environmental causes are focused on body weight gain mainly after menopause, physical inactivity, alcohol consumption, exposure to ionizing radiation. Regarding risk factors of a hormonal nature, menarche before 12 years of age, nulliparous, first pregnancy after 30 years of age, women who have never breastfed, the presence of late menopause (after 55 years), post-menopausal hormone replacement can be listed. Finally, genetic causes, focused on a family history of breast cancer[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFor the diagnosis of breast cancer, suspicions are first raised through physical and clinical examinations, the most complete being mammography, but to close the diagnosis it is essential to perform a biopsy. In 2021, for example, the SUS performed 3,497,439 mammograms, of which 3,145,930 were screening tests and 351,309 were diagnostic mammograms[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Treatment is performed according to the need and type of neoplasm, when it is local, surgery is usually performed followed by radiotherapy. In systemic cases, chemotherapy, hormone therapy and treatment with antibodies are recommended, which can be performed orally or intravenously[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn 2018, the SUS spent BRL 3.4\u0026nbsp;billion on cancer treatment, of which more than 40% were related to three cancers considered to be associated with excess weight, including breast cancer, evidencing the importance of preventive measures[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The Instituto Nacional de C\u0026acirc;ncer Jos\u0026eacute; Alencar Gomes da Silva (INCA), as the auxiliary body of the Ministry of Health in the development and coordination of integrated actions for the prevention and control of cancer in Brazil, has some programs and actions aimed at breast cancer, for example, the mammography quality program, which aims, among others, to improve the quality of exam images, applying criteria, monitoring and implementing automation[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe Brazilian guidelines for breast cancer screening indicate that mammography should be offered to women aged 50 to 69 years, every two years, since early detection is one of the factors that impact on a better prognosis and survival[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. In this aspect, with the results obtained in this study, it appears that the South and Southeast regions have high numbers of deaths from breast cancer, rates that exceed the national average.\u003c/p\u003e \u003cp\u003eHowever, studies show that the two regions also have the highest rates of mammography performed by the year 2017, in addition to the diagnosis being performed primarily in the early stages of the disease. However, regarding the start of treatment after diagnosis, it is observed that both the Southeast and the South do not show satisfactory results, with an average above 60 days, while in other regions this average is 10 days shorter, which may be a strong indicator for the high mortality rates from breast cancer in the Southeast and South regions of Brazil[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe limitations of the study were the difficulty in accessing more up-to-date and specific data on breast and cervical cancer morbidity and mortality in Brazil, as well as the scarcity of information that could support the data obtained in the research in relation to national and loco-regional characteristics.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn view of the above, it was noticed that breast and cervical cancer had a growth behavior in the period studied in the research in question (2010\u0026ndash;2020), but each Brazilian region has its particularities in relation to the development of cases during this period. time interval. The graphs for Brazil show a linear growth with a stabilization trend in 2018 in both types of cancer.\u003c/p\u003e \u003cp\u003eWith regard to uterine cancer, it is possible to observe in the central-west region a behavior of reduction between 2010 and 2012, followed by a growth reaching 4 cases per 100 thousand inhabitants in 2020. In addition, the northern region shows a rate higher than the national average. In the South region, in relation to breast cancer, it has the highest rates among the other regions with growth behavior.\u003c/p\u003e \u003cp\u003eTherefore, the two types of cancer studied cover the entire Brazilian territory, with a tendency to increase each year in the mortality rate, indicating that investments are not enough to control these data, since it is known that both types of cancer have a high chance when they present an effective and early investigation. Therefore, it is necessary to expand more resources throughout the national territory in order to increase the number of preventive exams and health education to demonstrate the importance of good adherence to preventive actions and treatment to reduce the mortality rate in Brazil.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eCSV - Comma-separated values\u003c/p\u003e\n\u003cp\u003eUSA - United States of Am\u0026eacute;rica\u003c/p\u003e\n\u003cp\u003eAPC - Annual Percentage Variation\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAAPC - Average Annual Percentage Variation\u003c/p\u003e\n\u003cp\u003eHPV - Human Papilloma Virus\u003c/p\u003e\n\u003cp\u003eHIV -Human Immunodeficiency Virus\u003c/p\u003e\n\u003cp\u003eAIDS - Acquired Immunodeficiency Syndrome\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSUS - Unified Health System\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSIM - Mortality Information System\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003ch4\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/h4\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the Coordination for the Improvement of Higher Education Personnel - Brazil (CAPES) - Financial Code 001.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNotes\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRole of the funder:\u003c/strong\u003e The funding sources had no role in the study design, data collection and analysis, publication decision or preparation of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDisclosures:\u003c/strong\u003e The authors declare that there are no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions:\u003c/strong\u003e Conceptualization: (GNC, MDL, KTSC, TNBM); Methodology (GNC, KTSC, TNBM); Resources (GNC, MDL, KTSC, TNBM); Formal analysis (FBA); Writing\u0026mdash;original draft (GNC, MDL, KTSC, TNBM); Writing\u0026mdash;review and editing (All authors); Supervision (FBA).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are not publicly available. They can be made available by contacting the corresponding author by email.\u003c/p\u003e\n\u003ch4\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/h4\u003e\n\u003cp\u003eThe following was only allowed to be created thanks to funding from the Coordination for the Improvement of Higher Education Personnel - Brazil (CAPES) and support from the Federal University of Rio Grande do Norte\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBrasil, Minist\u0026eacute;rio da Sa\u0026uacute;de. ABC do C\u0026acirc;ncer. 2011. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://bvsms.saude.gov.br/bvs/publicacoes/abc_do_cancer.pdf\u003c/span\u003e\u003cspan address=\"https://bvsms.saude.gov.br/bvs/publicacoes/abc_do_cancer.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e Accessed on 2022 jun 10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrasil, Minist\u0026eacute;rio da Sa\u0026uacute;de. Diretrizes para a Detec\u0026ccedil;\u0026atilde;o Precoce do C\u0026acirc;ncer de Mama no Brasil. 2015. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://conitec.gov.br/images/Protocolos/Diretrizes_DeteccaoPrecoce_CM.pdf\u003c/span\u003e\u003cspan address=\"http://conitec.gov.br/images/Protocolos/Diretrizes_DeteccaoPrecoce_CM.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e Accessed on 2022 jun 10\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization.Cervical Cancer. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.paho.org/en/topics/cervical-cancer\u003c/span\u003e\u003cspan address=\"https://www.paho.org/en/topics/cervical-cancer\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 10 de jun 2022\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrasil, Minist\u0026eacute;rio da Sa\u0026uacute;de. Falando sobre c\u0026acirc;ncer de colo de \u0026uacute;tero. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://bvsms.saude.gov.br/bvs/publicacoes/inca/falando_cancer_colo_utero.pdf\u003c/span\u003e\u003cspan address=\"https://bvsms.saude.gov.br/bvs/publicacoes/inca/falando_cancer_colo_utero.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 2022 jun 10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. International Agency for Research on Cancer. Estimated number of new cases in 2020. 2020. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://gco.iarc.fr/today/online-analysis-table?v=2018\u0026amp;\u003c/span\u003e\u003cspan address=\"https://gco.iarc.fr/today/online-analysis-table?v=2018\u0026amp;\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003emode=cancer\u0026amp;mode_population=continents\u0026amp;population=900\u0026amp;. Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstituto Nacional de C\u0026acirc;ncer. Incid\u0026ecirc;ncia. 2022. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.inca.gov.br/controle-do-cancer-do-colo-do-utero/dados-e-numeros/incidencia#:~:\u003c/span\u003e\u003cspan address=\"https://www.inca.gov.br/controle-do-cancer-do-colo-do-utero/dados-e-numeros/incidencia#:~:\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003etext=No%20Brasil%2C%20exclu%C3%ADdos%20os%20tumores,mulheres%20(INCA%2C%202021). Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFoerster V, Murtagh J. Vaccines for prevention of human papillomavirus infection [Issues in emerging health technologies issue 75]. Ottawa: Canadian Coordinating Office for Health Technology Assessment, 2005.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstituto Nacional de C\u0026acirc;ncer. Existe vacina contra o HPV?. 2021. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.inca.gov.br/perguntas-frequentes/existe-vacina-contra-o-hpv#:~:text=O%20Minist%C\u003c/span\u003e\u003cspan address=\"https://www.inca.gov.br/perguntas-frequentes/existe-vacina-contra-o-hpv#:~:text=O%20Minist%C\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e3%A9rio%20da%20Sa%C3%BAde%2C%20em,idade%2C%20com%20a%20vacina%20quadrivalente. Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrasil, Minist\u0026eacute;rio da Sa\u0026uacute;de. Vacina contra HPV na preven\u0026ccedil;\u0026atilde;o de c\u0026acirc;ncer de colo do \u0026uacute;tero. 2013. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://conitec.gov.br/images/Incorporados/VacinaHPV-final.pdf\u003c/span\u003e\u003cspan address=\"http://conitec.gov.br/images/Incorporados/VacinaHPV-final.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstituto Nacional de C\u0026acirc;ncer. Legisla\u0026ccedil;\u0026atilde;o - Controle do C\u0026acirc;ncer do Colo do \u0026Uacute;tero. 2021. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.inca.gov.br/controle-do-cancer-do-colo-do-utero/legislacao-controle-cancer-colo-utero\u003c/span\u003e\u003cspan address=\"https://www.inca.gov.br/controle-do-cancer-do-colo-do-utero/legislacao-controle-cancer-colo-utero\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstituto Nacional de C\u0026acirc;ncer. Exames citopatol\u0026oacute;gicos do colo do \u0026uacute;tero realizados no SUS. 2022. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.inca.gov.br/controle-do-cancer-do-colo-do-utero/dados-e-numeros/exames-citopatologicos-do-colo-do-utero-realizados-no-sus\u003c/span\u003e\u003cspan address=\"https://www.inca.gov.br/controle-do-cancer-do-colo-do-utero/dados-e-numeros/exames-citopatologicos-do-colo-do-utero-realizados-no-sus\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 2022 jun 27.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOliveira MM, Andrade SSCA, Oliveira PPV, Silva GA, Silva MMA, Malta DC. Cobertura de exame Papanicolaou em mulheres de 25 a 64 anos, segundo a Pesquisa Nacional de Sa\u0026uacute;de e o Sistema de Vigil\u0026acirc;ncia de Fatores de Risco e Prote\u0026ccedil;\u0026atilde;o para Doen\u0026ccedil;as Cr\u0026ocirc;nicas por Inqu\u0026eacute;rito Telef\u0026ocirc;nico, 2013. Rev Bras Epidemiol. 2018. DOI: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1590/1980-549720180014\u003c/span\u003e\u003cspan address=\"10.1590/1980-549720180014\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBarbosa IR, Souza D, Bernal MM, Costa ICC. Desigualdades regionais na mortalidade por c\u0026acirc;ncer de colo de \u0026uacute;tero no Brasil: tend\u0026ecirc;ncias e proje\u0026ccedil;\u0026otilde;es at\u0026eacute; o ano 2030, 2015. Cien Saude Colet. DOI: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1590/1413-81232015211.03662015\u003c/span\u003e\u003cspan address=\"10.1590/1413-81232015211.03662015\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrasil, Minist\u0026eacute;rio da Sa\u0026uacute;de. A mulher e o c\u0026acirc;ncer de mama no Brasil. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://bvsms.saude.gov.br/bvs/publicacoes/mulher_cancer_mama_brasil_3ed_rev_atual.pdf\u003c/span\u003e\u003cspan address=\"https://bvsms.saude.gov.br/bvs/publicacoes/mulher_cancer_mama_brasil_3ed_rev_atual.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: a Cancer Journal for Clinicians, v. 68, n. 6, p.\u0026nbsp;394\u0026ndash;424, 2018.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrasil, Minist\u0026eacute;rio da Sa\u0026uacute;de. Boletim tem\u0026aacute;tico da biblioteca do Minist\u0026eacute;rio da Sa\u0026uacute;de: preven\u0026ccedil;\u0026atilde;o tem\u0026aacute;tica do c\u0026acirc;ncer de mama. 2021.\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://bvsms.saude.gov.br/bvs/boletim_tematico/prevencao_cancer_mama_outubro_2021.pdf\u003c/span\u003e\u003cspan address=\"https://bvsms.saude.gov.br/bvs/boletim_tematico/prevencao_cancer_mama_outubro_2021.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstituto Nacional de C\u0026acirc;ncer. A situa\u0026ccedil;\u0026atilde;o do c\u0026acirc;ncer de mama no Brasil: s\u0026iacute;ntese de dados dos sistemas de informa\u0026ccedil;\u0026atilde;o. 2019. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://bvsms.saude.gov.br/bvs/publicacoes/situacao_cancer_mama_brasil_sintese_dados_sistema_informacao.pdf\u003c/span\u003e\u003cspan address=\"https://bvsms.saude.gov.br/bvs/publicacoes/situacao_cancer_mama_brasil_sintese_dados_sistema_informacao.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstituto Nacional de C\u0026acirc;ncer. C\u0026acirc;ncer de mama: \u0026eacute; preciso falar disso. 2014. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://bvsms.saude.gov.br/bvs/publicacoes/cancer_mama_preciso_falar_disso.pdf\u003c/span\u003e\u003cspan address=\"https://bvsms.saude.gov.br/bvs/publicacoes/cancer_mama_preciso_falar_disso.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstituto Nacional de C\u0026acirc;ncer. Mamografias no SUS. 2022. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.inca.gov.br/controle-do-cancer-de-mama/dados-e-numeros/mamografia-no-sus\u003c/span\u003e\u003cspan address=\"https://www.inca.gov.br/controle-do-cancer-de-mama/dados-e-numeros/mamografia-no-sus\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstituto Nacional de C\u0026acirc;ncer. A mulher e o c\u0026acirc;ncer de mama no Brasil. 2018. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://bvsms.saude.gov.br/bvs/publicacoes/mulher_cancer_mama_brasil_3ed_rev_atual.pdf\u003c/span\u003e\u003cspan address=\"https://bvsms.saude.gov.br/bvs/publicacoes/mulher_cancer_mama_brasil_3ed_rev_atual.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstituto Nacional de C\u0026acirc;ncer. Gastos do SUS com c\u0026acirc;nceres associados ao excesso de peso somam 41,1% do investimento em tratamento oncol\u0026oacute;gico. 2021. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.inca.gov.br/noticias/gastos-do-sus-com-canceres-associados-ao-excesso-de-peso-somam-411-do-investimento-em\u003c/span\u003e\u003cspan address=\"https://www.inca.gov.br/noticias/gastos-do-sus-com-canceres-associados-ao-excesso-de-peso-somam-411-do-investimento-em\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstituto Nacional do C\u0026acirc;ncer. Programa de qualidade em mamografia. 2021. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.inca.gov.br/programa-qualidade-em-mamografia\u003c/span\u003e\u003cspan address=\"https://www.inca.gov.br/programa-qualidade-em-mamografia\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstituto Nacional de C\u0026acirc;ncer Jos\u0026eacute; Alencar Gomes da Silva. Diretrizes para a detec\u0026ccedil;\u0026atilde;o precoce do c\u0026acirc;ncer de mama no Brasil. Rio de Janeiro, 2015. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www1.inca.gov.br/inca/Arquivos/livro_deteccao_precoce_final.pdf\u003c/span\u003e\u003cspan address=\"http://www1.inca.gov.br/inca/Arquivos/livro_deteccao_precoce_final.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstituto Nacional de C\u0026acirc;ncer Jos\u0026eacute; Alencar Gomes da Silva. A situa\u0026ccedil;\u0026atilde;o do c\u0026acirc;ncer de mama no Brasil: S\u0026iacute;ntese de dados dos sistemas de informa\u0026ccedil;\u0026atilde;o. Rio de Janeiro, 2019. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.inca.gov.br/sites/ufu.sti.inca.local/files/media/document/a_situacao_ca_mama_brasil_2019.pdf\u003c/span\u003e\u003cspan address=\"https://www.inca.gov.br/sites/ufu.sti.inca.local/files/media/document/a_situacao_ca_mama_brasil_2019.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed on 2022 jun 25.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Brazil, epidemiology, mortality rate, breast cancer, cervical cancer","lastPublishedDoi":"10.21203/rs.3.rs-2062282/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2062282/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e There are several types of cancer that can affect different organs of the body, however, the one that most affects the female population worldwide and in Brazil is breast cancer. For this reason, it is necessary to conduct a study to evaluate the epidemiological behavior of breast and cervical cancer mortality for the years 2009-2021 in Brazil.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThe study in question is an ecological research of time series, carried out through data obtained from secondary sources. It is a research of Brazilian origin and its main approach is the number of deaths from 2009 to 2021 due to breast and cervical cancer, this being the dependent variable of the research. In addition, independent variables were also collected from DataSUS. The data was analyzed using the Join Point open source software version.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The results obtained indicate that cervical and breast cancers show a growth behavior in the period analyzed (2010-2020), although each region of Brazil has variations in certain periods. It is possible to observe that Brazil presents a linear growth curve, with a tendency to stabilize as of 2018 in both types of cancer. However, the Midwest region of Brazil shows a decreasing behavior between 2010 and 2012 in cervical cancer. The South region most closely resembles the graphical behavior of the country when looking at cervical cancer rates over the period studied (about 2.5 to 3.5 cases per 100,000 population). However, breast cancer rates are higher than those in Brazil (about 85 to 113 cases per 100,000 population) and have a perspective of gradual growth.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eTherefore, the two types of cancer studied cover the entire Brazilian territory, with a tendency to increase each year in the mortality rate, indicating that investments are not enough to control these data, since it is known that both types of cancer have a high chance when they present an effective and early investigation.\u003c/p\u003e","manuscriptTitle":"Epidemiological profile of cancer breast and cervical cancer-related mortality from 2010 to 2020 in Brazil","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-09-28 21:12:57","doi":"10.21203/rs.3.rs-2062282/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fd8a9db6-ad4b-4d86-8e35-f1661cdb2264","owner":[],"postedDate":"September 28th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2022-09-29T20:14:18+00:00","versionOfRecord":[],"versionCreatedAt":"2022-09-28 21:12:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2062282","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2062282","identity":"rs-2062282","version":["v1"]},"buildId":"GqpaHPwrfC8PjnIFayRh5","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}