Incidência e mortalidade por câncer de tireoide na América Latina

Abstract

Introduction: Thyroid cancer is the most common endocrine neoplasia, accounting for 5.1% of the estimated global burden of female cancer, with a significant increase in the incidence rate in recent decades, despite the low mortality rates. Objective: To analyze the trend and projections of incidence and mortality from thyroid cancer (C73) in Latin American countries. Methods: Ecological study of time series. For Latin American countries, incidence data were extracted from the International Agency for Research on Cancer (IARC), for the period 1990- 2012; mortality data were obtained from the World Health Organization (WHO) for the period 1995-2013; For Brazil, mortality data were collected from the Mortality Information System (SIM) for the period 2001-2015. The incidence and mortality trends were analyzed by the Joinpoint regression, and Nordpred, enrolled in the R program, was used to calculate mortality projections in Brazil. The mean annual percentage change (APC and AAPC) and the 95% confidence interval (95% CI) were calculated for incidence and mortality. Results: Thyroid cancer incidence and mortality in Latin America were higher in women, with a higher incidence rate in Quito (Ecuador), in the age group of 40 to 59 years old, 42.2 new cases per 100,000 inhabitants, as well as mortality 4.8 deaths per 100,000 inhabitants in women, over 60 years. There were increasing trends in the incidence of thyroid cancer in women, for all age groups, in Cali (Colombia), Costa Rica and Quito (Ecuador) and in men in Costa Rica; (Cali, Colombia), Goiania (Brazil), Quito (Ecuador) and Valdivia (Chile) in men, as well as in women in Goiania (Brazil) and Valdivia (Chile). There was a trend of increased mortality in three countries for females: Ecuador (AAPC= 3.28, 95% CI: 1.36; 5.24), Guatemala (AAPC= 6.14, 95% CI: 2.81; 9.58) and Mexico (AAPC= 0.67, 95% CI: 0.16; 1.18). In Brazil, there were 0.48 deaths per 100,000 inhabitants for women and 0.27 deaths per 100,000 inhabitants for men, with a tendency of reduction for the female sex (APC= -1.6, 95% CI: -2.5; -0.6) and stability for males (APC= -0.5; 95% CI: -1.5; 0.5). A projection of reduction of mortality rates for females in Brazil until 2030 was identified. For males, this same characteristic will be observed, but the Northeast and North Regions will show a projection of elevation of the rates, and these numbers will be explained, mainly, by the variation in the Brazilian demographic structure. Conclusions: Thyroid cancer presented a high incidence for women and a trend of stability in mortality for most Latin American countries. In Brazil, mortality due to thyroid cancer shows a significant reduction for women and stability for men, with important regional differences, since the poorest regions of Brazil have the highest rates, while the South and Southeast, the most developed of Brazil, the lowest. This discrepancy is expected to continue until the year 2030.