Correlation of Cervical Cancer Mortality with Fertility, Access to Health Care and Socioeconomic Indicators

Abstract Objective The present study aimed to examine which development indicators are correlated with cervical cancer (CC) mortality rates in Brazil. Methods This was an ecological study that correlatedmortality rates and indicators, such as human development index (HDI), gross domestic product (GDP) per capita, illiteracy rate, fertility rate, screening coverage, proportion of private health insurance use, density of physicians, and density of radiotherapy centers. Themortality rateswere obtained fromthe Brazilian national registry, while the indicators were based on official reports from the Ministry of Health. Univariate and multivariate linear regression was used. Results Among the states of Brazil, the average age-specific CC mortality rate from 2008 to 2012 varied from 4.6 to 22.9 per 100,000 women/year. In the univariate analysis, HDI, proportion of private health insurance use, density of physicians, and density of radiotherapy centers were inversely correlated with the mortality rates. Fertility rate was positively correlated with the mortality rates. In the multivariate analysis, only fertility rate was significantly associated with the CC mortality rate (coefficient of correlation: 9.38; 95% confidence interval [CI]: 5.16-13.59). Conclusion A decrease in the fertility rate, as expected when the level of development of the regions increases, is related to a decrease in the mortality rate of CC. The results of the present study can help to better monitor the quality assessment of CC programs both among and within countries.

Bibliographic Details

Main Authors:	Vale,Diama Bhadra, Sauvaget,Catherine, Murillo,Raul, Muwonge,Richard, Zeferino,Luiz Carlos, Sankaranarayanan,Rengaswamy
Format:	Digital revista
Language:	English
Published:	Federação Brasileira das Sociedades de Ginecologia e Obstetrícia 2019
Online Access:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032019000400249
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