Trends in prostate cancer mortality in the state of São Paulo, 2000 to 2015

Abstract

OBJECTIVE: To estimate the magnitude and identify patterns of change in prostate cancer
mortality in the state of São Paulo and in the 17 regional health care networks, according to
age groups from 50 years onwards, in the period between 2000 to 2015.
METHODS: Age-adjusted mortality rates (per 100,000 men) were calculated by the direct
method using the Segi world population as standard. Joinpoint regression was used to calculate
the average annual percent change (AAPC), with a confidence interval of 95% (95%CI), by regional
network and age group (50–59, 60–69, 70–79 and 80 years or more).
RESULTS: For the state of São Paulo, age-adjusted mortality rates were 15.2, 13.3 and 11.9
per 100,000 men, respectively, in the periods between 2000 to 2005, 2006 to 2010 and 2011 to
2015, with a significant decrease trend (AAPC = -2.10%; 95%CI -2.42 – -1.79) each year. Among
the 17 networks, 11 presented significant mean annual reductions, ranging from -1.72% to
-3.05%. From the age of 50 onwards, there was a sharper reduction in the groups from 50 to 59
(AAPC = -2.33%; 95%CI -3.04 – -1.62) and 60 to 69 years (AAPC = -2.84%; 95%CI – 3.25 – -2.43).
CONCLUSION: Although reductions in mortality are still slight, they indicate progress in
prostate cancer control actions. Screening actions and changes in therapeutic behaviors in recent
decades may be modifying incidence and survival, resulting in changes in the mortality profile.
More detailed studies will be useful in understanding the factors that lead to the interregional
variations found.