Trends in mortality due to myeloid leukemia in regions of Brazil and the country as a whole between 1980 and 2012

Letter to the Editor Trends in mortality due to myeloid leukemia in regions of Brazil and the country as a whole between 1980 and 2012 Dear Editor, We read with great interest the article entitled " Trends in mortality of adult patients diagnosed with myeloid leukemia from 1994 to 2011 in southeastern Brazil " by Callera et al. published in the Revista Brasileira de Hematologia e Hemoterapia (2015;37(1):7–11), 1 and we would like to make some comments. The subject of the article is very important for clinical oncology and cancer surveillance as it presents a time series analysis showing a declining trend in mortality from myeloid leukemia in one area of the richest region of Brazil. It is understood that this decline is a result of the improving quality of access to health services with early diagnosis of the disease and clinical management. However, Brazil is the size of a continental and, therefore, we believe it is important to observe the trend of mortality due to myeloid leukemia in other regions of Brazil and the country as a whole. In 2014, the Brazilian National Cancer Institute estimated the incidence of leukemia in Brazil to be around 5050 and 4320 new cases for men and women, respectively. Excluding non-melanoma skin tumors, leukemia is the fifth most common cancer in men in the Northern Region of the it is the eleventh most frequent. 2 This inconsistency has been observed worldwide. GLOBO-CAN estimates the global prevalence of leukemia to be 4.7/100,000 inhabitants. The same report shows, however, that there are differences in the rates when comparing medium (3.8/100,000) and under (2.5/100,000) developed countries. With regard to mortality, the global estimate is 3.4/100,000 inhabitants, 3.2/100,000 for medium and 2.4/100,000 for under development countries. 3 By using a methodology 4 similar to Callera et al., 1 we identified important differences in different Brazilian regions. Myeloid leukemia mortality rates between 1980 and 2012 are different when stratified by gender. The rates in men are which may point to important differences between the genders. In addition, the rates are consistently higher in the Southeast and South, regardless of gender, which shows regional differences in the impact of the disease (Figure 1). Regarding the trend, there is a difference related to gender and region. For males, there was a significant increase in the incidence rates in Brazil between 1980 and 2005. After 2005, there was a statistically non-significant …