Time trends in breast cancer incidence and mortality in a mid-sized northeastern Brazilian city

BACKGROUND Breast cancer incidence within an area is usually proportional to the area's income level. High-income areas have shown the highest incidence rates and since 2003, negative trends. As for mortality, rates are often higher in low-income regions. The purpose of this study was to analyze trends in incidence and mortality in a capital city of a northeastern Brazilian state with an intermediate human development index. METHODS Incidence data from the Population-Based Cancer Registry of Aracaju and mortality data from the Official State Database for the period 1996-2006 were used. Incidence and mortality crude and age-standardized rates were calculated. Time trends were obtained using the Joinpoint Regression Model. RESULTS For the period studied, invasive breast cancer age-standardized incidence rates increased annually with an annual percentage change (APC) of 2.9 (95% CI: 1.2-4.6). Significant increasing trends were observed in groups aged 45-54 years (APC: 3.9, 95% CI: 1.4 to 6.6), and 55-64 years (APC: 5.6, 95% CI: 1.8 to 9.6). Age-standardized mortality rates did not show an increasing trend (APC: 3.0, (95% CI: -2.8 to9.1), except for the group aged 55-64 years (APC: 11.3, 95% CI: 1.1 to 22.4). CONCLUSIONS In the study community, breast cancer showed increasing incidence among women in the peri- and postmenopausal periods. However, mortality did not present increasing overall trends, except for among the group aged 55-64 years. For better outcomes, screening policies should focus on the peri- and postmenopausal periods of women's lives to diagnose disease.