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01.07.2019 | Original Article | Ausgabe 4/2019

Gastric Cancer 4/2019

Unequal burden of mortality from gastric cancer in Brazil and its regions, 2000–2015

Gastric Cancer > Ausgabe 4/2019
Lucia Libanez Bessa Campelo Braga, Alberto Novaes Ramos Jr., Manuel Bonfim Braga Neto, Anderson Fuentes Ferreira, Dulciene Maria Magalhães Queiroz, Danielle Calheiros Campelo Maia, Carlos Henrique Alencar, Jorg Heukelbach
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Gastric cancer (GC) is an important cause of morbidity and mortality worldwide. However, population-based data on GC mortality dynamics in low and middle income countries are scarce.


We analyzed GC mortality in Brazil based on all GC-related deaths registered 2000–2015.


A total of 17,374,134 deaths were recorded, with GC identified in 214,808 (1.24%) cases—203,941 (94.9%) as underlying cause, and 10,867 (5.1%) as associated cause of death. Adjusted rates for age and sex was 6.85 deaths/100,000 inhabitants [95% confidence interval (CI) 6.73–6.97]. The highest mortality rates were found in males [10.00; rate ratio (RR) 1.85; 95% CI 1.78–1.91; p < 0.0001] and patients ≥ 45 years of age (24.98; RR 3.79; 95% CI 3.55–4.05; p < 0.0001). The South (7.56; RR 1.62; 95% CI 1.50–1.76; p < 0.0001) and Southeast (7.36; RR 1.59; 95% CI 1.48–1.71; p < 0.0001) regions had the highest regional rates. Spatial and spatiotemporal high-risk mortality areas in 2004–2007 were located mainly in the South, Southeast, and Central-West regions. After 2008, the Northeast region became a high-risk area, especially Ceará State.


GC remains a significant public health problem with high mortality burden and unequal distribution in Brazilian states. The new patterns in poorer regions and the high risk in some specific populations show a clear process of epidemiological transition over time. There is a need to strengthen nationwide epidemiological monitoring, surveillance, prevention, and control for GC in the country.

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