Premature cancer mortality in Brazil is expected to decrease by 2030

Premature cancer mortality in Brazil is projected to decrease over the period 2026-2030. The projection was made by researchers from the National Cancer Institute (Inca), with respect to the premature mortality observed between 2011 and 2015, for the age group from 30 to 69 years, with data from the National Information System on Mortality ( SIM ). Despite this, the expected reduction will still be far from Target 3.4 of the United Nations (UN) Sustainable Development Goals (SDGs), which have established, by 2030, a one-third reduction in the risk of premature death from chronic non-communicable diseases (MNT) ), which include the various types of cancer.

This was informed by researcher Marianna Cancela, of the Inca Prevention and Surveillance Coordination (Conprev). Brazil Agency that, for some types of cancer, an increase is expected and, for others, a decrease. For 2026/2030, the forecast is for a national reduction of 12% in the age-standardized mortality rate from premature cancer among men and a smaller decline, of 4.6%, among women. In regional terms, it went from 2.8% among women, in the Northern Region, to 14.7% among men, in the Southern Region. The forecasts were calculated using the Software Nordpred, developed by the Cancer Registry of Norway, is widely used to make long-term predictions of cancer incidence and mortality.

Marianna explained that, speaking of number of cases, all types of cancer will increase in the period between 2026 and 2030 for two reasons. The first concerns the increase in population and changes in the structure of the population, with the aging of a large part of Brazilians, for whom most non-communicable diseases are more prevalent; the second reason is the increase in risk factors.

According to the Inca article Can the Sustainable Development Goals for Cancer be achieved in Brazil?published in the scientific journal Frontiers in Oncology On 10 January 2016, CNCDs accounted for 15 million premature deaths in the 30-69 age group, worldwide, in 2016, with more than 85% of these deaths occurring in low- and middle-income countries . Cancer is responsible for 9 million deaths per year, second only to cardiovascular disease (17.9 million deaths/year), considered the leading cause of death from CNCD worldwide. The outlook is that NCDs will continue to rise in low- and middle-income countries, contributing to economic losses associated with premature deaths of approximately $7 trillion in these countries over the next 15 years.

Major increase

According to the Inca study, bowel or colorectal cancer is expected to show the greatest increase in the risk of premature death for men and women by 2030, in Brazil, at around 10%. By region, the North of the country is expected to show the largest increase (52%) among men, followed by the Northeast (37%), Midwest (19.3%), South (13.2%) and Southeast (4.5 %). According to Marianna Cancela, the higher incidence “is a consequence of the so-called westernisation, of lifestyle habits, of greater obesity, of a sedentary lifestyle, of the food issue, with a preference for the consumption of industrialized products”. In regions where the incidence is currently lower, a higher increase is expected. Among women, the Northeast leads, with an expected expansion of 38%, followed by the Southeast (7.3%), North (2.8%), Midwest (2.4%) and South (0.8 %).

Bowel cancer is the second most common type of cancer in the country, behind prostate cancer among men and breast cancer among women. Inca estimates that, in each year of the three-year period 2023/2025, approximately 46,000 new cases of colorectal cancer will be diagnosed, corresponding to approximately 10% of all cancers diagnosed in Brazil, with the exception of non-melanoma skin cancer.

Other types of cancer

Marianna Cancela reported that lung cancer among men was the one that showed the greatest decline, close to 30%, demonstrating the effectiveness of all anti-smoking policies implemented since the 1980s. 1.1% probability in more than premature death.

In cervical cancer, a decrease in premature mortality was observed in all regions. “Except that, even with this decline, the rate of premature mortality in the North Region continues to be extremely high, compared to other locations and the national average.” In northern Brazil, premature mortality was the highest in the country between 2011/2015: 28 deaths per 100,000 people, against a national average of 16 deaths per 100,000.

The projection for 2026/2030 in the North Region is 24 deaths per 100,000 inhabitants, while the Brazilian average is 11 deaths per 100,000 inhabitants. “Even with this decline it continues to be very high,” Marianna assesses. The researcher stressed that, in addition to being a complicated region from a logistical point of view, treatment is lacking in northern Brazil. “For some cancers, we see exactly that, even with a decline, the number remains extremely high.”

For breast cancer, projections through 2030 are for a decline in the southeast, some stability in Brazil and the south, and an increase in the north, northeast, and central west. Marianna clarified that, in this type of cancer, there are hormonal factors that make it difficult to avoid the disease. The decrease in the number of children per woman and the fact that a woman has not had children increases the risk of breast cancer. “Breastfeeding is a protective factor.” As with colorectal cancer, the risk of breast cancer is increased by diet, physical inactivity and alcohol consumption. Another factor that increases the risk is the fact that women become pregnant at an older age, putting off motherhood. “All of this ultimately adds up to an increased risk.”

For stomach cancer, despite an expected decline, premature mortality remains high in the North Region. It is a tumor of infectious origin, which affects more men than women. “We have a mix of cancer from developing countries with cancer from developed countries which results in this double burden of disease.” Between 2011/2015, premature mortality from stomach cancer in Brazil was 20 deaths per 100,000 people. In the North there were 21 deaths per 100,000 inhabitants, in the Southeast 23; and in the South, 24. “But the fall [projetada] in other regions it was much more pronounced”. The Northern Region should drop to 19 deaths per 100,000 inhabitants by 2030; Southeast and South, for 13 cases each, and Brazil, for 12. That is, the decline is more pronounced in the richest regions of the country, the study found.

Public order

In 2019, cancer caused 232,040 deaths in Brazil, across all ages. In the range of 30 to 69 years, there were 121,264 deaths. “Overall, we have seen a slight decline,” the researcher said. Between 2011/2015, there were 145.8 cases per 100,000 among men and 118.3 cases per 100,000 among women. For 2026/2030, the projection is 127.1 deaths per 100,000 among men (a decrease of 14.8%) and 113 cases among women, per 100,000 (-4.7%). This was observed in all regions except the North where a slight increase is expected (1.3% in men and 3.5% in women). Marianna reiterated that, even with this decline, there will be an increase in cases because it ends up accompanying the aging of the population.

Inca’s article concludes that there is a need for public policies, especially for cancer prevention, in a multisectoral way. “There must be more effective access to all stages of cancer control: prevention, early diagnosis, treatment, to ensure that there is a reduction”, highlighted the researcher.

He reflected that, as with lung cancer, efforts need to be continuous and long-term, because cancer is a disease that has a long latency, meaning it needs years of exposure to develop. Therefore, it needs prevention policies with the population for years, so that there may be a decline in numbers.

To prevent the onset of cancer, experts recommend not smoking, not drinking, exercising, avoiding a sedentary lifestyle, giving preference to unprocessed foods. People should always pay attention to the signs that the body gives and do not hesitate to consult a doctor, Inca’s researcher recommended.

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