RESUMO
Age-standardized mortality rates of cancer were calculated for the Argentine provinces using deaths from 7 years of registration (1980-1986). Correlations between the geographical distributions of the rates for the main causes of death by cancer were analyzed. The correlations were adjusted for socioeconomic status using an indicator of low socioeconomic level (NBI) as a third variable in a multivariate analysis or stratifying by NBI. Correlations between the distribution of the age-standardized mortality rates in males and females for the same tumor site also were analyzed. Positive intersex correlations were observed for mortality rates of cancers of the colon, liver, pancreas, esophagus, stomach, gallbladder, and bladder. Negative correlations with NBI were observed for cancers of the breast and ovary in females, colon and pancreas in both sexes, and bladder in males. Positive correlations with NBI were observed for cancer of the cervix and for all uterine cancers. After adjusting by NBI, only the correlations between the distributions of cancer of the lung and cancers of the bladder, larynx, and pancreas in males remained statistically significant. The stratified analysis showed changes in the values of many of the correlation indexes by level of NBI. It is concluded that the socioeconomic level, measured by the NBI, is a strong confounder and an effective modifier of many correlations presented.
Assuntos
Atestado de Óbito , Neoplasias/mortalidade , Vigilância da População , Pobreza , Características de Residência , Adolescente , Adulto , Distribuição por Idade , Idoso , Argentina/epidemiologia , Viés , Causas de Morte , Criança , Pré-Escolar , Fatores de Confusão Epidemiológicos , Modificador do Efeito Epidemiológico , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Neoplasias/classificação , Análise de Regressão , Distribuição por Sexo , Fatores SocioeconômicosRESUMO
Mortality rates from different cancers in migrants to Argentina from 11 individual countries and 6 groups of countries were compared with those in the Argentina-born population and in their countries of origin. Almost all countries of origin had higher mortality rates from gastric cancer than Argentina, but the risk declines in migrants, and for European migrants becomes similar to that of the Argentina-born. In contrast, mortality from oesophageal cancer is significantly lower in European countries than in Argentina. For cancer of the colon and breast, most countries have lower mortality rates than the Argentina-born, the exceptions being Uruguay and Germany, and migrants demonstrate a convergence of risk towards that of Argentina-born. These results suggest that migrants to Argentina undergo changes in some environmental exposure, probably dietary, which give rise to substantial alterations in cancer risk within their lifespan.
Assuntos
Neoplasias/mortalidade , Argentina/epidemiologia , Emigração e Imigração , Europa (Continente)/etnologia , Feminino , Geografia , Humanos , América Latina/etnologia , MasculinoRESUMO
Mortality rates in 1980, for the major cancer sites, are presented for Argentina as a whole, and for the 22 provinces, the capital city, and the southern territories. In comparison with other countries, national mortality rates are high for oesophageal cancer and cancer of the larynx, and moderately elevated for cancers of the lung, colon, breast, and bladder in males. The rates of tobacco-related cancers (lung, bladder and larynx) were much higher in males than females, and in males showed similar geographical patterns. In females, breast cancer rates by province showed a positive correlation with those for cancer of the colon, and a negative correlation with cervical cancer. There were marked geographical variations, quite different in the two sexes, in the mortality from oesophageal cancer. It is suggested that, although some of these variations within Argentina may be related to ethnic differences and patterns of migration from neighbouring countries, for the majority the explanations must lie in different exposures to environmental of lifestyle factors, such as diet.