Análise espacial e temporal do câncer de mama na região metropolitana da Baixada Santista e sua relação com áreas contaminadas

• Autor(a) principal: Montanha, Dionize
• Data de Publicação: 2017
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UNISANTOS
• Texto Completo: https://tede.unisantos.br/handle/tede/3901
• topic: câncer de mama; contaminação ambiental; série espaço-temporal; breast cancer; environmental contamination; satial-temporal; CIENCIAS DA SAUDE::SAUDE COLETIVA

Breast cancer defies the world public health mainly by the high incidence and mortality of the disease. The Metropolitan Region of the Santos Area (RMBS) stands out for presenting high levels of mortality of the disease, as well as various environmental contaminants classified as carcinogens. The research has the objective of analyzing the temporal and spatial distribution of breast cancer in the Metropolitan Region of the Santos Area. Methodology: It is a mixed ecological study (spatial and temporal), about the distribution of breast cancer in the cities of RMBS, as well as in the regions exposed to environmental contaminants and regions of the state of Sao Paulo from 2000 to 2011. The population was composed by women at 20 years old or over, and data was provided by Oncocentro Foundation of Sao Paulo (FOSP), and from the contaminated areas, data was obtained from the Environmental Sanitation Technology Company (CETESB). Data about the population at risk was provided by the State System of Data Analysis (SEADE). The total number of breast cancer cases in the years from 2000 to 2011 was 87.354, 830 cases were excluded being: 779 cases of males over 20 years, and 51 cases under the age of 20 years (4 males and 47 females). From the total of 86.524 followed, 3.233 were in RMBS. Annual standardized coefficients of breast cancer were built to each city in RMBS and to each Regional Health Department (DRS) in the state of Sao Paulo. In order to characterize exposure a density indicator of density of contamination per city was built, for the analysis of the correlation between breast cancer and environmental contamination was utilized the correlation of Pearson. The analysis of variables was realized through Statistical Package for the Social Sciences, version 15.0 (SPSS). Through linear regression, a time trend analyses was done, and to that end SPSS and the Statistics or Windows 8.0 were also used. To the Spatial analyzes, four levels of coefficient intervals of breast cancer were created. A sequential cartographic was developed that reveals the distribution and the spatial-temporal evolution of outcome and exposure. Results: The results show that in RMBS the city with the highest levels of breast cancer is the city of Santos. The correlation of Pearson was positive, with r=0.7 and significance level of p=0,036. In the spatial part, the most contaminated areas presented the highest rates of breast cancer, except for the city of Peruíbe, where, despite low environmental containment, numbers showed high rates of the disease. By means of linear regression, the tendency analysis was done in all counties signaling growth of the disease, with exception of Bertioga county where the tendency is the reduction of the disease. When compared the breast cancer rates of RMBS with the DRS of the São Paulo State, certain regions showed much higher rates as: Araraquara, Araçatuba, Barretos, Bauru, Marília, Ribeirão Preto, São José do Rio Preto and Piracicaba, and the last cited region presented the highest levels of breast cancer in the State of São Paulo. This study confirms the hypothesis that environmental contamination interferes with the distribution of breast cancer, and the time trends indicates an increase in the disease in eight of the nine cities in the region.