Does inequality affect prostate cancer? Time trend of prostate cancer mortality and association with gini index in Brazil

Keywords

prostate cancer - mortality - income inequality - Gini index

Introduction: In Brazil, prostate cancer is the second most common cancer among men. Estimates for the period from 2023 to 2025 project approximately 72,000 new cases, emphasizing the need to examine factors influencing prostate cancer outcomes. This study focuses on analyzing prostate cancer mortality in Brazil, considering factors such as age, regional differences and socioeconomic indicators.

Objectives: The primary objective is to analyze the correlation between prostate cancer mortality and the Gini index, and to assess how socioeconomic inequalities and regional variations might influence these rates.

Methods: Ecological study with secondary data from 2011-2021. All data were sourced from Brazil's public health database (DATASUS). Data on prostate cancer mortality were obtained using the ICD-10 category C61 (Malignant Neoplasm of the Prostate). Mortality rates were analyzed by age and standardized through the World Health Organization's population. Descriptive statistics were used for both mortality and Gini index. Linear regression was used to analyze the relationship between mortality rates and the country's administrative regions over the years. Multiple linear regression analysis was performed to analyze the impact of inequality on cancer mortality.

Results: This study showed a significant decline in prostate cancer mortality rates over time among individuals aged 50-54 years (β = -0.0639, p = 0.016, R² = 0.4956) and 55-59 years (β = -0.1302, p = 0.002, R² = 0.6726). Notable decreases were observed in individuals aged 70-74 years (β = -2.0354, p = 0.0002, R² = 0.8048), 75-79 years (β = -3.1667, p = 0.0001, R² = 0.8265), and 80 years and older (β = -6.3263, p = 0.000, R² = 0.9422), highlighting a trend of decreasing mortality rates for those cohorts. Regional analysis revealed varying impacts of the Gini index on prostate cancer mortality with a significant negative correlation in the North (β = -169.0573, p = 0.017, R² = 0.5324), suggesting that higher income inequality may be associated with lower prostate cancer mortality in this region. No significant correlations were observed in the Northeast (p = 0.819), Southeast (p = 0.142), South (p = 0.318), or Central-West (p = 0.385) regions.

Conclusions: These results indicate significant improvements in prostate cancer survival rates for older age groups with varying impacts of income inequality on mortality rates across different regions of Brazil

Corresponding author: Juliana Goulart Xande (e-mail: [e-mail]).

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
06 May 2025