Colorectal cancer spatial pattern in the northeast region of São Paulo, Brazil

Adeylson Guimarães Ribeiro*, Allini Mafra da Costa, Talita Fernanda Pereira, Denise Peixoto Guimarães, José Humberto Tavares Guerreiro Fregnani

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review


Background: This study examined the spatial pattern of the colorectal cancer (CRC) in the 18 municipalities that compose the Regional Health Department of Barretos (RHD-V), which is in the northeast of the state of São Paulo, Brazil. Methods: All incident cases and deaths from CRC between 2002 and 2016 were included. Age-standardized rates (ASR) for incidence and mortality per 100,000 person-years were used to evaluate the spatial distribution for the total and five-year periods. The lethality rates were also assessed. Excess risk maps compared the observed and expected events. Age-standardized net survival was used to evaluate CRC survival. Results: For CRC incidence, the ASR value for the general population over the entire period (2002–2016) was 17.7 (95% CI: 16.7, 18.6), ranging from 16.7 (95% CI: 14.9, 18.4) (2002–2006) to 20.0 (95% CI: 18.3, 21.7) (2012–2016) per 100,000. When males and females were compared, the ASR was 20.1 (95% CI: 18.6, 21.6) and 15.7 (95% CI: 14.5, 17.0) per 100,000, respectively. For CRC mortality (2002–2016), the ASR was 8.2 (95% CI: 7.6, 8.9), ranging from 9.0 (95% CI: 7.8, 10.3) (2002–2006) to 8.2 (95% CI: 7.2, 9.3) (2012–2016) per 100,000. Overall, the excess risk up to 2.0 was more frequent. In terms of survival, municipalities with large port populations had lower survival in comparison with medium port. Conclusions: This study showed a variation in CRC incidence and mortality, with differences considering five-year periods and gender, being the incidence higher in males than females in the entire period, with mortality equivalent to half the incidence. The survival was lower in municipalities with large port populations in comparison with medium port. Knowing spatial patterns of incidence, mortality, lethality, and survival can be necessary to support policymakers to advance or implement effective cancer control programs.

Original languageEnglish
Article number100097
JournalGlobal Epidemiology
Publication statusPublished - Dec 2023
Externally publishedYes


  • Colorectal cancer
  • Incidence
  • Mortality
  • Spatial analysis
  • Trends


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