Modelagem de risco e padrões espaciais da mortalidade por câncer de mama e do colo do útero no Amazonas

Abstract

This thesis analyzes the crude and age-standardized mortality rates from breast and cervical cancer in the state of Amazonas, Brazil, from 2010 to 2023, considering the relevance of these neoplasms within the context of female mortality and the sociodemographic heterogeneity throughout the state. This is an ecological study with a quantitative approach, in which age-standardized rates were modeled using Generalized Linear Models with a Gamma distribution and a logarithmic link function, appropriate for the continuous and skewed distribution of the outcome. Spatial clusters were identified using Kulldorff’s spatial scan statistic, implemented in SaTScan. The results showed a progressive increase in mortality with advancing age, as well as a positive and statistically significant association between extreme poverty and higher age-standardized rates, highlighting the influence of social determinants. An association was also observed with the absence of religious affiliation, interpreted as a possible indirect marker of social support. The spatial analysis predominantly identified low-risk clusters, suggesting that elevated mortality is broadly distributed throughout the state. These results indicate that age-related and socioeconomic factors significantly influence the dynamics of mortality from these neoplasms in Amazonas, thereby reinforcing the need for strategies aimed at equity in access to screening and oncological care.