Impact of Age, Period, Cohort, Region, Race, and Health Services on Bladder Cancer Mortality in Brazil: A 23-Year Ecological Study.

Simple Summary: Bladder cancer is an economically costly cancer, especially in Brazil, where treatment and diagnosis vary greatly across regions. This study revealed that, after the age of 50, mortality from this disease increases, and is more common among white people and residents of the southern region of Brazil. The lack of health professionals and the lower investment in health actions and services contributed to this increase in mortality. In addition, the performance of basic procedures, such as punctures and cystoscopy examinations, was lower in regions with higher mortality rates; however, more complex surgeries failed to reduce mortality rates. These results underscore the need to improve public health policies and ensure better access to healthcare for cancer, especially in Brazilian regions with fewer resources. Bladder cancer is one of the most economically costly types of cancer, but few studies have evaluated its mortality considering the factors that impact this outcome. This study aimed to investigate the impact of sociodemographic factors, period, cohort, and health services on bladder cancer mortality. This ecological study analyzed bladder cancer mortality data in Brazil from 2000 to 2022 and evaluated sociodemographic variables (race, region of residence), socioeconomic variables (gross domestic product per capita, Gini index of household income per capita, number of health professionals per inhabitant, expenditure on public health services, and consultations per inhabitant), and bladder cancer diagnosis and treatment procedures. These data were subjected to statistical analysis, which revealed that after the age of 50, there was a progressive increase in the risk of bladder cancer. Indigenous people had the lowest mortality rate, while white people had a significantly greater mortality rate than black and brown people. The North Region and Northeast Region presented the lowest mortality rates, whereas the South Region presented the highest mortality rates. In the South and Southeast Regions, a higher GDP was related to lower mortality. In the South, higher mortality was associated with a lower number of consultations per inhabitant per region. Fewer bladder punctures/aspirations and bladder biopsies were associated with higher mortality rates. In oncology, more procedures, such as total cystectomy, cystoenteroplasty, and total cystectomy with a single shunt, do not reduce the mortality rate. These results can serve as guidelines for adjusting public health policies. [ABSTRACT FROM AUTHOR]