Trends and differences in breast cancer mortality by race, region and age among Brazilian women, 1996-2024: a nationwide ecological study

ObjectivesTo quantify the demographic contribution to Brazils rising number of breast cancer deaths and compare mortality trends by region and race/skin color. Study designNationwide, population-based ecological time-series study. MethodsDeaths from breast cancer (ICD-10 C50) in the Brazilian Mortality Information System, 1996-2024, were analysed. Crude rates use two denominators, the whole female population and women aged 20 and over. Age-standardized rates used the 2024 IBGE projection and, by race/skin color, Census populations for 2010 and 2022. Trends used weighted log-linear regression with BIC-selected joinpoints, and deaths were decomposed by the Das Gupta method. ResultsDeaths rose from 7,085 (1996) to 20,849 (2024). Over 2000-2024 the age-standardized rate rose from 11.4 to 14.3 per 100,000 women, with one joinpoint at 2017 (average annual percent change +0.87%, 95% CI 0.77 to 0.96). Growth and ageing accounted for 74.3% of the 12,542 additional deaths at ages 20 and over. Standardized rates rose in every region, fastest in the North (+3.09%/year) and slowest in the Southeast (+0.24%/year), narrowing the highest-to- lowest ratio from 2.67 to 1.38. White women had the highest age-standardized rate at both censuses (2022: 15.96 versus 12.28 and 11.48 per 100,000), Brown women had the larger increase (ratio of relative changes 1.20, 1.13 to 1.26). ConclusionsPopulation growth and ageing accounted for most of the increase in the number of recorded breast cancer deaths at ages 20 and over. Regional differences in level narrowed, White women had the highest age-standardized rates at both censuses and Brown women the larger increase.