Temporal trends and spatial distribution of prostate cancer incidence and mortality in a northeastern Brazilian state.

BACKGROUND

Prostate cancer incidence and mortality exhibit regional variation often linked to disparities in healthcare access and disease management. This study aimed to analyze temporal trends and spatial distribution of prostate cancer incidence (1996-2017) and mortality (1996-2022) in Sergipe, Brazil, to support targeted cancer control strategies.

METHODS

We analyzed prostate cancer data from the Aracaju Cancer Registry and the Mortality Information System. Age-standardized incidence and mortality rates were calculated using the World Standard Population. Joinpoint regression estimated Annual Percent Change (APC) and Average Annual Percent Change (AAPC) to assess trends. The Mortality-to-Incidence Ratio (MIR) and its complement (1-MIR) were used as proxies for survival. Spatial distribution was examined using Empirical Bayesian Kriging and local empirical Bayes smoothing in QGIS and TerraView.

RESULTS

Between 1996 and 2017, 10,133 incident prostate cancer cases were recorded. Incidence increased until 2007 (APC=11.9 %; p < 0.001), then declined (APC=-2.0 %; p = 0.027, with peaks in men aged ≥55. Mortality increased from 1996 to 2007 (APC=12.2 %; p < 0.001) and subsequently stabilised between 2007 and 2022 (APC=-0.8 %; p = 0.228), resulting in an overall AAPC of 2.4 % (p = 0.002) for the entire study period. By age group, mortality rose among men ≥ 75 years (AAPC=3.2 %; p = 0.001) but declined in those aged 15-54 (AAPC=-2.4 %; p = 0.004). The MIR remained flat over time, but estimated survival dropped substantially among men aged ≥ 75 years, from 63 % to 38 %. Spatial analysis revealed higher incidence in central/coastal municipalities, while elevated mortality clustered in southern/coastal areas.

CONCLUSIONS

Despite improvements in incidence rates, prostate cancer remains a significant burden in Sergipe, with persistent regional disparities in outcomes. Spatial and temporal analyses highlight the need for targeted public health interventions to improve early detection and access to care, especially in areas of high social vulnerability and among older men.