Abstract PO-166: Geographic distribution of the cervical cancer incidence in the northeast region of the state of São Paulo, Brazil
Authors: Ribeiro Adeylson G. , Costa Allini M. , Fregnani José Humberto T.G. 
Published: January 2022

Abstract
Background: Cervical cancer is the third most common cancer in Brazil among females. The National Cancer Institute (INCA) estimates 16,500 new cases of cervical cancer for each year of the 2020-2022 triennium with an estimated risk of 15.43 cases per 100,000 women. This study aimed to geographically analyze the incidence of cervical cancer in the 18 municipalities that make up the Regional Health Department of Barretos (RHD-V), located in the state of São Paulo, Brazil. Methods: A total of 357 incident cases of cervical cancer (ICD-O-3 C53) between 2002 and 2016 were obtained from the Population-Based Cancer Registry of Barretos. Age-standardized rates (ASR) for the entire study period, and five-year periods, were calculated by the direct method using the world population as the standard, and the results are presented in thematic maps with quintile categories. The relative risk (RR) was obtained by the ratio between the total number of observed and expected cases for each area producing excess risk maps. The expected cases resulted from the application of a reference risk for the RHD-V (the sum of all the events over the sum of all the populations at risk). Spatial autocorrelation between municipalities was assessed by the Moran Global Index, being significant when the pseudo-p value was ≤ 0.05 for 999 permutations. In the analysis, the software RStudio 1.4.1717 and GeoDa 1.16 were used. All maps were produced in QGIS 3.10 software. Study approved by a research ethics committee under the number CAAE: 33712320.4.0000.5437. Results: Annual ASR for cervical cancer incidence ranged from 1.2 to 16.4 (per 100,000) for the period 2002 – 2016, and from 0.0 to 29.8 (per 100,000), from 0.0 to 15.4 (per 100,000) and from 0.0 to 29.3 (per 100,000) for the periods 2002 – 2006, 2007 – 2011 and 2012 – 2016, respectively. Overall, half of the municipalities had excess risk (RR &gt; 1) for cervical cancer in all periods analyzed, most of them located in the northern region of the RHD-V. Higher RRs (from 2.0 to 4.0) were identified in one municipality in the period 2007 – 2011, and in two municipalities in the period 2012 – 2016. A weak spatial autocorrelation was detected for the entire period 2002 – 2016 and for the last period 2012 – 2016, with the Moran Global Index values of 0.241 (pseudo-p = 0.051) and 0.256 (pseudo-p = 0.038), respectively. Conclusions: Geographical variability was identified in the incidence and risk of cervical cancer among the RHD-V municipalities, with an evident fluctuation in rates over the years. Thus, this study made it possible to strategically visualize cancer research data, identifying spatial patterns that would possibly be incomprehensible in other analysis formats. The results can inform evidence-based decision-making and public policy and can support the implementation of community-level interventions and the efficient allocation of resources.
Citation Format: Adeylson G. Ribeiro, Allini M. Costa, José Humberto T.G. Fregnani. Geographic distribution of the cervical cancer incidence in the northeast region of the state of São Paulo, Brazil [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-166.