TRENDS IN LUNG CANCER MORBIMORTALITY IN BRAZIL

Introduction: Lung cancer (LC) is the third most frequent type of cancer in Brazil and the main cause of mortality from cancer. It is considered a challenge for public health, because its signs and symptoms usually manifest in advanced stages and is mistaken with other pulmonary pathologies. Objective: To present an overview of the morbimortality of lung cancer in the Brazilian Public Unified Health System (SUS). Methods: Descriptive, retrospective and longitudinal study with secondary data provided by the SUS Department of Informatics and the National Cancer Institute (INCA). Crude incidence rates were obtained from Cancer Incidence Estimates, number of deaths from Mortality Information System, and age-adjusted mortality rates from the Online Atlas of Cancer Mortality. The number of patients diagnosed with LC (ICD-10 C34) treated at SUS were obtained from INCA Oncology Panel and clinical information was obtained from Hospital Cancer Registry (HCR). Results: From 2014 to 2018, 44,457 LC patients were treated at SUS (56% man; 38% from 60 to 69 years old). Comprising all Brazilian population (SUS plus private health system patients), there were 135,829 deaths from LC in the same period (57% men; 29% from 60 to 69 years old), an average of 27,166 deaths/year. According to HCR, when considering the filled records about LC stage, 86% were diagnosed at late stages (III and IV). The proportion of advanced stages in men was 88% and, in women, 85%. Regarding smoking habit, 45% had no information; among those with available data, 81% of LC patients were smokers or had been smokers (86% of male patients and 72% of female). The crude incidence rate of LC from 2006 to 2020 showed no significant changes and the adjusted mortality rates showed a growth of 0.7% per year, but this, only due to women population, who showed a growth of 2.5% per year in adjusted mortality rate. Conclusion: Lung cancer has a great impact on the Brazilian population health; morbimortality trends point to a more critical future scenario to the women group. Smoking is still highly relevant in terms of incidence and mortality, despite advances in anti-Tabaco policies in the last decades. There is a great disparity between the numbers of patients treated at SUS with the number of deaths, showing the need to improve the country’s cancer registries. Early diagnosis is considered a challenge and improvement in health policies and infrastructure are mandatory to ensure longer survival for LC patients.