CERVICAL CANCER MORTALITY IN BRAZIL (2013–2022): A SPATIOTEMPORAL AND ENVIRONMENTAL ANALYSIS USING ADVANCED STATISTICAL MODELING

Abstract

Introduction: Cervical cancer mortality in Brazil shows heterogeneous trends across regions, reflecting inequalities in access to screening, early diagnosis, and timely treatment. In addition to sociodemographic variables, the impact of climatic factors on mortality is also noteworthy. Objective: To analyze the spatiotemporal patterns of cervical cancer mortality in Brazil between 2013 and 2022, investigating associations with environmental and socioeconomic factors. Methodology: This is an analytical ecological study with a quantitative approach, using data from SIM/DATASUS, INMET, INPE, and IBGE. Age-standardized mortality rates per 100,000 women were associated with variables such as mean annual temperature, wildfires, deforestation, and socioeconomic indicators. Multivariate regression models and Generalized Additive Models (GAM) were applied to identify significant associations. Results/Discussion: During the study period, 62,175 deaths were recorded, with a 28.6% increase in the annual number of deaths. The highest rates were observed in the North and Northeast regions. The models revealed a statistically significant association between the annual average of wildfires (β = 0.32; p = 0.003) and increases in mean annual temperature above 1.5°C (RR = 1.09; 95% CI: 1.02–1.17) with higher mortality. Most deaths occurred among mixed-race women aged 40 to 59 years living in areas with low health coverage. Conclusion: Cervical cancer is influenced not only by infectious factors but also by environmental and structural determinants, highlighting the need for intersectoral policies integrating health, environment, and territorial equity.