Introduction
Colorectal cancer (CRC) is the second most common cancer and the third leading cause of cancer-related deaths in Brazil. High-income countries with organized screening programs have achieved significant reductions in CRC mortality in the last decades through early detection, polypectomy, and improved therapeutic interventions. Meanwhile, several low- and middle-income nations continue to experience rising incidence and persistently high mortality rates. Understanding CRC mortality patterns across different age groups and sexes is essential to guide public health policies and optimize resource allocation for prevention, early detection, and treatment strategies.
Aims & Methods
This study aimed to analyze CRC mortality trends in Brazil from 2012 to 2021. We conducted a descriptive analysis of CRC-related deaths (ICD-10 codes C18, C19, and C20) using data from the Mortality Information System of the Unified Health System (DATASUS). The crude annual mortality rate (deaths per 100,000 inhabitants) was calculated by dividing the number of deaths by the estimated population provided by the Brazilian Institute of Geography and Statistics (IBGE). We also analyzed annual mortality rates by age range and sex and calculated the average annual percent change (AAPC) in mortality rates to assess trends over time.
Results
A total of 175,159 CRC-related deaths were recorded in Brazil between 2012 and 2021, with 86,330 occurring in men and 88,829 in women. Among men, 27.4% of deaths occurred before age 60, 53.8% between ages 60 and 79, and 18.8% at age 80 or older, while among women, these proportions were 27.4%, 47.1%, and 25.5%, respectively. During this period, CRC mortality rates increased in both sexes, rising from 7.06 to 9.73 deaths per 100,000 men and from 7.29 to 9.16 deaths per 100,000 women. Consequently, the male-to-female mortality ratio grew from 0.97 in 2012 to 1.06 in 2021, leading to a slight predominance of male gender at the end of the assessed period. The AAPC in mortality was higher in men than in women across all age groups, except for those aged 40–59 years (Table 1). Among younger individuals, those aged 30–39 years had a low absolute mortality rate (<0.4 deaths per 100,000 inhabitants) but showed the highest AAPC (3.5% per year in men and 2.8% per year in women). Among individuals within the recommended CRC screening age range, the highest AAPC was observed in those aged 60–69 years (2.1% per year in men and 1.7% per year in women).
Conclusion
The concerning rise in CRC mortality in Brazil underscores the need for enhanced public health strategies, including improved access to screening and better healthcare resources. Additionally, the greater increase in mortality rates from early-onset colorectal cancer, particularly between ages 20 and 39, warrants attention, with a focus on identifying high-risk individuals and addressing modifiable risk factors in the population.
Table 1 –Average annual percent change in colorectal cancer mortality rate by sex and age range.
Age range
| AAPC in men
| AAPC in women
|
| 20-29 | 2,8% | 1,6% |
| 30-39 | 3,5% | 2,8% |
| 40-49 | 0,7% | 1,0% |
| 50-59 | 1,1% | 1,4% |
| 60-69 | 2,1% | 1,7% |
| 70-79 | 1,2% | 0,7% |
| 80+ | 0,2% | 0,1% |
AAPC, average annual percent change.
