Temporal Trends of Esophagus Cancer Morbimortality in the State of Santa Catarina in the Period of 2009-2018

Background: Esophageal cancer (EC) is one of the most common malignant tumors in the world and is associated with a late diagnosis and poor prognosis in most cases, with an average 5-year survival ranging from 15 to 20%. The main risk factors are smoking, alcoholism and gastroesophageal reflux disease. Worldwide, epidemiological disparities of the disease were observed according to geographic location.

1) To analyze the temporal trend of esophageal cancer morbidity and mortality in Santa Catarina in the period 2009-2018.

2) To define the sociodemographic profile of affected patients, according to sex, age group, ethnicity and macro-region of occurrence.

3) To analyze the temporal trend of risk rates for hospitalizations and deaths.

4) To determine the proportion of hospitalizations in ICU beds, the proportion of diagnostic, clinical and surgical procedures, and the average length of stay.

5) To detail the proportional distribution of cases of hospitalization for the neoplasm, according to its topographic location.

6) To evaluate clinical variables and the outcome of patients with esophageal cancer undergoing treatment in Santa Catarina.

7) To correlate the time series of hospital morbidity of hospitalizations for esophageal cancer with those of mortality for this group of neoplasms.

Methods: Observational study of ecological type with quantitative approach and time series analysis. It studied the population resident in Santa Catarina with 20 years of age or older who was hospitalized for esophageal cancer in the period 2009–2018 in hospitals in the state of Santa Catarina (SC), whose procedures were financed by SUS, and the population residing in Santa Catarina with 20 years of age or older who died having esophageal cancer as the basic cause, according to the death certificates issued in the period 2009– 2018 in the state.

Results: During the study period, 8,920 hospitalizations and 3,644 deaths from esophageal cancer were registered. The average hospitalization rate for males (30.48/100,000 inhab) was 4 times higher than for females (7.57). The highest average rates of hospitalizations occurred in the 60 to 79 age group (66.43) and in the macro-regions of the Grande Oeste (37.05), the Meio Oeste e Serra Catarinense (23.66). The average length of stay for hospitalizations was 6.82 days in the period studied. The average mortality rate was higher for the population aged 80 years or older (44.85). The majority of deaths were registered in the population with white skin color (n = 3,202; 87.87%), and the average lethality rate of non-whites (48.95%) was approximately 22.55% higher than the found in the population with white skin (39.94%).

Conclusion: The results showed that the sociodemographic profile of patients suffering from esophageal cancer in Santa Catarina in the period 2009-2018, according to available variables, was men, aged between 60 and 79 years, of white ethnicity, and residents of the Grande Oeste macroregion. There was a temporal trend of stability in the hospitalization rates, proportion of intensive care and clinical and surgical procedures. There was a temporal trend of reduction in mortality, lethality rates and average length of stay.

Headings: Esophageal cancer; Morbidity and mortality; Temporal trend