Mortality trends of the leading cancers in Brazil: Real-world evidence from a national data platform.

e23421 Background: Cancer is a leading cause of mortality worldwide, with substantial variation by tumor type and region. Understanding national mortality patterns is essential to inform public health planning and cancer control strategies. We evaluated mortality trends of the leading cancers in Brazil using nationwide real-world data. Methods: This retrospective, population-based study analyzed deaths due to malignant neoplasms (ICD-10 C00–C97) recorded in the Brazilian Mortality Information System (SIM/DATASUS) between 2008 and 2024, using the Nodian platform, which aggregates, standardizes, and structures nationwide public health databases. Age-standardized mortality rates (ASRs) were estimated using the direct method, standardized to the Brazilian 2010 population. Analyses were stratified by sex, age group, and geographic macroregion. Temporal trends were assessed using average annual percent change (AAPC) estimated by linear regression and classified as increasing, decreasing, or stable (p < 0.05). Results: A total of 3,560,646 cancer-related deaths were identified nationwide. Lung cancer was the leading cause of cancer mortality (448,270 deaths; 12.6%), followed by breast (275,147; 7.7%), prostate (251,365; 7.1%), stomach (239,445; 6.7%), and colorectal cancer (192,023; 5.4%). Together, these five cancer types accounted for approximately 39% of all cancer deaths. Breast cancer represented the highest proportion of cancer deaths among women, while prostate cancer predominated among men. Most deaths occurred among individuals aged ≥60 years. Substantial regional heterogeneity was observed in the distribution of leading cancer types. Trend analyses showed declining mortality for stomach cancer (AAPC −1.6%, p < 0.001), increasing mortality for pancreatic cancer (AAPC +1.0%, p = 0.04), and relatively stable trends for breast and prostate cancer. Conclusions: Nationwide real-world data reveal marked heterogeneity in cancer mortality patterns in Brazil by sex, age, region, and time. Integrated population-level data platforms enable scalable and timely assessments to support cancer surveillance and evidence-based public health decision-making.