Malignant Brain Neoplasms in Brazil: Epidemiological Trends, Mortality, and Regional Inequalities in the SUS (2015–2025)

Resumo

Background: Malignant brain neoplasms are associated with high lethality and substantial healthcare burden within Brazil’s Unified Health System (SUS), being influenced by regional disparities in access to diagnosis and specialized treatment.

Objective: To analyze morbidity, mortality, geographic distribution, and healthcare characteristics of malignant brain neoplasms in Brazil between 2015 and 2025.

Methods: Ecological, retrospective, population-based study using secondary data from the Brazilian Unified Health System Hospital Information System (SIH/SUS), available through DATASUS. All hospitalizations with a primary diagnosis of malignant brain neoplasm (ICD-10: C71) were included. Population estimates from the Brazilian Institute of Geography and Statistics (IBGE) were used to calculate rates per 100,000 inhabitants. Demographic, geographic, and healthcare-related variables, as well as hospital production associated with neurosurgical procedures, were analyzed. Statistical analysis included absolute and relative frequencies, Pearson’s chi-square test, linear regression for temporal trend analysis, and Pearson’s correlation coefficient, adopting p < 0.05.

Results: Between 2015 and 2025, 166,123 hospitalizations and 22,608 in-hospital deaths related to malignant brain neoplasms were recorded in Brazil, corresponding to an in-hospital mortality rate of 13.6%. The mean hospitalization rate was approximately 8.0 per 100,000 inhabitants, while the mean mortality rate was 1.1 per 100,000 inhabitants. A progressive increase in hospitalizations and deaths was observed throughout the study period (p < 0.05). Emergency admissions accounted for 75.7% of hospitalizations and concentrated the highest number of deaths. The Southeast region presented the highest concentration of hospitalizations, deaths, and procedures, with statistically significant regional differences (p < 0.001). A slight male predominance was observed, as well as a higher concentration of admissions and deaths among White and Brown individuals. Case fatality rates were higher among Indigenous and Black populations. A total of 70,598 hospital procedures were performed, predominantly intracranial microsurgeries and craniotomies. Procedure-related mortality was approximately 7.0%, being higher in brain biopsies and craniotomies. A negative correlation was identified between higher procedural volume and lower associated mortality (r ≈ −0.3; p < 0.05).

Conclusion: Malignant brain neoplasms represent a major public health challenge in Brazil, characterized by increasing hospital burden, high lethality, and marked regional and sociodemographic inequalities. These findings reinforce the need to strengthen healthcare networks, expand access to early diagnosis, and improve neuro-oncological care within the SUS.