Incidence and mortality by pulmonary tuberculosis in Brazil: Trends and projections, 2002-2034

• The North region presented the worst scenario in the country. • High adjusted incidence and mortality rates were observed among men. • In general, the incidence and mortality decreased in Brazil by 2034. • Among females, there was a reduction in the risk of dying from tuberculosis. • It was projected an increase in death risk in the North, South, and Center-west. To analyze the temporal trend of incidence and mortality from pulmonary tuberculosis in Brazil from 2002 to 2019, and to project these trends until 2034. Ecological study with tuberculosis cases extracted from the Disease Notification and Mortality System in Brazil from 2002 to 2019. The age-period-cohort model was used for projection until 2034 using R. Subsequently, the percentage variation was estimated using Joinpoint. Brazil recorded 1,093,070 new cases and 76,205 deaths from 2002-2019, and projections util 2035-2034 estimated 1,192,092 new cases and 67,532 deaths. The North region had the highest standardized incidence and mortality rates in the country for both sexes. An increase in deaths among men and reduction among women was projected, along with an increase in incidence in both sexes. About 36% of the increase in incidence and 34.1% of the mortality among men was explained by a rise in disease risk. Among women, 11.7% of the increase in incidence was due to population growth, while 44.8% of the reduction in deaths was due to lower risk. The North presented the worst scenario in the country. The projections are not favorable to the globally established targets. An increase in incidence was projected for both men and women, with an increase in deaths only among men. More efforts are needed to change this potential scenario.