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De Camargo Cancela M, Monteiro Dos Santos JE, Lopes de Souza LB, Martins LFL, Bezerra de Souza DL, Barchuk A, Hanly P, Sharp L, Soerjomataram I, Pearce A. The economic impact of cancer mortality among working-age individuals in Brazil from 2001 to 2030. Cancer Epidemiol 2023; 86:102438. [PMID: 37579673 PMCID: PMC10577440 DOI: 10.1016/j.canep.2023.102438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/02/2023] [Accepted: 08/05/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND About half of cancer deaths in Brazil occur among individuals of working-age (under 65 years for men, under 60 for women), resulting in a substantial economic impact for the country. We aimed to estimate the years of potential productive life lost (YPPLL) and value the productivity lost due to premature deaths from cancer between 2001 and 2015 and the projected to 2030. METHODS We used the Human Capital Approach to estimate the productivity losses corresponding to YPPLL for cancer deaths in working age people (15-64 years). Mortality data were obtained from the Mortality Information System from 2001 to 2015 and projected between 2016 and 2030. Economic data were obtained from the Continuous National Household Sample Survey and forecasted to 2030. Productivity lost was calculated as the monetary value arising from YPPLL in Int$(2016). RESULTS Between 2001 and 2030, a total of 2.3 million premature deaths from all cancers combined were observed and forecasted in Brazil (57% men, 43% women), corresponding to 32 million YPPLL and Int$141.3 billion in productivity losses (men: Int$102.5 billion, women: Int$38.8 billion). Between 2001 and 2030, among men, lung (Int$ 12.6 billion), stomach (Int$ 10.6 billion) and colorectal (Int$ 9.4 billion) cancers were expected to contribute to the greatest productivity losses; and among women, it will be for breast (Int$ 10.0 billion), cervical (Int$ 6.4 billion) and colorectal (Int$ 3.2 billion) cancers. CONCLUSIONS Many preventable cancers result in high lost productivity, suggesting measure to reduce smoking prevalence, alcohol consumption, physical inactivity and inadequate diet, improving screening programs and increasing vaccination coverage for human papillomavirus and hepatitis B would have a positive impact on the economy, as well as reducing morbidity and mortality from cancer.
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Affiliation(s)
- Marianna De Camargo Cancela
- Division of Surveillance and Data Analysis, Coordination of Prevention and Surveillance, Brazilian National Cancer Institute, Ministry of Health, Rio de Janeiro, Brazil.
| | - Jonas Eduardo Monteiro Dos Santos
- Division of Surveillance and Data Analysis, Coordination of Prevention and Surveillance, Brazilian National Cancer Institute, Ministry of Health, Rio de Janeiro, Brazil
| | - Leonardo Borges Lopes de Souza
- Division of Surveillance and Data Analysis, Coordination of Prevention and Surveillance, Brazilian National Cancer Institute, Ministry of Health, Rio de Janeiro, Brazil
| | - Luís Felipe Leite Martins
- Division of Surveillance and Data Analysis, Coordination of Prevention and Surveillance, Brazilian National Cancer Institute, Ministry of Health, Rio de Janeiro, Brazil
| | | | - Anton Barchuk
- Faculty of Social Sciences, Health Sciences, Tampere University, Finland
| | - Paul Hanly
- School of Business, National College of Ireland, Dublin, Ireland
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, University of Newcastle, Newcastle Upon Tyne, United Kingdom
| | | | - Alison Pearce
- Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Toledo GM, Monteiro DGA, Melo TT, Silva HJT, Averbach M. LOGISTICS AND RESULTS OF A COLORECTAL CANCER SCREENING PROGRAM IN A MUNICIPALITY IN THE HINTERLAND OF ALAGOAS. ARQUIVOS DE GASTROENTEROLOGIA 2023; 60:463-469. [PMID: 38018551 DOI: 10.1590/s0004-2803.23042023-111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/18/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Colorectal cancer (CRC) has high mortality rates worldwide. In Brazil, it is the second most common cancer in both sexes. Delay in detecting premalignant lesions contributes to increased morbidity and mortality. In this scenario, the Piranhas project was created to track CRC in a low-income population in the hinterland of Alagoas. OBJECTIVE The study aimed to establish the main strategies and verify the feasibility of implementing a CRC tracking program and demonstrate the results obtained in the CRC Prevention Campaign in Piranhas/AL. METHODS The program took place in Piranhas, Alagoas, Brazil, through public-private partnerships. Individuals aged between 50 and 70 years of age were included for screening with a fecal occult blood test (FOBT) and colonoscopy in positive cases. Patient data were collected on standard forms. RESULTS A total of 2152 patients, aged between 50 and 70 years, were screened, 130 of which underwent colonoscopy. Several preneoplastic lesions were detected in 58 patients. The adenoma detection rate (ADR) was 33.85%. CONCLUSION The study proved to be effective and viable since 44.6% of the program participants, who underwent screening with FOBT, followed by colonoscopy in positive cases, had some type of preneoplastic lesion. In addition, the program generated a significant social impact on the population of Piranhas due to the opportunity to diagnose and treat CRC precursor lesions.
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Affiliation(s)
| | | | | | | | - Marcelo Averbach
- Instituto Sírio Libanês de Ensino e Pesquisa, São Paulo, SP, Brasil
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de Pinho JHS, Riscado LVS, Sales MPM, de Souza GS, de Castro AR, Bechara CDS. Low-cost Colonoscopic Simulator and Colonoscope to Train Basic Skills in Colonoscopy during Undergraduate Studies. JOURNAL OF COLOPROCTOLOGY 2022. [DOI: 10.1055/s-0042-1757774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract
Objective To develop a low-cost simulator model and a colonoscope with materials that are easily accessible to offer training on colonoscopy skills during undergraduate studies. Since this is the procedure of choice for colorectal cancer screening, the general practitioner must be able to recognize its main indications, preparation, and complications.
Methods Using materials such as a mannequin, a vehicle inspection camera, a conduit, polyvinyl chloride (PVC) pipe, acrylic, wood, and red paint, we built a simulator and a 150-cm long and 20-to-25-mm thick colonoscope. The colonoscope's handle and handhold were made of acrylic, the colonoscope's mobile end was made with articulated PVC rings, and the up and down movements were performed according to the traction of the steel cables. The camera attached to its distal end enables connection to a smartphone to view the image. In the simulator, the conduit was inserted into the mannequin to simulate the curvatures of the colon. Red spray paint was used to simulate the staining of the colonic mucosa in the inner region of the mannequin and the adventitial layer in the outer region.
Results We were able to build a simulator and a colonoscope with a total amount of R$ 182.82 (roughly US$ 36.50). Both were tested and proved to be useful in the acquisition of psychomotor and cognitive skills in colonoscopy.
Conclusion The simulator and colonoscope developed by us are cost-effective, useful in the acquisition of psychomotor and cognitive skills in colonoscopy, and can facilitate the structuring of a training program for undergraduate students.
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dos Santos W, dos Reis MB, Porto J, de Carvalho AC, Matsushita M, Oliveira G, Syrjänen K, Reis RM, Guimarães DP. Somatic targeted mutation profiling of colorectal cancer precursor lesions. BMC Med Genomics 2022; 15:143. [PMID: 35761395 PMCID: PMC9238170 DOI: 10.1186/s12920-022-01294-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 06/16/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Most colorectal cancers (CRC) arise from precursor lesions. This study aimed to characterize the mutation profile of colorectal cancer precursor lesions in a Brazilian population.
Methods
In total, 90 formalin-fixed paraffin-embedded colorectal precursor lesions, including 67 adenomas, 7 sessile serrated lesions, and 16 hyperplastic polyps, were analyzed by next-generation sequencing using a panel of 50 oncogenes and tumor suppressor genes. The genetic ancestry of the patients was estimated.
Results
Somatic driver mutations were identified in 66.7% of cases, including alterations in APC (32.2%), TP53 (20.0%), KRAS (18.9%), BRAF (13.3%) and EGFR (7.8%). Adenomas displayed a higher number of mutations, mainly in APC, compared to serrated polyps (73.1% vs. 47.8%, p = 0.026). Advanced adenomas had a significantly higher frequency of mutation in KRAS and a high overall mutation rate than early adenomas (92.9% vs. 59%, p = 0.006). A high degree of ancestry admixture was observed in the population studied, with a predominance of European components (mean of 73%) followed by African (mean of 11.3%). No association between genetic ancestry and type of lesions was found. The mutation profile of Brazilian colorectal precursor lesions exhibits alteration in APC, KRAS, TP53, and BRAF at different frequencies according to lesion type.
Conclusions
These results bestow the knowledge of CRC's biologic history and support the potential of these biomarkers for precursor lesions detection in CRC screening of the Brazilian population.
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Carvalho AED, Souza RAGD, Galvão ND, Melanda FN, Caló RDS, Souza BDSND, Lima FCDSD, Aguilar LB. Colorectal cancer mortality trend in Mato Grosso, Brazil, 2000 to 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220007. [PMID: 35766764 DOI: 10.1590/1980-549720220007.supl.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/07/2022] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVE To analyze the time series of colorectal cancer (CRC) mortality, according to sex and age group, in Mato Grosso, Brazil, from 2000 to 2019. METHODS Ecological time series study, with standardized mortality rates from CRC (C18 to C21) among residents of Mato Grosso. Information on deaths was provided by the Mato Grosso State Health Department, comprising the Mortality Information System and demographic information obtained from the Brazilian Institute of Geography and Statistics. The joinpoint regression analysis was used in the analysis of temporal trend. RESULTS A total of 2,406 deaths from CRC were identified in Mato Grosso between 2000 and 2019. The highest rates were found among the age group from 60 to 79 years. There was an increasing trend in mortality rates among men due to CRC for almost all age groups, with the exception of those aged 40 to 49 years and 80 years and older. For women, there was a significant increase in the age groups from 50 to 59 years and 80 years and older. CONCLUSION The results showed an increase in mortality rates from CRC in the state of Mato Grosso, from 2000 to 2019, in certain age groups for both sexes, but especially for men. Knowledge about the evolution of mortality can provide data on the epidemiological situation of cancer at the local level and, thus, contribute to the development of actions to control and prevent this disease.
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Affiliation(s)
- Alessandra Emídio de Carvalho
- Universidade Federal de Mato Grosso, Institute for Collective Health, Postgraduate Program in Collective Health - Cuiabá (MT), Brazil
- Hospital Universitário Júlio Müller - Cuiabá (MT), Brazil
| | - Rita Adriana Gomes de Souza
- Universidade Federal de Mato Grosso, Institute for Collective Health, Postgraduate Program in Collective Health - Cuiabá (MT), Brazil
| | - Noemi Dreyer Galvão
- Universidade Federal de Mato Grosso, Institute for Collective Health - Cuiabá (MT), Brazil
- Mato Grosso State Health Department - Cuiabá (MT), Brazil
| | - Francine Nesello Melanda
- Universidade Federal de Mato Grosso, Institute for Collective Health, Postgraduate Program in Collective Health - Cuiabá (MT), Brazil
| | - Romero Dos Santos Caló
- Universidade Federal de Mato Grosso, Institute for Collective Health, Postgraduate Program in Collective Health - Cuiabá (MT), Brazil
| | - Bárbara da Silva Nalin de Souza
- Universidade Federal de Mato Grosso, Institute for Collective Health, Postgraduate Program in Collective Health - Cuiabá (MT), Brazil
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Datorre JG, de Carvalho AC, dos Reis MB, dos Reis M, Matsushita M, Santos F, Guimarães DP, Reis RM. Accuracy and Clinical Relevance of Intra-Tumoral Fusobacterium nucleatum Detection in Formalin-Fixed Paraffin-Embedded (FFPE) Tissue by Droplet Digital PCR (ddPCR) in Colorectal Cancer. Diagnostics (Basel) 2022; 12:114. [PMID: 35054281 PMCID: PMC8775036 DOI: 10.3390/diagnostics12010114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 12/24/2022] Open
Abstract
The use of droplet digital PCR (ddPCR) to identify and quantify low-abundance targets is a significant advantage for accurately detecting potentially oncogenic bacteria. Fusobacterium nucleatum (Fn) is implicated in colorectal cancer (CRC) tumorigenesis and is becoming an important prognostic biomarker. We evaluated the detection accuracy and clinical relevance of Fn DNA by ddPCR in a molecularly characterized, formalin-fixed, paraffin-embedded (FFPE) CRC cohort previously analyzed by qPCR for Fn levels. Following a ddPCR assay optimization and an analytical evaluation, Fn DNA were measured in 139 CRC FFPE cases. The measures of accuracy for Fn status compared to the prior results generated by qPCR and the association with clinicopathological and molecular patients' features were also evaluated. The ddPCR-based Fn assay was sensitive and specific to positive controls. Fn DNA were detected in 20.1% of cases and further classified as Fn-high and Fn-low/negative, according to the median amount of Fn DNA that were detected in all cases and associated with the patient's worst prognosis. There was a low agreement between the Fn status determined by ddPCR and qPCR (Cohen's Kappa = 0.210). Our findings show that ddPCR can detect and quantify Fn in FFPE tumor tissues and highlights its clinical relevance in Fn detection in a routine CRC setting.
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Affiliation(s)
- José Guilherme Datorre
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos 14784400, Brazil; (J.G.D.); (A.C.d.C.); (M.B.d.R.); (D.P.G.)
| | - Ana Carolina de Carvalho
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos 14784400, Brazil; (J.G.D.); (A.C.d.C.); (M.B.d.R.); (D.P.G.)
| | - Mariana Bisarro dos Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos 14784400, Brazil; (J.G.D.); (A.C.d.C.); (M.B.d.R.); (D.P.G.)
| | - Monise dos Reis
- Department of Pathology, Barretos Cancer Hospital, Barretos 14784400, Brazil; (M.d.R.); (M.M.)
| | - Marcus Matsushita
- Department of Pathology, Barretos Cancer Hospital, Barretos 14784400, Brazil; (M.d.R.); (M.M.)
| | - Florinda Santos
- Department of Medical Oncology, Barretos Cancer Hospital, Barretos 14784400, Brazil;
| | - Denise Peixoto Guimarães
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos 14784400, Brazil; (J.G.D.); (A.C.d.C.); (M.B.d.R.); (D.P.G.)
- Department of Prevention, Barretos Cancer Hospital, Barretos 14784400, Brazil
| | - Rui Manuel Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos 14784400, Brazil; (J.G.D.); (A.C.d.C.); (M.B.d.R.); (D.P.G.)
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4704553 Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4704553 Braga, Portugal
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Carvalho AED, Souza RAGD, Galvão ND, Melanda FN, Caló RDS, Souza BDSND, Lima FCDSD, Aguilar LB. Tendência da mortalidade por câncer colorretal em Mato Grosso, Brasil, de 2000 a 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220007.supl.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
RESUMO: Objetivo: Analisar a tendência temporal da mortalidade por câncer colorretal (CCR) segundo sexo e faixa etária, em Mato Grosso, Brasil, de 2000 a 2019. Métodos: Estudo ecológico de série temporal das taxas ajustadas de mortalidade pelo CCR (C18 a C21) de residentes de Mato Grosso. As informações sobre os óbitos foram fornecidas pela Secretaria de Estado de Saúde de Mato Grosso e compõem o Sistema de Informações sobre Mortalidade, e as informações demográficas foram obtidas do Instituto Brasileiro de Geografia e Estatística. Para a tendência temporal, foi empregada a análise de regressão por joinpoint. Resultados: Foram identificados 2.406 óbitos por CCR em Mato Grosso no período de 2000 a 2019. As maiores taxas foram encontradas entre as faixas etárias de 60 e 79 anos. Para os homens, evidenciou-se tendência crescente das taxas de mortalidade por CCR para quase todas as faixas etárias, com exceção das de 40 a 49 anos e de 80 anos ou mais. Para as mulheres, houve aumento significativo nas faixas etárias de 50 a 59 anos e de 80 anos ou mais. Conclusão: Os resultados do estudo mostraram aumento das taxas de mortalidade por CCR no estado do Mato Grosso, no período de 2000 a 2019, em determinadas faixas etárias de ambos os sexos, mas sobretudo para os homens. O conhecimento sobre a evolução da mortalidade pode oferecer dados da situação epidemiológica do câncer em nível local e, assim, contribuir para a elaboração de ações de controle e prevenção desse agravo.
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Affiliation(s)
| | | | - Noemi Dreyer Galvão
- Universidade Federal de Mato Grosso, Brazil; Mato Grosso State Health Department, Brazil
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Carvalho TCD, Borges AKDM, Koifman RJ, Silva IFD. Time trends in colorectal cancer incidence in four regions of Latin America: 1983-2012. CAD SAUDE PUBLICA 2021; 37:e00175720. [PMID: 34787282 DOI: 10.1590/0102-311x00175720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 02/06/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess time trends in colorectal cancer incidence from 1983 to 2012 in Latin America. This was an ecological time-series study whose population consisted of individuals aged 20 years or older diagnosed with colorectal cancer. Data from population-based cancer registries in Cali (Colombia), Costa Rica, Goiânia (Brazil), and Quito (Ecuador), were used for rates estimation, while time trends estimations were proceeded by the Joinpoint Regression Program. The study showed an increase in colorectal cancer incidence in men and women in Cali (2.8% and 3.2%, respectively), Costa Rica (3.1% and 2.1%, respectively), and Quito (2.6% and 1.2%, respectively), whereas in Goiânia, only women showed an increase in colorectal cancer rates (3.3%). For colon cancer, we observed an increasing trend in incidence rates in men and women in Cali (3.1% and 2.9%, respectively), Costa Rica (3.9% and 2.8%, respectively), and Quito (2.9% and 1.8%). For rectal cancer, we observed an increasing trend in incidence in men and women in Cali (2.5% and 2.6%, respectively), Costa Rica (2.2% and 1%, respectively), and Goiânia (5.5% and 4.6%, respectively), while in Quito only men showed an upward trend (2.8%). The study found increases in colorectal cancer, colon cancer, and rectal cancer in four Latin America regions. This findings reflect lifestyle, such as dietary changes, following the economic opening, and the prevalence variations of colorectal cancer risk factors by sex and between the four studied regions. Finally, the different strategies adopted by regions for colorectal cancer diagnosis and screening seem to influence the observed variation between anatomical sites.
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Affiliation(s)
| | | | - Rosalina Jorge Koifman
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Ilce Ferreira da Silva
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Feitosa MR, Parra RS, Freitas LFD, Camargo HPD, Rocha JJRD, Féres O. TEACHING BASIC COLONOSCOPY SKILLS: QUALITY AND SAFETY STANDARDS CAN BE FULFILLED IN AN OUTPATIENT UNIVERSITY CENTER. ARQUIVOS DE GASTROENTEROLOGIA 2021; 58:384-389. [PMID: 34705975 DOI: 10.1590/s0004-2803.202100000-64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Recent studies have shown that endoscopy fellows can perform colonoscopy effectively and safely. However, little is known about the performance of surgical residents without prior knowledge of endoscopic techniques. OBJECTIVE To assess whether quality indicators were met at an outpatient endoscopy center and whether surgical residents, without prior upper or lower endoscopy skills, could perform colonoscopy adequately. METHODS A prospective non-randomized cohort study was undertaken. All exams were performed either by assistant physicians or by residents. Quality measures were compared between those groups. RESULTS A total of 2720 colonoscopies were analyzed. In the resident group, we observed older patients (57.7±12.7 years vs 51.5±14.5 years, P<0.001), a higher prevalence of screening colonoscopies (52% vs 39.4%, P<0.001) and a higher prevalence of colorectal cancer (6.4% vs 1.8%, P<0.001). The cecal intubation rate was higher in the attending group (99.9% vs 89.3%; P<0.001). The polyp detection rate was 40.8%, and no differences were observed between the studied groups. The residents had a higher rate of perforation in all exams (0.4% vs 0%; P=0.02). Postpolypectomy bleeding and 7-day readmission rates were the same (0.2%). All readmissions in 7 days occurred due to low digestive bleeding, and none required intervention. CONCLUSION Quality indicators were met at a university outpatient endoscopy center; however, medical residents achieved lower rates of cecal intubation and higher rates of perforation than the attending physicians.
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Affiliation(s)
- Marley Ribeiro Feitosa
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Cirurgia e Anatomia, Ribeirão Preto, SP, Brasil
| | - Rogério Serafim Parra
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Cirurgia e Anatomia, Ribeirão Preto, SP, Brasil
| | - Lucas Fernandes de Freitas
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Cirurgia e Anatomia, Ribeirão Preto, SP, Brasil
| | - Hugo Parra de Camargo
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Cirurgia e Anatomia, Ribeirão Preto, SP, Brasil
| | - José Joaquim Ribeiro da Rocha
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Cirurgia e Anatomia, Ribeirão Preto, SP, Brasil
| | - Omar Féres
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Cirurgia e Anatomia, Ribeirão Preto, SP, Brasil
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da Silva WC, Godman B, de Assis Acúrcio F, Cherchiglia ML, Martin A, Maruszczyk K, Izidoro JB, Portella MA, Lana AP, Campos Neto OH, Andrade EIG. The Budget Impact of Monoclonal Antibodies Used to Treat Metastatic Colorectal Cancer in Minas Gerais, Brazil. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2021; 19:557-577. [PMID: 33506317 DOI: 10.1007/s40258-020-00626-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Biological medicines have increased the cost of cancer treatments, which also raises concerns about sustainability. In Brazil, three monoclonal antibodies (mAbs)-bevacizumab, cetuximab, and panitumumab-are indicated for the treatment of metastatic colorectal cancer (mCRC) but not currently funded by the Unified Health System (SUS). However, successful litigation has led to funding in some cases. OBJECTIVE Our objective was to evaluate the budgetary impact of including the mAbs bevacizumab, cetuximab, and panitumumab in standard chemotherapy for the treatment of mCRC within the SUS of Minas Gerais (MG), Brazil. METHOD A budget impact analysis of incorporating mAbs as first-line treatment of mCRC in MG was explored. The perspective taken was that of the Brazilian SUS, and a 5-year time horizon was applied. Data were collected from lawsuits undertaken between January 2009 and December 2016, and the model was populated with data from national databases and published sources. Costs are expressed in $US. RESULTS In total, 351 lawsuits resulted in funding for first-line treatment with mAbs for mCRC. The three alternative scenarios analyzed resulted in cost increases of 348-395% compared with the reference scenario. The use of panitumumab had a budgetary impact of $US103,360,980 compared with the reference scenario over a 5-year time horizon, and bevacizumab and cetuximab had budgetary impacts of $US111,334,890 and 113,772,870, respectively. The use of the anti-epidermal growth factor receptor (EGFR) mAbs (cetuximab and panitumumab) is restricted to the approximately 41% of patients with KRAS mutations, so the best cost alternative for incorporation would be the combination of panitumumab and bevacizumab, with a cost of approximately $US106 million. CONCLUSION These results highlight the appreciable costs for incorporating bevacizumab, cetuximab, and panitumumab into the SUS. Appreciable discounts are likely to be necessary before incorporation of these mAbs is approved.
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Affiliation(s)
- Wânia Cristina da Silva
- Postgraduate Program in Medicines and Pharmaceutical Services, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Health Economics Centre, University of Liverpool Management School, Liverpool, UK
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Francisco de Assis Acúrcio
- Postgraduate Program in Medicines and Pharmaceutical Services, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Postgraduate Program in Public Health, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Mariângela Leal Cherchiglia
- Postgraduate Program in Medicines and Pharmaceutical Services, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Postgraduate Program in Public Health, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Antony Martin
- Health Economics Centre, University of Liverpool Management School, Liverpool, UK
| | | | - Jans Bastos Izidoro
- Divisão de Medicamentos Essenciais, Departamento de Assistência Farmacêutica, Secretaria de Estado de Saúde de Minas Gerais, Belo Horizonte, Brazil
| | | | - Agner Pereira Lana
- Postgraduate Program in Public Health, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Eli Iola Gurgel Andrade
- Postgraduate Program in Medicines and Pharmaceutical Services, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Postgraduate Program in Public Health, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
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Datorre JG, de Carvalho AC, Guimarães DP, Reis RM. The Role of Fusobacterium nucleatum in Colorectal Carcinogenesis. Pathobiology 2020; 88:127-140. [PMID: 33291114 DOI: 10.1159/000512175] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 10/06/2020] [Indexed: 12/24/2022] Open
Abstract
Colorectal cancer (CRC) is one of the most frequent and deadly neoplasms worldwide. Genetic factors, lifestyle habits, and inflammation are important risk factors associated with CRC development. In recent years, growing evidence has supporting the significant role of the intestinal microbiome in CRC carcinogenesis. Disturbances in the healthy microbial balance, known as dysbiosis, are frequently observed in these patients. Pathogenic microorganisms that induce intestinal dysbiosis have become an important target to determine the role of bacterial infection in tumorigenesis. Interestingly, the presence of different bacterial strains, such as Fusobacterium nucleatum, has been detected in tissue and stool from patients with CRC and associated with substantial clinical and molecular features, as well as with patient therapy response. Therefore, understanding how the presence and levels of F. nucleatumstrains in the gut affect the risk of CRC onset and progression may inform suitable candidates for interventions focused on modulation of this bacteria. Here we review new insights into the role of gut microbiota in CRC carcinogenesis and the clinical utility of using the detection of F. nucleatum in different settings such as screening, prognosis, and microbiota modulation as a means to prevent cancer, augment therapies, and reduce adverse effects of treatment.
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Affiliation(s)
| | | | - Denise Peixoto Guimarães
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.,Department of Prevention, Barretos Cancer Hospital, Barretos, Brazil
| | - Rui Manuel Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil, .,Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal, .,ICVS/3B's-PT Government Associate Laboratory, Braga, Portugal,
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12
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Guimarães DP, Mantuan LA, de Oliveira MA, Junior RL, Costa AMD, Rossi S, Fava G, Taveira LN, Giardina KM, Talarico T, Costa M, Scapulatempo-Neto C, Matsushita MM, Véo CA, Fregnani JHT, Reis RM, Hawk ET, Mauad EC. The Performance of Colorectal Cancer Screening in Brazil: The First Two Years of the Implementation Program in Barretos Cancer Hospital. Cancer Prev Res (Phila) 2020; 14:241-252. [PMID: 32998941 DOI: 10.1158/1940-6207.capr-20-0179] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/01/2020] [Accepted: 09/22/2020] [Indexed: 11/16/2022]
Abstract
Colorectal cancer is the second most common cancer in Brazil. Yet, a nationally organized colorectal screening program is not implemented. Barretos Cancer Hospital (BCH) is one of the largest Brazilian institution that cares for underserved patients. BCH developed a fecal immunochemical test (FIT)-based organized colorectal cancer screening program to improve colorectal cancer outcomes.This study aims to present the quality/performance measures of the first 2 years of the FIT-based colorectal cancer screening program and its impact on the colorectal cancer disease stage. Between 2015 and 2017, a total of 6,737 individuals attending the Outpatient Department of Prevention or the Mobile Unit of BCH, which visits 18 cities of Barretos county, ages 50 to 65 years, were personally invited by a health agent/nurse practitioner. Exclusion criteria were personal history of colorectal cancer, adenomatous polyps, inflammatory bowel disease, and colonoscopy, or flexible sigmoidoscopy performed in the past 5 years. European Union (EU) guidelines for colorectal cancer screening programs were evaluated. Overall, 92.8% returned the FIT, with an inadequate examination rate of 1.5%. Among the 6,253 adequately tested, 12.5% had a positive result. The colonoscopy compliance and completion rates were 84.6 and 98.2%, respectively. The PPVs were 60.0%, 16.5%, and 5.6% for adenoma, advanced adenoma, and cancer, respectively. Stage distribution of screen-detected cancers shows earlier stages than clinically diagnosed colorectal cancer cancers reported at BCH and Brazilian cancer registries. Our colorectal cancer screening program achieved desirable quality metrics, aligned with the EU guidelines. The observed shift toward earlier colorectal cancer stages suggests an exciting opportunity to improve colorectal cancer-related cancers in Brazil.
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Affiliation(s)
- Denise Peixoto Guimarães
- Department of Endoscopy, Barretos Cancer Hospital, Barretos, Brazil. .,Department of Prevention, Barretos Cancer Hospital, Barretos, Brazil.,Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | | | | | | | | | - Silvana Rossi
- Department of Endoscopy, Barretos Cancer Hospital, Barretos, Brazil
| | - Gilberto Fava
- Department of Endoscopy, Barretos Cancer Hospital, Barretos, Brazil
| | | | | | - Thais Talarico
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | - Maraisa Costa
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | | | | | - Carlos Augusto Véo
- Department of Lower Digestive Surgery, Barretos Cancer Hospital, Barretos, Brazil
| | | | - Rui Manuel Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.,Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga, Portugal
| | - Ernest T Hawk
- Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Usman M, Hameed Y, Ahmad M. Does human papillomavirus cause human colorectal cancer? Applying Bradford Hill criteria postulates. Ecancermedicalscience 2020; 14:1107. [PMID: 33144875 PMCID: PMC7581335 DOI: 10.3332/ecancer.2020.1107] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Indexed: 11/04/2022] Open
Abstract
The role of human papillomavirus (HPV) in human colorectal cancer (CRC) has already been widely investigated worldwide with conflicting results. Although researchers have tried to establish the link between HPV and CRC through a statistical meta-analysis of the previous studies associating HPV with CRC, they failed to establish a more reliable link due to the shortcomings of the statistical meta-analysis. In the present study, we identified population-wide studies relating HPV with CRC through the PubMed search engine. Then, we examined the available data of HPV prevalence in CRC and normal/benign samples and applied the postulates of Bradford Hill criteria on the available evidence to investigate the association between HPV and CRC. The Bradford Hill criteria are very old, reliable and widely accepted for establishing a link between the cause and disease. In addition, to further enhance the reliability of the outcomes, we have also evaluated the methodologies of the previous studies to address the possibility of false-negative and false-positive results. After a careful evaluation of the extracted data against the postulates of Bradford Hill criteria, it was observed that none of the studies fulfil all the major postulates of Bradford Hill criteria for causation including temporality, consistency, biological gradient, experiment, coherence, specificity and analogy. Hence, no causal relationship has been suggested between HPV and CRC patients of the any included population. The results failed to prove the causal relationship between HPV and CRC and suggested HPV as a coparticipant in the pathogenesis of CRC.
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Affiliation(s)
- Muhammad Usman
- Department of Biochemistry and Biotechnology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Yasir Hameed
- Department of Biochemistry and Biotechnology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Mukhtiar Ahmad
- Department of Biochemistry and Biotechnology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
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14
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Alves CMM, Souza VGB, Bastos RR. Colorectal cancer mortality in Mato Grosso, Brazil: Spatiotemporal trends. GEOSPATIAL HEALTH 2020; 15. [PMID: 32575967 DOI: 10.4081/gh.2020.826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/27/2020] [Indexed: 06/11/2023]
Abstract
Mortality due to colorectal cancer is increasing in Brazil, but an organised approach to screening and prevention is lacking. Considering the importance of this disease, the present study examines recent mortality trends of colorectal cancer mortality in the meso- and microregions in the state of Mato Grosso with the objective of analysing spatiotemporal trends to help guide the allocation of health services related to this type of cancer. Mortality data from the Brazilian national public health system from 1996 to 2015 were analysed investigating spatiotemporal trends using Conditional Autoregressive (CAR) models, a class of Bayesian hierarchical models that rely on Markov Chain Monte Carlo (MCMC) simulations. Convergence issues arose with several types of CAR models, but notably not with the linear variant, which models the mortality within each spatial region as a linear function of time. Men and women of all ages displayed higher and increasing mortality rates in the Cuiabá and Rondonópolis microregions. Additional regions of increasing mortality were found for specific age and gender strata. It was concluded that spatiotemporal modelling is a useful tool for the characterisation of diseases, including cancer, which are influenced by several factors and need to be monitored over space and time. The combination of spatial and temporal analyses of mortality shown in this paper unveils important information regarding the small areas dynamics, which may guide discussions, regulation and application of decentralised public health policies.
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Affiliation(s)
| | - Vitor Gabriel Barra Souza
- Universidade Federal de Juiz de Fora, Departamento de Estatística, São Pedro - Juiz de Fora, Minas Gerais.
| | - Ronaldo Rocha Bastos
- Universidade Federal de Juiz de Fora, Departamento de Estatística, São Pedro - Juiz de Fora, Minas Gerais.
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15
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Age-Related and Gender-Related Increases in Colorectal Cancer Mortality Rates in Brazil Between 1979 and 2015: Projections for Continuing Rises in Disease. J Gastrointest Cancer 2020; 52:280-288. [PMID: 32248507 PMCID: PMC7900022 DOI: 10.1007/s12029-020-00399-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Purpose Brazil is the largest country in South America. Although a developing nation, birth rates have been decreasing in the last few decades, while its overall population is undergoing lifestyle changes and ageing significantly. Moreover, Brazil has had increasingly high mortality rates related to colorectal cancer (CRC). Herein, we investigated whether the Brazilian population is exhibiting increasing mortality rates related to colon cancer (CC) or rectal cancer (RC) in recent years. Methods We examined data from the Brazilian Federal Government from 1979 to 2015 to determine whether CRC mortality and the population ageing process may be associated. Results Our mathematical modelling suggests that mortality rates related to CC and RC events in the Brazilian population may increase by 79% and 66% in the next 24 years, respectively. This finding led us to explore the mortality rates for both diseases in the country, and we observed that the highest levels were in the south and southeast regions from the year 2000 onwards. CC events appear to decrease life expectancy among people during their second decade of life in recent years, whereas RC events induced decreases in life expectancy in those aged >30 years. Additionally, both CC and RC events seem to promote significant mortality rates in the male population aged > 60 years and living in the southern states. Conclusion Our dataset suggests that both CC and RC events may lead to a significantly increasing number of deaths in the Brazilian male population in coming years.
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Trends in colorectal cancer incidence in western Kazakhstan through the first decade of the screening implementation, 2009‒2018. JOURNAL OF COLOPROCTOLOGY 2020. [DOI: 10.1016/j.jcol.2019.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract
Introduction The study is aimed to outline the vector of colorectal cancer incidence in the industrial Aktobe province of western Kazakhstan through the first decade of the screening implementation, 2009–2018.
Methods Rough incidence rates and annual percent changes were estimated for each age group at diagnosis, ethnicities, gender, residences, the disease stages and anatomic subsites (total N 1128) via regression analysis.
Results Within 2009–2018 colorectal cancer rates increased from 14.74 to 23.19, with annual percent changes of 4.69%. The most significant growth was traced in men compared to women, up to 28.39 by 2018, with annual percent changes 6.64% vs. 2.64% (p = 0.0009). Annual percent changes in Kazakhs reached 8.7%, whereas Slavic groups showed decline in the incidence, annual percent changes −4.3% (p = 0.002). Declining in rates was also observed in urban population compared to rural one, annual percent changes −3.3% vs. 17.6%, respectively. Patients aged 60–69 made 31% of all cases and showed the largest annual percent changes 9.37% (p = 0.002). Patients at Stage II made 61% of all observations, but general trend evidenced sharp growth in the group of Stage I (annual percent changes 28.91%, p < 0.0001).
Conclusion Overall, during the last decade colorectal cancer incidence increased 1.5 fold with expected further rise. However, the increment of Stage I portion by 2018 vs. advanced stages at diagnosis and the trend to decrease in rates among urban population inspire a definite assurance in potential efficiency of the screening program in long run. The next researches on colorectal cancer should include scenarios to reveal the role of disadvantaged environment in the region and consuming unhealthy ultra-processed food.
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17
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Hameed Y, Usman M, Ahmad M. Does human papillomavirus have any association with human colorectal cancer? A brief and critical review of the existing literature. CLINICAL CANCER INVESTIGATION JOURNAL 2020. [DOI: 10.4103/ccij.ccij_45_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Soares SCM, dos Santos KMR, de Morais Fernandes FCG, Barbosa IR, de Souza DLB. Testicular Cancer mortality in Brazil: trends and predictions until 2030. BMC Urol 2019; 19:59. [PMID: 31277621 PMCID: PMC6611043 DOI: 10.1186/s12894-019-0487-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/19/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite the fact that testicular cancer presents good prognosis, wide variations in mortality rates have been reported internationally. In Brazil, mortality trends and estimates have not been fully assessed. The objective of the study presented herein is to analyze the mortality trends for testicular cancer in Brazil in the period 2001-2015 and calculate mortality predictions for the period 2016-2030. METHODS This is a population-based ecological study that utilized information of the Mortality Information System, on testicular cancer-related deaths in Brazil. Mortality trends were analyzed by Joinpoint regression, and Nordpred was utilized for the calculation of predictions. RESULTS The mortality rate for men, standardized to the world population, varied between 0.36/100,000 for the year 2001, to 0.41/100,000 for the year 2015. There was an increasing trend for Brazil (APC = 1.3% CI95% 0.6; 2.0) and the Southeast region (APC = 1.5% CI95%0.2; 2.7). When analyzing Brazilian data for the period 2016-2030, predictions indicate 2888 deaths due to testicular cancer, which corresponds to a 26.6% change when compared to the 2011-2015 period. This change is mostly explained by an increase in the risk of death (14.2%) when compared with modifications in the demographic structure (12.4%). CONCLUSIONS Testicular cancer mortality in Brazil presents increasing trends, and until 2030 these rates continue to increase.
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Affiliation(s)
- Samara Carollyne Mafra Soares
- Student in the Graduate Program in Collective Health, Health Science Faculty of Trairi, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | | | | | - Isabelle Ribeiro Barbosa
- Graduate Program in Collective Health, Universidade Federal do Rio Grande do Norte/Federal University of Rio Grande do Norte. Programa de Pós-Graduação em Saúde Coletiva, Avenida Senador Salgado Filho 1787, CEP: 59010-000 Lagoa Nova, Natal, RN Brazil
| | - Dyego Leandro Bezerra de Souza
- Graduate Program in Collective Health, Universidade Federal do Rio Grande do Norte/Federal University of Rio Grande do Norte. Programa de Pós-Graduação em Saúde Coletiva, Avenida Senador Salgado Filho 1787, CEP: 59010-000 Lagoa Nova, Natal, RN Brazil
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Araghi M, Soerjomataram I, Jenkins M, Brierley J, Morris E, Bray F, Arnold M. Global trends in colorectal cancer mortality: projections to the year 2035. Int J Cancer 2019; 144:2992-3000. [PMID: 30536395 DOI: 10.1002/ijc.32055] [Citation(s) in RCA: 313] [Impact Index Per Article: 62.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/01/2018] [Accepted: 11/06/2018] [Indexed: 12/24/2022]
Abstract
Colorectal cancer (CRC) is the third most common cancer worldwide and the fourth most common cause of cancer death. Predictions of the future burden of the disease inform health planners and raise awareness of the need for cancer control action. Data from the World Health Organization (WHO) mortality database for 1989-2016 were used to project colon and rectal cancer mortality rates and number of deaths in 42 countries up to the year 2035, using age-period-cohort (APC) modelling. Mortality rates for colon cancer are predicted to continue decreasing in the majority of included countries from Asia, Europe, North America and Oceania, except Latin America and Caribbean countries. Mortality rates from rectal cancer in general followed those of colon cancer, however rates are predicted to increase substantially in Costa Rica (+73.6%), Australia (+59.2%), United States (+27.8%), Ireland (+24.2%) and Canada (+24.1%). Despite heterogeneous trends in rates, the number of deaths is expected to rise in all countries for both colon and rectal cancer by 60.0% and 71.5% until 2035, respectively, due to population growth and ageing. Reductions in colon and rectal cancer mortality rates are probably due to better accessibility to early detection services and improved specialized care. The expected increase in rectal cancer mortality rates in some countries is worrisome and warrants further investigations.
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Affiliation(s)
- Marzieh Araghi
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Mark Jenkins
- University of Melbourne, Centre for MEGA Epidemiology, Carlton, Victoria, Australia
| | - James Brierley
- University of Toronto, Department of Radiation Oncology, Toronto, Ontario, Canada
| | - Eva Morris
- University of Leeds, Leeds Institute of Cancer Studies & Pathology, Division of Epidemiology & Biostatistics, St James's University Hospital, Leeds, United Kingdom
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Melina Arnold
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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de Carvalho AC, de Mattos Pereira L, Datorre JG, dos Santos W, Berardinelli GN, Matsushita MDM, Oliveira MA, Durães RO, Guimarães DP, Reis RM. Microbiota Profile and Impact of Fusobacterium nucleatum in Colorectal Cancer Patients of Barretos Cancer Hospital. Front Oncol 2019; 9:813. [PMID: 31555583 PMCID: PMC6727361 DOI: 10.3389/fonc.2019.00813] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/08/2019] [Indexed: 12/24/2022] Open
Abstract
Microbial diversity has been pointed out as a major factor in the development and progression of colorectal cancer (CRC). We sought to explore the richness and abundance of the microbial community of a series of colorectal tumor samples treated at Barretos Cancer Hospital, Brazil, through 16S rRNA sequencing. The presence and the impact of Fusobacterium nucleatum (Fn) DNA in CRC prognosis was further evaluated by qPCR in a series of 152 CRC cases. An enrichment for potentially oncogenic bacteria in CRC was observed, with Fusobacterium being the most abundant genus in the tumor tissue. In the validation dataset, Fn was detected in 35/152 (23.0%) of fresh-frozen tumor samples and in 6/57 (10.5%) of paired normal adjacent tissue, with higher levels in the tumor (p = 0.0033). Fn DNA in the tumor tissue was significantly associated with proximal tumors (p = 0.001), higher depth of invasion (p = 0.014), higher clinical stages (p = 0.033), poor differentiation (p = 0.011), MSI-positive status (p < 0.0001), BRAF mutated tumors (p < 0.0001), and the loss of expression of mismatch-repair proteins MLH1 (p < 0.0001), MSH2 (p = 0.003), and PMS2 (p < 0.0001). Moreover, the presence of Fn DNA in CRC tissue was also associated with a worse patient cancer-specific survival (69.9 vs. 82.2% in 5 years; p = 0.028) and overall survival (63.5 vs. 76.5%; p = 0.037). Here we report, for the first time, the association of F. nucleatum presence with important clinical and molecular features in a Brazilian cohort of CRC patients. Tumor detection and classification based on the gut microbiome might provide a promising approach to improve the prediction of patient outcome.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Denise Peixoto Guimarães
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
- Department of Prevention, Barretos Cancer Hospital, Barretos, Brazil
| | - Rui Manuel Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's–PT Government Associate Laboratory, Braga, Portugal
- *Correspondence: Rui Manuel Reis
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Nahas SC, Nahas CS, Bustamante-Lopez LA, Pinto RA, Marques CFS, Campos FG, Cecconello I. PROGNOSTIC FACTORS FOR LEFT COLECTOMY FOR COLON CANCER: A TEN YEARS EXPERIENCE OF A SINGLE UNIVERSITY INSTITUTION. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2018; 30:103-107. [PMID: 29257844 PMCID: PMC5543787 DOI: 10.1590/0102-6720201700020006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 04/05/2017] [Indexed: 12/26/2022]
Abstract
Background: Colorectal cancer is the third most common cancer in the world. In Brazil, it is the leading cause of cancer in the gastrointestinal tract. Aim: To evaluate the preoperative, perioperative, and postoperative risk factors for recurrence and overall survival of patients with left colon cancer operated during a ten-year period. Methods: Patients with left colon cancer surgically treated underwent clinical preoperative workout and cancer staging. The following factors were studied: gender, age, tumor location, T stage, lymph node yield, N stage, M stage, histological type, and tumor differentiation. It was analyzed the influence in five-year overall survival. Results: A total of 173 patients underwent left colectomy for colon cancer. There was a slight predominance of male gender with 50.9%. The mean age was 60.8 years old. Fifteen (8.7%) tumors were located at splenic flexure, 126 (72.8%) at sigmoid colon, and 32 (18.5%) at descending colon. The median length of hospital stay was seven days. Mean survival was 47.5 months. At 60 months seven patients (4%) lost follow-up, 38 patients (21.9%) deceased and 135 patients (78%) were alive. Overall survival time was 48 months. Conclusion: Advanced stages (T3-T4, N+ and M+) were the only factors associated with poor long term survival in left colon cancer.
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Affiliation(s)
- Sergio Carlos Nahas
- Gastroenterology Department, Clinic Hospital, University of São Paulo, São Paulo, SP, Brazil
| | - Caio Sergio Nahas
- Gastroenterology Department, Clinic Hospital, University of São Paulo, São Paulo, SP, Brazil
| | | | - Rodrigo Ambar Pinto
- Gastroenterology Department, Clinic Hospital, University of São Paulo, São Paulo, SP, Brazil
| | | | - Fabio Guilherme Campos
- Gastroenterology Department, Clinic Hospital, University of São Paulo, São Paulo, SP, Brazil
| | - Ivan Cecconello
- Gastroenterology Department, Clinic Hospital, University of São Paulo, São Paulo, SP, Brazil
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Oliveira AGD, Curado MP, Koechlin A, Oliveira JCD, Silva DRME. Incidence and mortality from colon and rectal cancer in Midwestern Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 19:779-790. [PMID: 28146167 DOI: 10.1590/1980-5497201600040008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 05/31/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: To describe the incidence and mortality rates from colon and rectal cancer in Midwestern Brazil. Methods: Data for the incidence rates were obtained from the Population-Based Cancer Registry (PBCR) according to the available period. Mortality data were obtained from the Mortality Information System (SIM) for the period between 1996 and 2008. Incidence and mortality rates were calculated by gender and age groups. Mortality trends were analyzed by the Joinpoint software. The age-period-cohort effects were calculated by the R software. Results: The incidence rates for colon cancer vary from 4.49 to 23.19/100,000, while mortality rates vary from 2.85 to 14.54/100,000. For rectal cancer, the incidence rates range from 1.25 to 11.18/100,000 and mortality rates range between 0.30 and 7.90/100,000. Colon cancer mortality trends showed an increase among males in Cuiabá, Campo Grande, and Goiania. For those aged under 50 years, the increased rate was 13.2% in Campo Grande. For those aged over 50 years, there was a significant increase in the mortality in all capitals. In Goiânia, rectal cancer mortality in males increased 7.3%. For females below 50 years of age in the city of Brasilia, there was an increase of 8.7%, while females over 50 years of age in Cuiaba showed an increase of 10%. Conclusion: There is limited data available on the incidence of colon and rectal cancer for the Midwest region of Brazil. Colon cancer mortality has generally increased for both genders, but similar data were not verified for rectal cancer. The findings presented herein demonstrate the necessity for organized screening programs for colon and rectal cancer in Midwestern Brazil.
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Affiliation(s)
| | - Maria Paula Curado
- Postgraduate Program in Health Sciences, Universidade Federal de Goiás - Goiânia (GO), Brazil.,Epidemiology Department, International Center for Research, A.C. Camargo Cancer Center - São Paulo (SP), Brazil.,International Prevention Research Institute - Écully, France
| | - Alice Koechlin
- International Prevention Research Institute - Écully, France
| | - José Carlos de Oliveira
- Population-Based Cancer Registry of Goiânia, Association Against Cancer of Goiás - Goiânia (GO), Brazil
| | - Diego Rodrigues Mendonça E Silva
- Postgraduate Program in Health Sciences, Universidade Federal de Goiás - Goiânia (GO), Brazil.,Epidemiology Department, International Center for Research, A.C. Camargo Cancer Center - São Paulo (SP), Brazil
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Gasparini B, Valadão M, Miranda-Filho A, Silva CMFPD. [Analysis of the age-period-cohort effect on mortality from colorectal cancer in Rio de Janeiro State, Brazil, from 1980 to 2014]. CAD SAUDE PUBLICA 2018; 34:e00038017. [PMID: 29538496 DOI: 10.1590/0102-311x00038017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 10/09/2017] [Indexed: 01/13/2023] Open
Abstract
The aim of this study was to estimate the contribution of the effect of age, period, and birth cohort on mortality from colorectal cancer. The study analyzed data on deaths from this cancer in individuals over 35 years of age in Rio de Janeiro State, Brazil, obtained from the Mortality Information System (SIM) from 1980 to 2014. Mortality rates were calculated by gender and age bracket. The effect of age, period, and birth cohort was estimated by the method that uses estimable functions: deviations, curves, and drift in the Epi library of the R software. Standardized mortality rates from colorectal cancer were 27.37/100,000 men and 21.83/100,000 women in 2014. The data showed an increase in mortality from this cancer from 1980 to 2014, and mortality rates were higher in men than in women after the 1990s. Age effect was observed with an increase in the rates and aging. Generational analysis showed lower risk of death in older versus younger cohorts, possibly related to the adoption of the Western lifestyle. This scenario underscores the need for screening strategies aimed at early diagnosis and treatment of precursor lesions.
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Affiliation(s)
- Brenda Gasparini
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de janeiro, Brasil
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brasil
| | - Marcus Valadão
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brasil
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DUTRA VGP, PARREIRA VAG, GUIMARÃES RM. EVOLUTION OF MORTALITY FOR COLORECTAL CANCER IN BRAZIL AND REGIONS, BY SEX, 1996-2015. ARQUIVOS DE GASTROENTEROLOGIA 2018; 55:61-65. [DOI: 10.1590/s0004-2803.201800000-12] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/13/2017] [Indexed: 11/22/2022]
Abstract
ABSTRACT BACKGROUND: Colorectal cancer is among the three most frequent neoplasms in Brazil, being a public health problem. OBJECTIVE: To describe distribution pattern of colorectal cancer mortality in Brazil and regions, according to sex, between 1996 and 2015. METHODS: Values of standardized and stratified mortality rates by sex between 1996 and 2015 were used, through polynomial regression models and joinpoint analysis. RESULTS: It was observed that, for linear trends in mortality rates, for both sexes, there is a statistically significant trend increasing in both models, with rates and trends, and higher for men than for women, respectively, 7.3% per year (R2=0.95, P<0.001) and 6.5% per year (R2=0.87, P<0.001). It is observed a difference in magnitude and behavior of trend between the regions. CONCLUSION: It is understood that it is important to know the trend of rates in order to define priority populations for early interventions that increase survival and reduce mortality.
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Teixeira CR, Bonotto ML, Lima JP, Figueiredo LF, Conrado L, Frasca C. Clinical impact of the immunochemical fecal occult blood test for colorectal cancer screening in Brazil. Ann Gastroenterol 2017; 30:442-445. [PMID: 28655982 PMCID: PMC5479998 DOI: 10.20524/aog.2017.0151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/03/2017] [Indexed: 11/24/2022] Open
Abstract
Background Colorectal cancer (CRC) screening programs based on the fecal occult blood test (FOBT) reduce CRC mortality. We carried out an observational prospective study to determine the accuracy of immunochemical FOBTs for the detection of CRC in individuals at average risk for the disease. Methods This population-based study was performed between April 2015 and January 2016 in two gastroenterology referral centers in Southern Brazil. It included 1039 average-risk volunteers aged 50-75 years who were symptom-free for colonic disease. Participants underwent OC-Light immunochemical fecal occult blood test (i-FOBT, EIKEN chemical Co., Tokyo, Japan) as well as screening colonoscopy. Results Nine hundred forty-eight (91.2%) of the 1039 participants completed and returned the i-FOBT (95% confidence interval [CI] 89.4-92.9). Among the 73 participants with a positive i-FOBT who underwent colonoscopy, advanced CRC was detected in 9 (12.3%). Two (2.7%) early CRCs, 7 (9.5%) high-grade dysplasia adenomas and 25 (34.2%) low-grade dysplasia adenomas were also diagnosed. Among the 243 negative i-FOBT cases who underwent colonoscopy, one (0.4%) advanced CRC and 91 (37.6%) low-grade dysplasia adenomas were detected. The detection rate of CRC considering the whole screened population (n=1039) was 1.05% (11/1039). Conclusions The i-FOBT test in the CRC screening programs in Brazil showed a high compliance and high detection rates for cancers and high-risk adenomas. The i-FOBT test is feasible for CRC screening in an average-risk population.
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Affiliation(s)
- Cláudio R Teixeira
- Department of Endoscopy, Moinhos de Vento Hospital (Cláudio R. Teixeira, Michele L. Bonotto, Júlio P. Lima, Luciana F. Figueiredo, Leonardo Conrado, Carlos Frasca)
| | - Michele L Bonotto
- Department of Endoscopy, Moinhos de Vento Hospital (Cláudio R. Teixeira, Michele L. Bonotto, Júlio P. Lima, Luciana F. Figueiredo, Leonardo Conrado, Carlos Frasca).,Gastroenterology Fundation of Rio Grande do Sul, Fugast, Endoscopy Unit (Michele L. Bonotto, Júlio P. Lima, Luciana F. Figueiredo, Leonardo Conrado, Carlos Frasca), Brazil
| | - Júlio P Lima
- Department of Endoscopy, Moinhos de Vento Hospital (Cláudio R. Teixeira, Michele L. Bonotto, Júlio P. Lima, Luciana F. Figueiredo, Leonardo Conrado, Carlos Frasca).,Gastroenterology Fundation of Rio Grande do Sul, Fugast, Endoscopy Unit (Michele L. Bonotto, Júlio P. Lima, Luciana F. Figueiredo, Leonardo Conrado, Carlos Frasca), Brazil
| | - Luciana F Figueiredo
- Department of Endoscopy, Moinhos de Vento Hospital (Cláudio R. Teixeira, Michele L. Bonotto, Júlio P. Lima, Luciana F. Figueiredo, Leonardo Conrado, Carlos Frasca).,Gastroenterology Fundation of Rio Grande do Sul, Fugast, Endoscopy Unit (Michele L. Bonotto, Júlio P. Lima, Luciana F. Figueiredo, Leonardo Conrado, Carlos Frasca), Brazil
| | - Leonardo Conrado
- Department of Endoscopy, Moinhos de Vento Hospital (Cláudio R. Teixeira, Michele L. Bonotto, Júlio P. Lima, Luciana F. Figueiredo, Leonardo Conrado, Carlos Frasca).,Gastroenterology Fundation of Rio Grande do Sul, Fugast, Endoscopy Unit (Michele L. Bonotto, Júlio P. Lima, Luciana F. Figueiredo, Leonardo Conrado, Carlos Frasca), Brazil
| | - Carlos Frasca
- Department of Endoscopy, Moinhos de Vento Hospital (Cláudio R. Teixeira, Michele L. Bonotto, Júlio P. Lima, Luciana F. Figueiredo, Leonardo Conrado, Carlos Frasca).,Gastroenterology Fundation of Rio Grande do Sul, Fugast, Endoscopy Unit (Michele L. Bonotto, Júlio P. Lima, Luciana F. Figueiredo, Leonardo Conrado, Carlos Frasca), Brazil
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Pelizzer T, Dias CP, Poeta J, Torriani T, Roncada C. Prevalência de câncer colorretal associado ao papilomavírus humano: uma revisão sistemática com metanálise. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2016; 19:791-802. [DOI: 10.1590/1980-5497201600040009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 08/31/2016] [Indexed: 01/05/2023] Open
Abstract
RESUMO: Introdução: O câncer colorretal é um dos tipos de tumor mais prevalentes na população mundial. A mortalidade causada por esses tumores malignos continua elevada e mantém-se praticamente no mesmo nível nas últimas décadas. Entre os fatores de risco já estabelecidos para o desenvolvimento do câncer estão as infecções por patógenos ou vírus. Entre os vírus, o papilomavírus humano (HPV) é o mais prevalente, tendo mais de 180 cepas, das quais 40 estão diretamente relacionadas com infecções anogenitais. Objetivo: Avaliar de forma sistemática, com metanálise, os principais estudos que associam o HPV ao câncer colorretal. Métodos: Como estratégia de busca foi adotada a lógica baseada em descritores específicos (idioma inglês), vinculados aos operadores booleanos (AND/OR). As buscas foram aplicadas nas bases de dados PubMed, ScienceDirect e Scientific Electronic Library Online (SciELO), no período de abril e maio de 2015. Resultados: Foram avaliadas 1.549 amostras, sendo 956 (61,7%) do sexo masculino. Foram diagnosticados 630/1.358 casos de câncer colorretal por HPV (51,9%). Destes, 408/767 (51,9%) eram do sexo masculino e 404/598 (67,5%) foram associados aos HPVs 16 e 18, com prevalência tumoral na região do colo (253/411; 61,3%). Do total de 598 amostras para estimativa das prevalências de HPV-16 e HPV-18, a quantidade de casos com valores muito semelhantes foi de 204 (31,7%) e 200 (35,8%), respectivamente. Foram verificados valores relativamente expressivos na região do colo, 253 (61,3%), e na região retal, 158 (38,7%). Conclusão: Após a realização do presente estudo, a associação entre HPV e câncer colorretal ficou evidente, não havendo distinção entre gêneros, com valores muito semelhantes entre o HPV-16 e o HPV-18.
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Affiliation(s)
| | | | - Julia Poeta
- Faculdade da Serra Gaúcha, Brazil; Universidade Federal do Rio Grande do Sul, Brazil
| | - Tânia Torriani
- Faculdade da Serra Gaúcha, Brazil; Universidade Feevale, Brazil
| | - Cristian Roncada
- Faculdade da Serra Gaúcha, Brazil; Pontifícia Universidade Católica do Rio Grande do Sul, Brazil
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de Souza Giusti ACB, de Oliveira Salvador PTC, dos Santos J, Meira KC, Camacho AR, Guimarães RM, Souza DLB. Trends and predictions for gastric cancer mortality in Brazil. World J Gastroenterol 2016; 22:6527-6538. [PMID: 27605887 PMCID: PMC4968132 DOI: 10.3748/wjg.v22.i28.6527] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/18/2016] [Accepted: 06/13/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To analyze the effect of age-period and birth cohort on gastric cancer mortality, in Brazil and across its five geographic regions, by sex, in the population over 20 years of age, as well as make projections for the period 2010-2029.
METHODS: An ecological study is presented herein, which distributed gastric cancer-related deaths in Brazil and its geographic regions. The effects of age-period and birth cohort were calculated by the Poisson regression model and projections were made with the age-period-cohort model in the statistical program R.
RESULTS: Progressive reduction of mortality rates was observed in the 1980’s, and then higher and lower mortality rates were verified in the 2000’s, for both sexes, in Brazil and for the South, Southeast and Midwest regions. A progressive decrease in mortality rates was observed for the Northeast (both sexes) and North (men only) regions within the period 1995-1999, followed by rising rates.
CONCLUSION: Regional differences were demonstrated in the mortality rates for gastric cancer in Brazil, and the least developed regions of the country will present increases in projected mortality rates.
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Parreira VG, Meira KC, Guimarães RM. Socioeconomic differentials and mortality from colorectal cancer in large cities in Brazil. Ecancermedicalscience 2016; 10:614. [PMID: 26823683 PMCID: PMC4720492 DOI: 10.3332/ecancer.2016.614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Indexed: 12/29/2022] Open
Abstract
The objective of this study was to compare the mortality pattern of colorectal cancer according to the social development profile of the large Brazilian cities. This was an ecological study that used as units of analysis Brazilian municipalities that were considered to be large (i.e. over 100,000 inhabitants). The social indicators adopted were obtained from the Atlas of Human Development in Brazil. Mortality data came from the Mortality Information System (MIS), represented by codes C18, C19, and C20. For data analysis, municipalities were characterised according to the indicator profile used by multivariate classification cluster analysis. It was observed that the Southeast, South, and Midwest regions concentrated over 90% of cities in the group of more developed municipalities, while the North and Northeast regions were represented by 60% of cities in the group of less developed municipalities. The mortality pattern of colorectal cancer in both groups was different, with a higher average mortality rate from colorectal cancer for populations living in cities from the more developed group (p = 0.02). The mortality rate from this cancer was shown to be directly proportional to the Municipal Human Developlemnt Index (MHDI) and inversely proportional to the inequality indicator (p < 0.001); therefore the highest means were observed among the municipalities with better socioeconomic conditions. It is important to consider social disparities to ensure equity in healthcare policy management.
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Affiliation(s)
| | - Karina Cardoso Meira
- Universidade Federal do Rio Grande do Norte, Escola de Enfermagem de Natal, Brazil
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Barbosa IR, Souza DLBD, Bernal MM, Costa ÍDCC. Cancer mortality in Brazil: Temporal Trends and Predictions for the Year 2030. Medicine (Baltimore) 2015; 94:e746. [PMID: 25906105 PMCID: PMC4602680 DOI: 10.1097/md.0000000000000746] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 03/04/2015] [Accepted: 03/17/2015] [Indexed: 12/29/2022] Open
Abstract
Cancer is currently in the spotlight due to their heavy responsibility as main cause of death in both developed and developing countries. Analysis of the epidemiological situation is required as a support tool for the planning of public health measures for the most vulnerable groups. We analyzed cancer mortality trends in Brazil and geographic regions in the period 1996 to 2010 and calculate mortality predictions for the period 2011 to 2030.This is an epidemiological, demographic-based study that utilized information from the Mortality Information System on all deaths due to cancer in Brazil. Mortality trends were analyzed by the Joinpoint regression, and Nordpred was utilized for the calculation of predictions.Stability was verified for the female (annual percentage change [APC] = 0.4%) and male (APC = 0.5%) sexes. The North and Northeast regions present significant increasing trends for mortality in both sexes. Until 2030, female mortality trends will not present considerable variations, but there will be a decrease in mortality trends for the male sex. There will be increases in mortality rates until 2030 for the North and Northeast regions, whereas reductions will be verified for the remaining geographic regions. This variation will be explained by the demographic structure of regions until 2030.There are pronounced regional and sex differences in cancer mortality in Brazil, and these discrepancies will continue to increase until the year 2030, when the Northeast region will present the highest cancer mortality rates in Brazil.
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Affiliation(s)
- Isabelle R Barbosa
- From the Graduate Program in Collective Health (IRB); Department of Collective Health (DLBDS); Department of Odontology, Federal University of Rio Grande do Norte, Natal, Brazil (IDCCC); Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (MMB)
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