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da Cunha AR, Antunes JLF. Impact of the COVID-19 pandemic on cancer mortality in Brazil. BMC Cancer 2024; 24:1125. [PMID: 39256699 DOI: 10.1186/s12885-024-12761-1] [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: 03/04/2024] [Accepted: 08/05/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND In the first year of the COVID-19 pandemic, data projections indicated an increase in cancer mortality for the following years due to the overload of health services and the replacement of health priorities. The first studies published with data from mortality records have not confirmed these projections. However, cancer mortality is not an outcome that occurs immediately, and analyses with more extended follow-up periods are necessary. This study aims to analyze the impact of the COVID-19 pandemic on the mortality from all types and the five most common types of cancer in Brazil and investigate the relationship between the density of hospital beds and mortality from COVID-19 in cancer patients in Brazil's Intermediate Geographic Regions (RGIs). METHODS The Brazilian Mortality Information System provided data on the deaths from trachea, bronchus, and lung, colorectal, stomach, female breast, and prostate cancer and all types of cancer, and from COVID-19 in individuals who had cancer as a contributing cause of death. Predicted rates for 2020-2022 were compared with the observed ones, through a rate ratio (RR). An association analysis, through multivariate linear regression, was carried out between mortality from COVID-19 in cancer patients, the rate of hospital beds per 100,000 inhabitants, and the Human Development Index of the 133 RGIs of Brazil. RESULTS In 2020, 2021, and 2022, mortality from all cancers in Brazil was lower than expected, with an RR of 0.95, 0.94, and 0.95, respectively, between the observed and predicted rates. Stomach cancer showed the largest difference between observed and expected rates: RR = 0.89 in 2020 and 2021; RR = 0.88 in 2022. Mortality from COVID-19 in cancer patients, which reached its peak in 2021 (6.0/100,000), was negatively associated with the density of hospital beds in the public health system. CONCLUSIONS The lower-than-expected cancer mortality during 2020-2022 seems to be partly explained by mortality from COVID-19 in cancer patients, which was probably underestimated in Brazil. The findings suggested a protective role of the availability of hospital care concerning deaths due to COVID-19 in this population. More extensive follow-up is needed to understand the impact of the COVID-19 pandemic on cancer mortality.
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Affiliation(s)
- Amanda Ramos da Cunha
- School of Public Health, University of São Paulo, 715 Doutor Arnaldo Ave, São Paulo-SP, 01246904, Brazil.
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Ribeiro TS, Simões TC, Silva IFD, Koifman RJ, Borges MFDSO, Opitz SP. Effects of age, period, and cohort on mortality by prostate cancer among men in the state of Acre, in the Brazilian Western Amazon. CIENCIA & SAUDE COLETIVA 2024; 29:e14782022. [PMID: 39194117 DOI: 10.1590/1413-81232024299.14782022] [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: 05/30/2023] [Accepted: 09/01/2023] [Indexed: 08/29/2024] Open
Abstract
The present study aimed to analyze the effects of age, time period, and birth cohort on the temporal evolution of mortality rates due to prostate cancer in men from the state of Acre, Brazil, in the period of 1990 to 2019. This is an ecological study in which the temporal trend was evaluated by the joinpoint method, estimating the annual percentage variations of the mortality rates. The age-period-birth cohort effects were calculated by using the Poisson Regression method, using estimation functions. The mortality rates showed an increase of 2.20% (95%CI: 1.00-3.33) in the period studied, tended to increase with age. A relative risk (RR) of 0.67 (95%CI: 0.59-0.76) was observed between 2005 and 2009, 0.76 (95%CI: 0.67-0.87) from 2005 on, and 1.44 (95%CI: 1.25-1.68) from 2015 on. The cohorts from 1910 to 1924 presented a risk reduction (RR < 1), when compared to the reference cohort (1935). Regarding the time period, the creation of public policies and the establishment of guidelines are suggested as factors which may have contributed to more access to diagnosis, in consonance with the cohort effect. These findings can contribute to a better understanding of the epidemiological scenario of prostate cancer in regions that are more vulnerable in terms of socioeconomic conditions.
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Affiliation(s)
- Thainá Souza Ribeiro
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Acre. Campus da Universidade Federal do Acre. 69917-400 Rio Branco AC Brasil.
| | | | - Ilce Ferreira da Silva
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
| | - Rosalina Jorge Koifman
- Programa de Pós-Graduação em Saúde e Meio Ambiente Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
| | | | - Simone Perufo Opitz
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Acre. Campus da Universidade Federal do Acre. 69917-400 Rio Branco AC Brasil.
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Jardim BC, Junger WL, Daumas RP, Silva GAE. [Estimation of cancer incidence in Brazil and its regions in 2018: methodological aspects]. CAD SAUDE PUBLICA 2024; 40:e00131623. [PMID: 39082568 PMCID: PMC11321612 DOI: 10.1590/0102-311xpt131623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 03/15/2024] [Accepted: 04/18/2024] [Indexed: 08/15/2024] Open
Abstract
The aim of this study was to develop a methodology for estimating cancer incidence in Brazil and its regions. Using data from population-based cancer registries (RCBP, acronym in Portuguese) and the Brazilian Mortality Information System (SIM, acronym in Portuguese), annual incidence/mortality (I/M) ratios were calculated by type of cancer, age group and sex in each RCBP. Poisson longitudinal multilevel models were applied to estimate the I/M ratios by region in 2018. The estimate of new cancer cases in 2018 was calculated by applying the estimated I/M ratios to the number of SIM-corrected deaths that occurred that year. North and Northeast concentrated the lowest I/M ratios. Pancreatic, lung, liver and esophageal cancers had the lowest I/M ratios, whereas the highest were estimated for thyroid, testicular, prostate and female breast cancers. For 2018, 506,462 new cancer cases were estimated in Brazil. Female breast and prostate were the two main types of cancer in all regions. In the North and Northeast, cervical and stomach cancers stood out. Differences in the I/M ratios between regions were observed and may be related to socioeconomic development and access to health services.
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Affiliation(s)
- Beatriz Cordeiro Jardim
- Instituto Nacional de Câncer, Rio de Janeiro, Brasil
- Instituto de Medicinal Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Washington Leite Junger
- Instituto de Medicinal Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Regina Paiva Daumas
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Gulnar Azevedo E Silva
- Instituto de Medicinal Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
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Paredes LP, da Silva Brandao Rodrigues M, Santos-Oliveira R. Deciphering Trends in Cancer Mortality: A Comprehensive Analysis of Brazilian Data From 1979 to 2021 With Emphasis on Breast and Prostate Cancers. World J Oncol 2024; 15:463-471. [PMID: 38751694 PMCID: PMC11092415 DOI: 10.14740/wjon1831] [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: 01/30/2024] [Accepted: 03/30/2024] [Indexed: 05/18/2024] Open
Abstract
Background This study examined cancer mortality trends in Brazil from 1979 to 2021, emphasizing breast and prostate cancers. Methods Utilizing data from the Brazilian Mortality Information System and the Brazilian Institute of Geography and Statistics, it analyzed cancer deaths nationally and regionally, highlighting gender-specific and regional disparities. Results The research finds that cancer death rates have been growing at an average of 12% per year, contrasting with the population growth rate of 2.2%. This trend is more pronounced in the southern and southeastern regions of Brazil. A comparison of cancer mortality rates between Brazil, the USA, and China reveals that while the Brazilian and Chinese rates exhibit slower growth, the US rate shows a continuous decline since the 1990s. Conclusions The study adopts a novel approach by focusing on growth rates and employing polynomial interpolation, revealing a deceleration in cancer death growth over the last 15 years across all malignant neoplasms. The study also contextualizes these findings within Brazil's cancer control policies, tracing the evolution of preventive measures and treatment advancements. It highlights the significant role of the National Cancer Institute and the Unified Health System in implementing effective strategies. The decreasing trend in cancer mortality rates in Brazil, despite population growth, illustrates the effectiveness of comprehensive cancer control and prevention measures, underlining their importance in public health policy.
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Affiliation(s)
- Leonardo Pires Paredes
- Brazilian Nuclear Energy Commission, Nuclear Engineering Institute, Rio de Janeiro 21941906, Brazil
| | | | - Ralph Santos-Oliveira
- Brazilian Nuclear Energy Commission, Nuclear Engineering Institute, Rio de Janeiro 21941906, Brazil
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Dias MBK, Assis MD, Santos ROMD, Ribeiro CM, Migowski A, Tomazelli JG. [Adequacy of provision of procedures for early detection of breast cancer in the Brazilian Unified National Health System: a cross-sectional study conducted in Brazil and its regions, 2019]. CAD SAUDE PUBLICA 2024; 40:e00139723. [PMID: 38775611 PMCID: PMC11111169 DOI: 10.1590/0102-311xpt139723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/13/2023] [Accepted: 11/28/2023] [Indexed: 05/24/2024] Open
Abstract
Early detection is a major strategy in breast cancer control and, for this reason, it is important to ensure access to investigation of suspected cases for care continuity and timely treatment. This study aimed to estimate the need for procedures of breast cancer early detection and assess their adequacy for providing care to screened and symptomatic women in the Brazilian Unified National Health System (SUS) in 2019. A descriptive cross-sectional study was conducted to analyze the provision of tests for breast cancer early detection, comparing the estimated need with the procedures performed in the SUS. Parameters provided by the Brazilian National Cancer Institute were used to estimate the population and the need for early detection tests. The number of procedures performed in 2019 was obtained from the Outpatient Information System of the SUS. A deficit in screening mammograms was observed in the country (-45.1%), ranging from -31.4% in the South Region to -70.5 % in the North Region. If this test was offered to the target population, the deficit in the country would reduce to -14.8% and there would be an oversupply in the South Region (6.2%). Diagnostic investigation procedures varied between the regions, with higher deficits in coarse needle biopsy (-90.8%) and breast lump biopsy/excision (-80.6%) observed in the Central-West Region, and the highest deficit in anatomopathological exams in the North Region (-88.5%). The comparison between the production and need for procedures of breast cancer early detection in Brazil and its regions identified deficits and inadequacies that must be better understood and addressed at the state and municipal levels.
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Affiliation(s)
| | | | | | | | - Arn Migowski
- Instituto Nacional de Câncer, Rio de Janeiro, Brasil
- Instituto Nacional de Cardiologia, Rio de Janeiro, Brasil
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Silva GAE, Damacena GN, Ribeiro CM, Alcantara LLDM, de Souza PRB, Szwarcwald CL. Papanicolaou test in Brazil: analysis of the National Health Survey of 2013 and 2019. Rev Saude Publica 2023; 57:55. [PMID: 37878841 PMCID: PMC10519687 DOI: 10.11606/s1518-8787.2023057004798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/26/2022] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVES To compare the coverage of cervical cancer screening in Brazil in 2013 and 2019, investigating the factors associated with having the test performed and the reasons given for not doing it. Additionally, a comparison is made concerning the time taken to receive the test result in SUS (Sistema Único de Saúde) and in the private health services. METHODS Using data from the National Health Survey (Pesquisa Nacional de Saúde - PNS), prevalence rates and corresponding confidence intervals were calculated to determine the frequency of recent cervical cancer screenings among women aged between 25 and 64 years old in Brazil, for both 2013 and 2019. Poisson regression models were employed to compare the prevalence of the outcome according to sociodemographic characteristics. The reasons for not having the test and the time between performing and receiving the result were also analyzed. RESULTS The findings revealed an increase in the coverage of preventive cervical cancer exams in Brazil from 78.7% in 2013 to 81.3% in 2019. Additionally, there was a decline in the proportion of women who had never undergone the exam, from 9.7% to 6.1%. Prevalence of test uptake was higher among white women, those with higher levels of education and income, and those residing in the South and Southeast regions of the country. The most commonly cited reasons for not taking the test were the impression it was unnecessary (45% in both 2013 and 2019) and never having been asked to undergo the test (20.6% in 2013 and 14.8% in 2019). CONCLUSIONS Despite the high coverage of screening achieved in the country, there is great inequality in access to the test, and a non-negligible number of women are at greater risk of dying from a preventable disease. Efforts must be made to structure an organized screening program that identifies and captures the most vulnerable women.
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Affiliation(s)
- Gulnar Azevedo e Silva
- Universidade do Estado do Rio de JaneiroInstituto de Medicina Social Hesio CordeiroRio de JaneiroRJBrazilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social Hesio Cordeiro. Rio de Janeiro, RJ, Brazil
| | - Giseli Nogueira Damacena
- Fundação Oswaldo CruzInstituto de Comunicação e Informação Científica e Tecnológica em SaúdeRio de JaneiroRJBrazil Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brazil
| | - Caroline Madalena Ribeiro
- Ministério da SaúdeProgramas de RastreamentoRio de JaneiroRJBrazilMinistério da Saúde. Programas de Rastreamento. Rio de Janeiro, RJ, Brazil
| | - Luciana Leite de Mattos Alcantara
- Universidade Federal do Rio de JaneiroPrograma de Engenharia BiomédicaRio de JaneiroRJBrazil Universidade Federal do Rio de Janeiro. Programa de Engenharia Biomédica. Rio de Janeiro, RJ, Brazil
| | - Paulo Roberto Borges de Souza
- Fundação Oswaldo CruzInstituto de Comunicação e Informação Científica e Tecnológica em SaúdeRio de JaneiroRJBrazil Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brazil
| | - Célia Landmann Szwarcwald
- Fundação Oswaldo CruzInstituto de Comunicação e Informação Científica e Tecnológica em SaúdeRio de JaneiroRJBrazil Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brazil
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Paglia EB, Baldin EKK, Freitas GP, Santiago TSA, Neto JBMR, Silva JVL, Carvalho HF, Beppu MM. Circulating Tumor Cells Adhesion: Application in Biosensors. BIOSENSORS 2023; 13:882. [PMID: 37754116 PMCID: PMC10526177 DOI: 10.3390/bios13090882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/23/2023] [Accepted: 09/01/2023] [Indexed: 09/28/2023]
Abstract
The early and non-invasive diagnosis of tumor diseases has been widely investigated by the scientific community focusing on the development of sensors/biomarkers that act as a way of recognizing the adhesion of circulating tumor cells (CTCs). As a challenge in this area, strategies for CTCs capture and enrichment currently require improvements in the sensors/biomarker's selectivity. This can be achieved by understanding the biological recognition factors for different cancer cell lines and also by understanding the interaction between surface parameters and the affinity between macromolecules and the cell surface. To overcome some of these concerns, electrochemical sensors have been used as precise, fast-response, and low-cost transduction platforms for application in cytosensors. Additionally, distinct materials, geometries, and technologies have been investigated to improve the sensitivity and specificity properties of the support electrode that will transform biochemical events into electrical signals. This review identifies novel approaches regarding the application of different specific biomarkers (CD44, Integrins, and EpCAm) for capturing CTCs. These biomarkers can be applied in electrochemical biosensors as a cytodetection strategy for diagnosis of cancerous diseases.
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Affiliation(s)
- Eduarda B. Paglia
- School of Chemical Engineering, Department of Process and Product Development, University of Campinas, Campinas 13083-852, Brazil; (E.B.P.); (E.K.K.B.); (G.P.F.); (T.S.A.S.)
| | - Estela K. K. Baldin
- School of Chemical Engineering, Department of Process and Product Development, University of Campinas, Campinas 13083-852, Brazil; (E.B.P.); (E.K.K.B.); (G.P.F.); (T.S.A.S.)
- Renato Archer Information Technology Center, Campinas 13069-901, Brazil;
| | - Gabriela P. Freitas
- School of Chemical Engineering, Department of Process and Product Development, University of Campinas, Campinas 13083-852, Brazil; (E.B.P.); (E.K.K.B.); (G.P.F.); (T.S.A.S.)
- Renato Archer Information Technology Center, Campinas 13069-901, Brazil;
| | - Thalyta S. A. Santiago
- School of Chemical Engineering, Department of Process and Product Development, University of Campinas, Campinas 13083-852, Brazil; (E.B.P.); (E.K.K.B.); (G.P.F.); (T.S.A.S.)
| | - João B. M. R. Neto
- Technology Center, Federal University of Alagoas, Maceió 57072-900, Brazil;
| | - Jorge V. L. Silva
- Renato Archer Information Technology Center, Campinas 13069-901, Brazil;
| | - Hernandes F. Carvalho
- Institute of Biology, Department of Structural and Functional Biology, University of Campinas, Campinas 13083-864, Brazil;
| | - Marisa M. Beppu
- School of Chemical Engineering, Department of Process and Product Development, University of Campinas, Campinas 13083-852, Brazil; (E.B.P.); (E.K.K.B.); (G.P.F.); (T.S.A.S.)
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Luizaga CTDM, Jardim BC, Wünsch V, Eluf J, Silva GAE. Recent changes in trends of mortality from cervical cancer in Southeastern Brazil. Rev Saude Publica 2023; 57:25. [PMID: 37075421 PMCID: PMC10118416 DOI: 10.11606/s1518-8787.2023057004709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/08/2022] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVE To analyze the trends of cervical cancer mortality in Brazilian Southeastern states, and to compare them to Brazil and other regions between 1980 and 2020. METHODS Time series study based on data from the Sistema de Informações de Mortalidade (Brazilian Mortality Information System). Death data were corrected by proportional redistribution of deaths from ill-defined causes and cervical cancer of unspecified portion. Age-standardized and age-specific rates were calculated by screening target (25-39 years; 40-64 years) and non-target (65 years or older) age groups. Annual percentage changes (APC) were estimated by linear regression model with breakpoints. The coverage of Pap Smear exam in the Unified Health System (SUS) was evaluated between 2009 and 2020 according to age group and locality. RESULTS There were increases in corrected mortality rates both in 1980 and in 2020 in all regions, with most evident increments at the beginning of the series. There was a decrease in mortality nationwide between 1980-2020; however, the state of São Paulo showed a discrete upward trend in 2014-2020 (APC=1.237; 95%CI 0.046-2.443). Noteworthy is the trend increment in the 25-39 year-old group in all study localities, being sharper in the Southeast region in 2013-2020 (APC=5.072; 95%CI 3.971-6.185). Screening coverage rates were highest in São Paulo and lowest in Rio de Janeiro, with a consistent decline from 2012 onwards at all ages. CONCLUSIONS São Paulo is the first Brazilian state to show a reversal trend in mortality from cervical cancer. The changes in mortality patterns identified in this study point to the need for reorganization of the current screening program, which should be improved to ensure high coverage, quality, and adequate follow-up of all women with altered test results.
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Affiliation(s)
| | - Beatriz Cordeiro Jardim
- Universidade do Estado do Rio de JaneiroInstituto de Medicina Social Hesio CordeiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social Hesio Cordeiro. Rio de Janeiro, RJ, Brasil
- nstituto Nacional de CâncerRio de JaneiroRJBrasilInstituto Nacional de Câncer. Rio de Janeiro, RJ, Brasil
| | - Victor Wünsch
- Fundação Oncocentro de São PauloSão PauloSPBrasilFundação Oncocentro de São Paulo. São Paulo, SP, Brasil
- Universidade de São PauloFaculdade de Saúde PúblicaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil
| | - José Eluf
- Universidade de São PauloFaculdade de MedicinaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Medicina. São Paulo, SP, Brasil
| | - Gulnar Azevedo e Silva
- Universidade do Estado do Rio de JaneiroInstituto de Medicina Social Hesio CordeiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social Hesio Cordeiro. Rio de Janeiro, RJ, Brasil
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Claro IB, Araújo MLC, Ribeiro CM, Dias MBK, Tomazelli J. Evaluation of histopathological examinations of the cervix diagnosed as "other neoplasms" on the Cancer Information System, Brazil, 2013-2020: a descriptive study. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2022; 31:e2022466. [PMID: 36477185 PMCID: PMC9887978 DOI: 10.1590/s2237-96222022000300012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/26/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE to describe and reclassify cervical histopathology test result diagnoses recorded as other neoplasms on the Cancer Information System (SISCAN), Brazil, 2013-2020. METHODS this was a descriptive study based on diagnoses input to the "other malign neoplasms" field on the SISCAN; a pathologist assessed the diagnoses and reclassified them based on the categories existing on the standardized record form; absolute and relative frequencies of incorrectly recorded diagnoses were calculated. RESULTS histopathology test results registered as "other malign neoplasms" accounted for 2.4% (n = 5,778) of all records, 67.4% of which in fact fell into categories already existing on the form, 8.9% were indeed other neoplasms and 24.5% were results not compatible with other neoplasms and were not covered by the form categories, such as benign findings or findings outside the cervix. CONCLUSION the "other malignant neoplasms" field is frequently misused on the SISCAN; the analysis highlighted the need to train professionals to use the system properly, as well as the need to include new categories on the form.
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Affiliation(s)
- Itamar Bento Claro
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Divisão de
Detecção Precoce e Apoio a Organização de Rede, Rio de Janeiro, RJ, Brazil
| | - Mario Lucio Cordeiro Araújo
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Seção
Integrada de Tecnologia em Citopatologia, Rio de Janeiro, RJ, Brazil
| | - Caroline Madalena Ribeiro
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Divisão de
Detecção Precoce e Apoio a Organização de Rede, Rio de Janeiro, RJ, Brazil
| | - Maria Beatriz Kneipp Dias
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Divisão de
Detecção Precoce e Apoio a Organização de Rede, Rio de Janeiro, RJ, Brazil
| | - Jeane Tomazelli
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Divisão de
Pesquisa Populacional, Rio de Janeiro, RJ, Brazil
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Temporal trends and factors associated with the cancer diagnosed at stage IV in patients included in the integrated hospital-based cancer registry system in Brazil in two decades. Cancer Epidemiol 2022; 80:102242. [PMID: 36087358 DOI: 10.1016/j.canep.2022.102242] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/16/2022] [Accepted: 08/21/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND In several countries, such as Brazil, the oncological diagnosis usually occurs at an advanced stage of the disease. Thus, the aim of this study was to investigate temporal trends and factors associated with the cancer diagnosed at stage IV in Brazil in two decades. METHODS Secondary-based study, with time series analysis for trend assessment and cross-sectional of factors associated with diagnosis of female breast, prostate, cervix uteri, colorectal, lung, stomach, lip and oral cavity, thyroid, esophagus or corpus uteri at stage IV. RESULTS 1,218,322 cases were evaluated. The types of cancer with the highest proportion of stage IV at diagnosis in men and women, respectively, were: lung (53.7% and 57.4%), stomach (48.4% and 45.0%) and lip/oral cavity (53.5% and 43.4%). Most showed an increasing trend of annual percent change of cancer diagnosed at stage IV, being more pronounced in corpus uteri cancer (2013-2019: +7.4%, p < 0.001). The odds of cancer diagnosed at stage IV were associated with different factors, according to primary tumor site, but marked by the inverse association with female sex [odds ratio (OR) ranging from 0.42 to 0.91, p < 0.001] and direct association in cases with < 7 years of study (OR ranging from 1.08 to 1.81, p < 0.001), living without a partner (OR ranging from 1.06, p < 0.050 to1.27, p < 0.001), living in the South and Southeast regions (OR ranging from 1.04 to 1.13, p < 0.001), with more than one tumor (OR ranging from 1.19, p < 0.050 to 1.54, p < 0.001) and treated in Centers of High Complexity in Oncology (OR ranging from 1.03, p < 0.050 to1.24, p < 0.001). CONCLUSION There was a high frequency of cancer diagnosed at stage IV and an increasing trend in different cancer types, which were associated with distinct sociodemographic, lifestyle, and clinical factors.
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Impact of sociodemographic factors and screening, diagnosis, and treatment strategies on colorectal cancer mortality in Brazil: A 20-year ecological study. PLoS One 2022; 17:e0274572. [PMID: 36107976 PMCID: PMC9477339 DOI: 10.1371/journal.pone.0274572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/30/2022] [Indexed: 11/19/2022] Open
Abstract
Colorectal cancer (CRC) caused 261,060 deaths in Brazil over a 20-year period, with a tendency to increase over time. This study aimed to verify the sociodemographic factors predicting higher mortality caused by CRC and survival rates. Moreover, we aimed to verify whether the performance of screening, diagnostic and treatment procedures had an impact on mortality. Ecological observational study of mortality due to CRC was conducted in Brazil from 2000–2019. The adjustment variable was age, which was used to calculate the age-standardized mortality rate (ASMR). The exposure variables were number of deaths and ASMR. Outcome variables were age-period-cohort, race classification, marital status, geographic region, and screening, diagnostic, and treatment procedures. Age-period-cohort analysis was performed. ANOVA and Kruskal-Wallis test with post hoc tests were used to assess differences in race classification, marital status, and geographic region. Multinomial logistic regression was used to test for interaction among sociodemographic factors. Survival analysis included Kaplan-Meier plot and Cox regression analysis were performed. Multivariate linear regression was used to test prediction using screening, diagnosis, and treatment procedures. In Brazil, mortality from CRC increased after age 45 years. The highest adjusted mortality rates were found among white individuals and in the South of the country (p < 0.05). Single, married, and widowed northern and northeastern persons had a higher risk of death than legally separated southern persons (p < 0.05). Lower survival rates were observed in brown and legally separated individuals and residents from the North (p < 0.05). An increase in first-line chemotherapy and a decrease in second-line chemotherapy were associated with high mortality in the north (p<0.05). In the south, second-line chemotherapy and abdominoperineal rectal resection were associated with high mortality (p < 0.05). Regional differences in sociodemographic factors and clinical procedures can serve as guidelines for adjusting public health policies.
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Prevalence, Diversity, and Risk Factors for Cervical HPV Infection in Women Screened for Cervical Cancer in Belém, Pará, Northern Brazil. Pathogens 2022; 11:pathogens11090960. [PMID: 36145392 PMCID: PMC9506000 DOI: 10.3390/pathogens11090960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Human papillomavirus (HPV) is the most common viral sexually transmitted infection of the reproductive tract, and cervical cancer is the most common HPV-related disease. This study estimated the prevalence, diversity of HPV genotypes, and associated risk factors in women screened for cervical cancer in northern Brazil. Methods: The cross-sectional study was conducted in Belém, Pará, in the Amazon region of Brazil, and it included 162 women who were spontaneously undergoing a Pap-smear routine. Epidemiological, sexual, and health-related information was collected by interviews, and cervical samples were collected for cytological examination and HPV-DNA detection. HPV genotypes were classified as low risk (LR) and high risk (HR) by nucleotide sequencing. Results: In total, 17.3% (28/162) of the participants had HPV-DNA, and LR-HPV was the most prevalent (71.4%). Among the 13 different types of HPV detected, HPV-11 was found most frequently (12/28; 42.9%), followed by HPV-31 (3/28; 10.7%). Of the participants with cytological alterations, HPV infection was detected in only four: two were diagnosed with low-grade squamous intraepithelial lesions (15.4%), one with atypical squamous cells of undetermined significance (7.7%), and one with atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesions (7.7%). Of the 61 women who presented a normal cytology, 13 (21.3%) had positive tests for HPV infection, 4 (8.2%) of which were positive for a high-risk genotype. Conclusion: The prevalence of HPV was high in Belém, Pará, and especially in women who had normal cytology results, which suggests the need for greater screening for HPV infection in women’s primary health care.
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Nogueira MC, Costa ALS, Reis JLDO, Pereira Í. Segregação Residencial Racial e Mortalidade por Câncer do Colo do Útero nas Regiões de Saúde do Brasil. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2022v68n3.2458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Introdução: O câncer do colo do útero (CCU) é um dos mais frequentes em mulheres e tem sido relacionado a baixos níveis de desenvolvimento. Objetivo: Investigar a associação entre a taxa de mortalidade padronizada por CCU e a segregação residencial racial. Método: Estudo ecológico que teve como unidade de análise as 438 Regiões de Saúde do Brasil em 2010. O desfecho foi a taxa de mortalidade por CCU em mulheres, padronizada por idade, por 100 mil mulheres. A exposição de interesse foi o Índice de Interação Racial (IIR), uma medida de segregação residencial da dimensão uniformidade, estimada a partir de dados do Censo Demográfico 2010 agregados por setores censitários. O Índice de Desenvolvimento Humano (IDH) foi covariável de controle. A associação entre as variáveis foi analisada por modelo de regressão linear. Resultados: A taxa de mortalidade por CCU teve os maiores valores nas Regiões de Saúde do Norte e do Centro-Oeste, e os menores no Sul e no Sudeste, padrão diferente do IDH e do IIR, com valores menores no Norte e no Nordeste e maiores no Sul e no Sudeste. O IIR teve associação negativa com a taxa de mortalidade; no modelo ajustado pelo IDH, cada aumento de 0,1 no IIR esteve associado à diminuição de 0,6 óbitos por 100 mil mulheres. Conclusão: A segregação residencial racial está associada à mortalidade por CCU. Os indicadores de segregação residencial deveriam ser considerados para inclusão em futuros estudos epidemiológicos como importantes determinantes contextuais do processo saúde-doença.
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Alcantara LLDM, Tomazelli J, Zeferino FRG, Oliveira BFAD, Azevedo e Silva G. Tendência Temporal da Cobertura de Mamografias no Sistema Único de Saúde, Brasil, 2010-2019. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2022v68n3.2407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Introdução: O câncer de mama no Brasil apresenta elevadas taxas de incidência e mortalidade apesar da tendência de redução da mortalidade em algumas Regiões. Objetivo: Descrever a tendência da cobertura de mamografias de rastreamento nas Macrorregiões e Estados brasileiros e identificar a influência de Políticas Nacionais voltadas ao controle do câncer de mama entre 2010-2019. Método: Foi calculada a razão entre mamografias de rastreamento na faixa etária de 50-69 anos por local de residência e subtraída a população das residentes com plano de saúde na faixa etária e no período referidos. A tendência foi avaliada pelo modelo de regressão Joinpoint. Resultados: A cobertura aumentou no Brasil de 2010-2014 e apresentou queda de 2014-2019, com aumento na proporção de exames realizados na população-alvo. Esse padrão foi observado nas demais Regiões, exceto na Centro-Oeste, porém com ano de mudança da tendência diferente. Foram identificados dois pontos de mudança no país: de 2010-2014, com tendência crescente (APC 8,7, IC 95% 6,2; 11,3), e de 2014-2019, com tendência decrescente (APC -4,2, IC 95% -5,7; -2,7), ambos significantes. A Região Nordeste foi a única com três pontos de mudança de tendência: 2010-2012 (APC 30,3, IC 95% 22,9; 38,2), 2012-2017 (APC 4,7, IC 95% 3,0; 6,4) e 2017-2019 (APC -14,9, IC 95% -19,7; - 9,8). Não foi identificada tendência para a Região Centro-Oeste. Conclusão: Houve crescimento na proporção de mamografias de rastreamento realizadas na população-alvo no período, para Brasil e Regiões, e tendência de redução na cobertura da mamografia a partir de 2014. Esses resultados indicam priorização da população-alvo do programa nas ações de rastreamento.
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Aguilar LB, Gomes CV, Lima Neto GSD, Montenegro LHF, Oliveira JCDS, Galvão ND, Melanda FN, Alves MR, Souza BDSND. Mortality trend of cancer and main types according to macroregion in the state of Mato Grosso, Brazil, 2000 to 2015. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220004. [PMID: 35766761 DOI: 10.1590/1980-549720220004.supl.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/02/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe the mortality trend from all cancers and the five main ones in the state of Mato Grosso, Brazil, from 2000 to 2015. METHODS This is a descriptive, ecological, time series study, with data referring to deaths of residents of Mato Grosso due to cancer (ICD-10 codes C00 to C97), from the Mortality Information System (SIM). Time trend analyses of the standardized mortality rate from all cancers and five specific cancers (lung, prostate, breast, colorectal and cervical) for the state and according to macroregion (South, West, North, East and Center-North) were performed using linear regression (p<0.05). RESULTS From 2000 to 2015, 28,525 deaths from all cancers in residents of the state of Mato Grosso were recorded. An increasing trend was observed for all cancers, in addition to lung, breast and colorectal cancers. The South and North macroregions showed an increasing trend for all cancers, breast and colorectal, and Center-North for breast and colorectal. East showed an increasing trend for all cancers, prostate and colorectal, and decreasing for cervical. CONCLUSION In the state of Mato Grosso, there was an increasing trend in mortality for all cancers and from specific ones, with emphasis on breast and colorectal cancer in most macroregions.
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Affiliation(s)
| | - Camila Vieira Gomes
- Universidade Federal de Mato Grosso, School of Medicine - Cuiabá (MT), Brazil
| | | | | | | | - Noemi Dreyer Galvão
- Universidade Federal de Mato Grosso, Institute of Collective Health - Cuiabá (MT), Brazil.,Mato Grosso State Health Department- Cuiabá (MT), Brazil
| | | | - Mário Ribeiro Alves
- Universidade Federal de Mato Grosso, Institute of Collective Health - Cuiabá (MT), Brazil
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Silva PFDO, Souza BDSND, Melanda FN, Soares EDFG, Bringhenti MV, Lima FCDSD, Andrade ACDS. Stomach cancer incidence and mortality in Greater Cuiabá, Mato Grosso, Brazil, 2000-2016. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220015. [PMID: 35766772 DOI: 10.1590/1980-549720220015.supl.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 03/04/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the incidence and mortality trend of stomach cancer in the Greater Cuiabá, in the state of Mato Grosso, Brazil, from 2000 to 2016. METHODS The incidence information was obtained from the Population-Based Cancer Registry, and the mortality information from the Mortality Information System. Crude and standardized rates were calculated using the direct method, with the world population as reference. The trends were estimated using the Joinpoint regression method, according to sex and age group, and evaluated through the Annual Percent Change (APC) and the Average Annual Percent Change (AAPC). The Joinpoint Regression Program software, version 4.9.0.0, was used. RESULTS There was a decreasing incidence trend of stomach cancer in males (AAPC=-5.2; 95% confidence interval - 95%CI -7.7--2.6), in men aged 60 to 69 years (AAPC=-3.7; 95%CI -5.6--1.8) and in 70-79 years (AAPC=-3.7; 95%CI -5.6--1.8), as well as in women aged 50 to 59 years (AAPC=-5.2; 95%CI -7.8--2.6) and 80 years or older (AAPC=-5.2; 95%IC -7.8--2.6). The mortality initially increased in women aged 60-69 years (AAPC=28.4; 95%CI 9.7-50.4), decreased for 80 years or older (AAPC=-26.4; 95%CI -38.0--12.6) and stable for the other age groups and males. CONCLUSION A decreasing incidence trend of stomach cancer was found among men and, when analyzed by age, among elderly males and adults and elderly females, as well as a stability in the mortality, with an initial variation in elderly women. The production of regional information supports the planning of local policies aimed at reducing the burden of disease and deaths, considering unequal risk conditions and access to health services.
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Modesto VC, Evangelista FDM, Soares MR, Alves MR, Neves MABD, Corrêa MLM, Sousa NFDSE, Galvão ND, Andrade ACDS. Cancer mortality in the State of Mato Grosso from 2000 to 2015: temporal trend and regional differences. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220005. [PMID: 35766762 DOI: 10.1590/1980-549720220005.supl.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 02/15/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To analyze the trend of standardized cancer mortality rate in the state of Mato Grosso according to health regions, from 2000 to 2015. METHODS Ecological time series study with data on deaths by cancer from the Mortality Information System. The rates were standardized using direct method and calculated by year and health regions. The annual percentage changes (APC) and respective confidence interval (95%CI) were obtained through simple linear regression. Thematic maps were built to show the spatial distribution of rates. RESULTS There were 28,525 deaths by cancer registered in Mato Grosso, with the main types being lung, prostate, stomach, breast and liver cancer. The highest mortality rates were found in regions Médio Norte, Baixada Cuiabana and Sul Mato-Grossense. From 2000 to 2015, an upward trend was seen in the mortality rate by cancer in Mato Grosso (APC=0.81%; 95%CI 0.38-1.26), and in four health regions, Garças Araguaia (APC=2.27%; 95%CI 1.46-3.08), Sul Mato-Grossense (APC=1.12%; 95%CI 0.28-1.97), Teles Pires (APC=1.93%; 95%CI 0,11-3,74) and Vale dos Arinos (APC=2.61%; 95%CI 1.10-4.70), while the other regions remained stable. CONCLUSION In the state of Mato Grosso and in the four health regions, cancer mortality rate showed a growing trend. The results point to the need to consider regional differences when thinking about actions for cancer prevention, control and assistance.
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Affiliation(s)
- Viviane Cardozo Modesto
- Universidade Federal de Mato Grosso, Postgraduate Program in Public Health - Cuiabá (MT), Brazil
| | | | - Mariana Rosa Soares
- Universidade Federal de Mato Grosso, Center for Collective Health - Cuiabá (MT), Brazil
| | - Mário Ribeiro Alves
- Universidade Federal de Mato Grosso, Postgraduate Program in Public Health - Cuiabá (MT), Brazil
| | - Marco Aurélio Bertúlio das Neves
- Universidade Federal de Mato Grosso, Center for Collective Health - Cuiabá (MT), Brazil.,Health Department of the State of Mato Grosso - Cuiabá (MT), Brazil
| | | | | | - Noemi Dreyer Galvão
- Universidade Federal de Mato Grosso, Center for Collective Health - Cuiabá (MT), Brazil.,Health Department of the State of Mato Grosso - Cuiabá (MT), Brazil
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Yu P, Xu R, Li S, Coelho MSZS, Saldiva PHN, Sim MR, Abramson MJ, Guo Y. Associations between long-term exposure to PM 2.5 and site-specific cancer mortality: A nationwide study in Brazil between 2010 and 2018. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 302:119070. [PMID: 35231538 DOI: 10.1016/j.envpol.2022.119070] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 05/21/2023]
Abstract
Long-term exposure to PM2.5 has been linked to lung cancer incidence and mortality, but limited evidence existed for other cancers. This study aimed to assess the association between PM2.5 on cancer specific mortality. An ecological study based on the cancer mortality data collected from 5,565 Brazilian cities during 2010-2018 using a difference-in-differences approach with quasi-Poisson regression, was applied to examine PM2.5-cancer mortality associations. Globally gridded annual average surface PM2.5 concentration was extracted and linked with the residential municipality of participants in this study. Sex, age stratified and exposure-response estimations were also conducted. Totalling 1,768,668 adult cancer deaths records of about 208 million population living across 5,565 municipalities were included in this study. The average PM2.5 concentration was 7.63 μg/m3 (standard deviation 3.32) with range from 2.95 μg/m3 to 28.5 μg/m3. With each 10 μg/m3 increase in three-year-average (current year and previous two years) concentrations of PM2.5, the relative risks (RR) of cancer mortality were 1.16 (95% confidence interval [CI]: 1.11-1.20) for all-site cancers. The PM2.5 exposure was significantly associated with several cancer-specific mortalities including oral, nasopharynx, oesophagus, and stomach, colon rectum, liver, gallbladder, larynx, lung, bone, skin, female breast, cervix, prostate, brain and leukaemia. No safe level of PM2.5 exposure was observed in the exposure-response curve for all types of cancer. In conclusion, with nationwide cancer death records in Brazil, we found that long-term exposure to ambient PM2.5 increased risks of mortality for many cancer types. Even low level PM2.5 concentrations had significant impacts on cancer mortality.
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Affiliation(s)
- Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | | | - Malcolm R Sim
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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Jardim BC, Migowski A, Corrêa FDM, Silva GAE. Covid-19 in Brazil in 2020: impact on deaths from cancer and cardiovascular diseases. Rev Saude Publica 2022; 56:22. [PMID: 35476100 PMCID: PMC9004704 DOI: 10.11606/s1518-8787.2022056004040] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/20/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To analyze the impact of the covid-19 pandemic on mortality from cancer and cardiovascular diseases (CVD) as underlying cause and comorbidity in Brazil and Brazilian regions in 2020. METHODS We used the 2019 and 2020 databases of the Mortality Information System (SIM) to analyze deaths occurring between March and December of each year that had cancer or CVD as the underlying cause or comorbidity. Deaths from covid-19 in 2020 were also analyzed. To estimate the Standardized Mortality Ratio (SMR) and the excess of deaths, 2019 data were considered as standard. RESULTS Between March and December 2020, there were 181,377 deaths from cancer and 291,375 deaths from cardiovascular diseases in Brazil, indicating reduction rates of 9.7% and 8.8%, respectively, compared to the same period of the previous year. The pattern was maintained in the five Brazilian regions, with lower variation for cancer (-8.4% in the South to -10.9% in the Midwest). For CVD, the variation was greater, from -2.2% in the North to -10.5 in the Southeast and South. In the same period of 2020, these diseases were classified as comorbidities in 18,133 deaths from cancer and 188,204 deaths from cardiovascular diseases, indicating a proportional excess compared to data from 2019, of 82.1% and 77.9%, respectively. This excess was most significant in the Northern Region, with a ratio of 2.5 between observed and expected deaths for the two conditions studied. CONCLUSIONS Excess deaths from cancer and CVD as comorbidities in 2020 may indicate that covid-19 had an important impact among patients with these conditions.
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Affiliation(s)
- Beatriz Cordeiro Jardim
- Instituto Nacional de CâncerCoordenação de Prevenção e VigilânciaDivisão de Detecção Precoce e Apoio à Organização de RedeRio de JaneiroRJBrasilInstituto Nacional de Câncer. Coordenação de Prevenção e Vigilância. Divisão de Detecção Precoce e Apoio à Organização de Rede. Rio de Janeiro, RJ, Brasil
- Universidade do Estado do Rio de JaneiroInstituto de Medicina Social Hésio CordeiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social Hésio Cordeiro. Rio de Janeiro, RJ, Brasil
| | - Arn Migowski
- Instituto Nacional de CâncerCoordenação de Prevenção e VigilânciaDivisão de Detecção Precoce e Apoio à Organização de RedeRio de JaneiroRJBrasilInstituto Nacional de Câncer. Coordenação de Prevenção e Vigilância. Divisão de Detecção Precoce e Apoio à Organização de Rede. Rio de Janeiro, RJ, Brasil
- Instituto Nacional de CardiologiaCoordenação de Ensino e PesquisaNúcleo de EpidemiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia. Coordenação de Ensino e Pesquisa. Núcleo de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Flávia de Miranda Corrêa
- Instituto Nacional de CâncerCoordenação de Prevenção e VigilânciaDivisão de Detecção Precoce e Apoio à Organização de RedeRio de JaneiroRJBrasilInstituto Nacional de Câncer. Coordenação de Prevenção e Vigilância. Divisão de Detecção Precoce e Apoio à Organização de Rede. Rio de Janeiro, RJ, Brasil
| | - Gulnar Azevedo e Silva
- Universidade do Estado do Rio de JaneiroInstituto de Medicina Social Hésio CordeiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social Hésio Cordeiro. Rio de Janeiro, RJ, Brasil
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Aguilar LB, Gomes CV, Lima Neto GSD, Montenegro LHF, Oliveira JCDS, Galvão ND, Melanda FN, Alves MR, Souza BDSND. Tendência da mortalidade por câncer e principais tipos segundo macrorregiões do Estado de Mato Grosso, 2000 a 2015. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220004.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: 11/22/2022] Open
Abstract
RESUMO: Objetivo: Descrever a tendência da mortalidade por todas as causas de câncer e as cinco principais causas no Estado de Mato Grosso, Brasil, no período de 2000 a 2015. Métodos: Trata-se de um estudo descritivo, ecológico, do tipo série temporal, com dados referentes aos óbitos de residentes de Mato Grosso por neoplasias (códigos C00 a C97 da Classificação Internacional de Doenças — CID-10), provenientes do Sistema de Informações sobre Mortalidade. A tendência temporal da taxa de mortalidade padronizada de todas as causas de câncer e de cinco causas específicas (pulmão, próstata, mama feminina, colorretal e colo do útero) para o Estado e segundo macrorregiões (Sul, Oeste, Norte, Leste e Centro-Norte) foi analisada por meio de regressão linear (p<0,05). Resultados: De 2000 a 2015, ocorreram 28.525 óbitos por todas as causas de câncer em residentes do Estado de Mato Grosso. Tendência crescente foi observada para todas as causas de câncer, além dos cânceres de pulmão, mama e colorretal. As macrorregiões Sul e Norte apresentaram tendência crescente para todas as causas, mama e colorretal; Centro-Norte para mama e colorretal; Leste foi crescente para todas as causas, próstata e colorretal e decrescente para colo do útero. Conclusão: No Estado de Mato Grosso, verificou-se tendência crescente de mortalidade por todas as causas de câncer e por causas específicas, com destaque para mama e colorretal na maioria das macrorregiões.
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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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Silva PFDO, Souza BDSND, Melanda FN, Soares EDFG, Bringhenti MV, Lima FCDSD, Andrade ACDS. Incidência e mortalidade por câncer de estômago na Grande Cuiabá, Mato Grosso, 2000–2016. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220015.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: 11/22/2022] Open
Abstract
RESUMO: Objetivo: Analisar a tendência da incidência e da mortalidade por câncer de estômago na Grande Cuiabá, Mato Grosso, entre 2000 e 2016. Métodos: Dados de casos novos e óbitos de residentes dos municípios Cuiabá e Várzea Grande foram obtidos no Registro de Câncer de Base Populacional e no Sistema de Informações sobre Mortalidade, respectivamente. Foram calculadas taxas brutas e padronizadas pelo método direto, utilizando-se a população mundial como referência. As tendências foram estimadas pelo método de regressão Joinpoint, segundo sexo e faixa etária, e avaliadas por meio da variação percentual anual (annual percent change — APC) e da variação percentual média anual (average annual percent change — AAPC). Utilizou-se o software Joinpoint Regression Program, versão 4.9.0.0. Resultados: Verificou-se tendência decrescente da incidência do câncer de estômago no sexo masculino (AAPC=-5,2; intervalo de confiança — IC95% −7,7–-2,6), em homens com 60–69 anos (AAPC=-3,7; IC95% −5,6–-1,8) e 70–79 anos (AAPC=-3,7; IC95% −5,6–-1,8), bem como em mulheres com 50–59 anos (AAPC=-5,2; IC95% −7,8–-2,6) e 80 anos ou mais (AAPC=-5,2; IC95% −7,8–-2,6). A mortalidade apresentou, inicialmente, aumento em mulheres com 60–69 anos (AAPC=28,4; IC95% 9,7–50,4), redução para 80 anos ou mais (AAPC=-26,4; IC95% −38,0–-12,6) e estabilidade nas demais faixas etárias e entre homens. Conclusão: Verificou-se redução da incidência de câncer de estômago em homens e, quando analisada por idade, entre homens idosos e mulheres adultas e idosas, bem como estabilidade na mortalidade, com variação inicial em idosas. A produção de informações regionais subsidia o planejamento de políticas locais que visem à redução da carga da doença e de óbitos, considerando condições desiguais de risco e acesso a serviços de saúde.
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Modesto VC, Evangelista FDM, Soares MR, Alves MR, Neves MABD, Corrêa MLM, Sousa NFDSE, Galvão ND, Andrade ACDS. Mortalidade por câncer no estado de Mato Grosso, Brasil, no período de 2000 a 2015: tendência temporal e diferenças regionais. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220005.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: 12/09/2022] Open
Abstract
RESUMO: Objetivo: Analisar a tendência da taxa padronizada de mortalidade por câncer no estado de Mato Grosso, Brasil, conforme regiões de saúde, no período de 2000 a 2015. Métodos: Estudo ecológico de séries temporais com dados de óbitos por neoplasias do Sistema de Informação sobre Mortalidade. As taxas foram padronizadas pelo método direto e calculadas por ano e por regiões de saúde. A variação anual percentual (annual percent change — APC) e seu respectivo intervalo de 95% de confiança (IC95%) foram obtidos por meio da regressão linear simples. Construíram-se mapas temáticos para descrever a distribuição espacial das taxas. Resultados: Foram registrados 28.525 óbitos por câncer em Mato Grosso, e os cinco principais tipos de câncer foram de pulmão, próstata, estômago, mama e fígado. As maiores taxas de mortalidade foram encontradas nas regiões Médio Norte, Baixada Cuiabana e Sul-Mato-Grossense. No período de 2000 a 2015 foi observada tendência crescente na taxa de mortalidade por câncer em Mato Grosso (APC=0,81%; IC95% 0,38–1,26), e em quatro regiões de saúde, Garças Araguaia (APC=2,27%; IC95% 1,46–3,08), Sul-Mato-Grossense (APC=1,12%; IC95% 0,28–1,97), Teles Pires (APC=1,93%; IC95% 0,11–3,74) e Vale dos Arinos (APC=2,61%; IC95% 1,10–4,70). As demais regiões apresentaram estabilidade. Conclusão: No estado de Mato Grosso e em quatro regiões de saúde foi verificada tendência crescente de mortalidade por câncer. Os resultados indicam a necessidade de se considerar as diferenças regionais para as ações de prevenção e assistência ao câncer e de controle.
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Affiliation(s)
| | | | | | | | | | | | | | - Noemi Dreyer Galvão
- Universidade Federal de Mato Grosso, Brazil; Health Department of the State of Mato Grosso, Brazil
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Palliative sedation in patients with advanced cancer in a specialized unit in a middle-income country: A retrospective cohort study. Palliat Support Care 2021; 20:491-495. [PMID: 34425935 DOI: 10.1017/s1478951521001371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To describe the 5-year practice on palliative sedation in a specialized palliative care unit in a deprived region in Brazil, and to compare survival of patients with advanced cancer who were and were not sedated during their end-of-life care. METHOD Retrospective cohort study in a tertiary teaching hospital. We described the practice of palliative sedation and compared the survival time between patients who were and were not sedated in their last days of life. RESULTS We included 906 patients who were admitted to the palliative care unit during the study period, of whom, 92 (10.2%) received palliative sedation. Patients who were sedated were younger, presented with higher rates of delirium, and reported more pain, suffering, and dyspnea than those who were not sedated. Median hospital survival of patients who received palliative sedation was 9.30 (CI 95%, 7.51-11.81) days and of patients who were not sedated was 8.2 (CI 95%, 7.3-9.0) days (P = 0.31). Adjusted for age and sex, palliative sedation was not significantly associated with hospital survival (hazard ratio = 0.93; CI 95%, 0.74-1.15). SIGNIFICANCE OF RESULTS Palliative sedation can be accomplished even in a deprived area. Delirium, dyspnea, and pain were more common in patients who were sedated. Median survival was not reduced in patients who were sedated.
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