Data quality in Brazilian population-based cancer registries for gastrointestinal cancers.

BACKGROUND: Population-based cancer registries (PBCRs) are the primary source of information for cancer surveillance and monitoring. Currently, there are 30 active PBCRs in Brazil. The objective of this study was to analyze the data quality of five gastrointestinal cancers (esophagus, stomach, colorectal, liver, and pancreas) according to the criteria of comparability, validity, completeness, and timeliness in Brazilian cancer registries. METHODS: This study included data from Brazilian PBCRs with more than ten years of historical data starting in the year 2000, regardless of the type of defined geographical coverage (state, metropolitan region, or capital), totaling 16 registries. Brazilian PBCRs were evaluated based on four international data quality criteria: comparability, validity (accuracy), completeness, and timeliness. All cancer cases were analyzed, except for nonmelanoma skin cancer cases (C44) and five gastrointestinal tumors (esophageal cancer, stomach cancer, colorectal cancer, liver cancer, and pancreatic cancer) per cancer registry and sex, according to the available period. RESULTS: The 16 Brazilian PBCRs represent 17% of the population (36 million inhabitants in 2021) according to data from 2000 to 2018. There was a variation in the incidence in the historical series ranging from 12 to 19 years. The proportion of morphologically verified (MV%) cases varied from 74.3% (Manaus) to 94.8% (Aracaju), and the proportion of incidentally reported death certificate only (DCO%) cases varied from 3.0% (São Paulo) to 23.9% (Espírito Santo). High-lethality malignant neoplasms, such as liver and pancreas, had DCO percentages greater than 30% in most cancer registries. The sixteen registries have more than a 48-month delay in data release compared to the 2022 calendar year. CONCLUSION: The studied Brazilian cancer registries met international comparability criteria; however, half of the registries showed indices below the expected levels for validity and completeness criteria for high-lethality tumors such as liver and pancreas tumors, in addition to a long delay in data availability and disclosure. Significant efforts are necessary to ensure the operational and stability of the PBCR in Brazil, which continues to be a tool for monitoring cancer incidence and assessing national cancer control policies.

Survival trends in gastric cancer in Brazil: real-life data from a large cancer center.

Background: Gastric cancer (GC) is the fourth leading cause of cancer deaths globally. There is a paucity of real-life data on GC in Brazil. Our study aimed to evaluate survival trends in gastric adenocarcinoma (GA) in a large cancer center in Brazil during 2000-2017. Methods: Based on our Hospital Cancer Registry Database, all individuals diagnosed with GA between 2000 and 2017, and treated at A.C. Camargo Cancer Center, were retrospectively included. The primary objectives were to describe the patient demographics, clinicopathological characteristics, treatment modalities and survival trends during four separate periods of diagnosis (2000-2004; 2005-2009; 2010-2014 and 2015-2017). χ2 test was performed between two specified periods (2000-2004 and 2015-2017) to compare categorical variables. Overall survival (OS) curves were stratified by four separate periods and compared with log-rank tests. Results: This analysis included 1,406 individuals. Across all periods, most patients were men aged 50-69 and presented with Lauren's intestinal subtype. The frequency of stage IV disease significantly decreased between 2000-2004 and 2015-2017 (43.6% to 32.8%, p < 0.001). In contrast, we observed a rise in stage II (9.4% to 24.8%, p < 0.001) in the same comparison. We noticed an increased utilization of a combined approach involving chemotherapy and surgery (12% in 2000-2004 and 36.3% in 2015-2017, p < 0.001). The predicted 5-year OS of patients with GA in 2000-2004 was 27.8%, which increased to 53.9% in 2015-2017 (p < 0.001). Conclusion: Our retrospective cohort showed an upward trend in survival rates during the period. We observed that 5-year OS almost doubled among men and women during 2000-2017. Mini Abstract: The present retrospective cohort showed an upward trend in survival rates during the period from 2000 to 2017, in which the OS almost doubled among men and women.

The impact of the human development index on stomach cancer incidence in Brazil.

Background: The incidence of stomach cancer (SC) is declining in most countries in the world, potentially associated with increases in the human development index (HDI). This study was conducted to characterise the incidence and trends of SC in the Brazilian population and its correlations with HDI components: longevity, education and income. Methods: Data on incidence of SC from Population-based cancer registries (PBCR) in Brazil during the period 1988-2017 were extracted from the Instituto Nacional de Câncer. Incidence rates were estimated for each PBCR in the same calendar period. Trends were analysed using the Joinpoint Regression Program, and correlations with HDI components (longevity, education and income) were examined using the Pearson test. Results: SC incidence rates in Brazil ranged from 22 to 89/100,000 among men and from 8 to 44/100,000 among women. The highest incidence rates for men and women occurred in northern Brazil. The SC incidence is stable in most of the capitals of the northern and northeast parts of the country, with reductions for both sexes in the South, Southeastern and Midwest. There was an inverse correlation of SC incidence rates for women with the components of HDI education (p = 0.038) and longevity (p = 0.012). For men, the inverse correlation occurred for the longevity HDI (p = 0.013). Conclusion: The improvement of HDIs in Brazil during the study period may have contributed to the stability of SC incidence but was not sufficient to reduce the overall SC incidence in the whole country. To better understand SC incidence in Brazil, efforts should be made towards ensuring that incidence data is recorded by PBCRs promptly.

Children and adolescents cancer incidence, mortality and survival a population-based study in Midwest of Brazil.

OBJECTIVE: To identify time trends in incidence, mortality and 5-year relative survival in children and adolescents with cancer in Goiania-Goias, Brazil, during the years of 1996-2012. METHODS: Incidence and mortality age-standardized rates (ASR) were calculated, and trends were identified by determining the Average Annual Percentage Change (AAPC). Five-year relative survival were estimated. RESULTS: The overall incidence ASR (1996-2012) was 164.2/1,000,000 in both genders. In boys was 176.6/1,000,000, in girls it was 151.8/1,000,000. Overall mortality ASR for both gender were 69.3/1,000,000. Incidence rates (AAPC: -0.5; 95 %CI: -2.4;1.4) and mortality rates (AAPC: 0.0; 95 %CI: -2.6;2;7) were stable in the period. Five-year relative survival for all cancers were 63.9 %, with the highest survival rates for retinobastoma (83.5 %), germ cell tumors (79.8 %), and lymphomas (72.7 %). It was observed an increase in survival in the period from de 62.8 % (1996 a 2003) to 65.0 % from 2004 to 2012. CONCLUSIONS: Children and adolescent cancer incidence and mortality rates were higher in Goiania, but both are stable overall. The relative survival slighly improved in the period but remained lower mainly for leukemias.

High incidence of esophageal cancer in central-western Brazil: a migrant effect?

To determine the incidence and mortality rates of esophageal cancer in central-western Brazil: Goiânia, Brasília, Cuiabá, and Campo Grande, incidence data for Cuiabá (2000-2005) and Brasília (1999-2002) were obtained from the National Cancer Institute, and data from Goiânia (1995-2008) from the Population-Based Cancer Registry of Goiânia. Mortality data for the cities of central-western Brazil were obtained for the period 1980-2008 from the Ministry of Health. Age-standardized incidence and mortality rates were calculated using the world population of Segi. Mortality trends were assessed with the Joinpoint Regression Program and a P value less than 0.05 was defined as significant. The highest incidence of esophageal cancer among men was in Cuiabá (16.0/100 000); the lowest was in Goiânia (6.5/100 000). Among women, the incidence rates were similar in Brasília and Cuiabá, but in Goiânia, the incidence declined. There was a significant increase in mortality among men in Cuiabá (2.4%, P=0.03) and Campo Grande (1.2%, P=0.05), and in women (1.6%, P=0.04) in Goiânia. Mortality by age group increased significantly in Campo Grande by 1.9% for men aged at least 50 years and in Goiânia by 2.7% among women aged at least 50 years; the mortality decreased in Goiânia by 2.2% for women aged less than 50 years. The incidence of esophageal cancer in Brasília and Cuiabá was similar to that of southern Brazil in some periods. There was an increase in mortality trends for men in Cuiabá and Campo Grande, and for women in Goiânia.