Gynaecological cancer incidence and mortality trends in a Brazilian State with medium human development index: A 22-year analysis.

OBJECTIVE: This study aimed to analyse trends in incidence and mortality rates of gynaecological cancer (GC) in Sergipe, a medium Human Development Index (HDI) state in northeastern Brazil during 1996-2017. METHODS: Data were obtained from the Population-based Cancer Registry of Aracaju and Brazilian Mortality Information System database. We included vulvar (VUC), vaginal (VAC), cervical (CC), uterine (UC; C54-C55), ovarian (OC), placental (PC), and unspecified female genital organ cancers. Crude rates, and age-standardised incidence and mortality rates (ASIR and ASMR, respectively) were calculated using a denominator of 100,000 women. We assessed changes in trends using the annual percentage change (APC) and the average APC (AAPC), using the Joinpoint Regression Program. RESULTS: From 1996-2017, GC ASIR exhibited a declining trend (AAPC: -3.1), while ASMR increased (AAPC: 2.1). CC had the highest ASIR and ASMR over the years, ranging from 11.6 to 34.3 cases and 4.2-9.0 deaths per 100,000, respectively. Annual decreases in ASIR were observed for CC (AAPC: -5.2) and VAC (AAPC: -5.5). OC saw an increase in mortality rates (AAPC: 1.9; 1996-2017), and CC experienced an increase during 1996-2003 (APC: 6.9). VUC displayed a substantial rise in ASMR from 2001 to 2009 (APC: 27.1), followed by a decrease (APC: -11.3). An increase in mortality trends for UC was observed during 1996-2004 (APC: 10.0), while its ASIR remained relatively unchanged over the years. CONCLUSION: While overall GC incidence trends declined, mortality rates either increased or failed to decrease significantly. Therefore, additional efforts are required to enhance prevention, diagnosis, and treatment strategies, aimed at reducing and managing the burden of GC in the future.

Estimativa de Incidência de Câncer no Brasil, 2023-2025 / Estimated Cancer Incidence in Brazil, 2023-2025 / Incidencia Estimada de Cáncer en Brasil, 2023-2025

O câncer é um problema de saúde pública mundial. Na última década, houve um aumento de 20% na incidência e espera-se que, para 2030, ocorram mais de 25 milhões de casos novos. Estimativas do número de casos novos de câncer são uma ferramenta poderosa para fundamentar políticas públicas e alocação racional de recursos para o combate ao câncer. A vigilância do câncer é um elemento crucial para planejamento, monitoramento e avaliação das ações de controle do câncer. Objetivo: Estimar e descrever a incidência de câncer no país, Regiões geográficas, Unidades da Federação, Distrito Federal e capitais, por sexo, para o triênio 2023-2025. Método: As informações foram extraídas do Sistema de Informação sobre Mortalidade e dos Registros de Câncer de Base Populacional. Foram estimados os casos novos e suas respectivas taxas de incidência pelos modelos de predição tempo-linear ou pela razão de incidência e mortalidade. Resultados: São esperados 704 mil casos novos de câncer para o triênio 2023-2025. Excetuando o câncer de pele não melanoma, ocorrerão 483 mil casos novos. O câncer de mama feminina e o de próstata foram os mais incidentes com 73 mil e 71 mil casos novos, respectivamente. Em seguida, o câncer de cólon e reto (45 mil), pulmão (32 mil), estômago (21 mil) e o câncer do colo do útero (17 mil). Conclusão: No Brasil, por suas dimensões continentais e heterogeneidade, em termos de território e população, o perfil da incidência reflete a diversidade das Regiões geográficas, coexistindo padrões semelhantes ao de países desenvolvidos e em desenvolvimento

Cancer is a worldwide public health problem, in the last decade there was an increase of 20% of the incidence and more than 25 million new cases are expected by 2030. Estimates of the number of new cancer cases are a powerful tool to support public policies and rational allocation of resources to fight cancer. Cancer surveillance is paramount for planning, monitoring and evaluating cancer control programs. Objective: To estimate and to describe the incidence of cancer in the country, geographic regions, states, Federal District and capitals, by sex, for the 2023-2025 period. Method: Cancer mortality and incidence information were extracted from the Mortality Information System and from Population-Based Cancer Registries. The number of new cases and their respective incidence rates were estimated by time-linear prediction models or by the incidence and mortality ratio. Results: 704,000 new cases of cancer are expected for the triennium 2023-2025. Except for nonmelanoma skin cancer, 483,000 new cases will occur. Female breast cancer and prostate cancer were the most frequent with 73,000 and 71,000 new cases, respectively, followed by colorectal cancer (45,000), lung (32,000) and stomach (21,000), and cervical cancer (17,000). Conclusion: In Brazil, due to its continental dimensions and heterogeneity both in terms of population and territory, the incidence profile reflects the diversity of geographic regions, and patterns similar to developed and developing countries.

Introducción: El cáncer es un problema de salud pública mundial, en la última década, hubo un incremento de un 20% en la incidencia y se espera, para 2030, más de 25 millones de nuevos casos. Estimaciones del número de nuevos casos de cáncer son una herramienta poderosa para fundamentar políticas públicas y la asignación racional de recursos para el combate contra el cáncer. La vigilancia es un elemento crucial para la planificación, monitoreo y evaluación de las acciones de control del cáncer. Objetivo: Estimar y describir la incidencia de cáncer en el país, regiones geográficas, Unidades de la Federación, Distrito Federal y capitales, por género, para el trienio 2023-2025. Método: Las informaciones fueron extraídas del Sistema de Información sobre Mortalidad y de los Registros de Cáncer de Base Poblacional. Fueron estimados los nuevos casos y sus respectivas tasas de incidencia mediante los modelos de predicción tiempo-lineal o por la razón de incidencia y mortalidad. Resultados: Se prevén 704 mil nuevos casos de cáncer para el trienio 2023-2025. Exceptuando el cáncer de piel no-melanoma, ocurrirán 483 mil nuevos casos. El cáncer de mama femenino y el de próstata fueron los que tuvieron mayor incidencia con 73 mil y 71 mil nuevos casos, respectivamente. Les siguen el cáncer de colon y recto (45 mil), pulmón (32 mil), estómago (21 mil) y el cáncer del cuello uterino (17 mil). Conclusión: En el Brasil, por sus dimensiones continentales y heterogeneidad, en términos de territorio y población, el perfil de la incidencia refleja la diversidad de las regiones geográficas, coexistiendo estándares similares al de los países desarrollados y en vías de desarrollo

Trends in prostate cancer incidence and mortality to monitor control policies in a northeastern Brazilian state.

Prostate cancer differently affects different regions of the world, displaying higher rates in more developed areas. After the implementation of prostate-specific antigen (PSA) testing, several studies described rising rates globally, but it is possible that indolent lesions are being detected given the lack of changes in mortality data. The Brazilian government recommends against PSA screening in the male population regardless of age, but the Urology Society issued a report recommending that screening should start at 50 years old for certain men and for those aged ≥75 years with a life expectancy exceeding 10 years. In this study, we examined the incidence and mortality rates of invasive prostate cancer over time in the Sergipe state of Brazil. The databases of the Aracaju Cancer Registry and Mortality Information System were used to calculate age-standardized rates for all prostate tumors (International Classification of Diseases 10th edition: C61 and D07.5) in the following age ranges: 20-44, 45-54, and ≥65 years. We identified 3595 cases of cancer, 30 glandular intraepithelial high-grade lesions, and 3269 deaths. Using the Joinpoint Regression Program, we found that the incidence of prostate cancer dramatically increased over time until the mid-2000s for all age groups, after which the rates declined. Prostate cancer mortality rates increased until 2005, followed by a non-significant annual percent change of 22.0 in 2001-2005 and a stable rate thereafter. We noticed that the increases and decreases of the incidence rates of prostate cancer were associated with the screening recommendations. Meanwhile, the increased mortality rates did not appear to be associated with decreased PSA testing; instead, they were linked to the effects of age and improvements in identification of the cause of death. Thus, we do not believe a PSA screening program would benefit the population of this study.

Trends in cervical cancer and its precursor forms to evaluate screening policies in a mid-sized Northeastern Brazilian city.

Cervical cancer is a health issue that disproportionately affects developing countries, where the Papanicolaou test (Pap smear) remains an important screening tool. Brazilian government recommendations have focused screening on the female population aged from 25 to 64 years old. In this study, we examined the incidence and mortality rates of invasive cervical cancer lesions and the incidence rates of in situ precancerous cervical lesions, aiming to calculate their respective statistics over time in a mid-sized Brazilian city, Aracaju. The 1996-2015 database from the Aracaju Cancer Registry and Mortality Information System was used to calculate age standardized rates for all invasive cervical tumors (International code of diseases, ICD-10: C53) and preinvasive cervical lesions (ICD-10: D06) in the following patient age ranges; ≤ 24, 25-34, 35-44, 45-54, 55-64 and ≥ 65 years old. We identified 1,030 cancer cases, 1,871 in situ lesions and 334 deaths. Using the Joinpoint Regression Program, we calculated the annual percentage incidence changes and our analyses show that cervical cancer incidence decreased up to 2008, increased up to 2012 and decreased again thereafter, a significant trend in all age groups from 25 years. The incidence of precursor lesions increased from 1996 to 2005 and has since decreased, a result significant in all age groups until 64 years. Cervical cancer mortality has decreased by 3.8% annually and trend analysis indicates that Pap smears have been effective in decreasing cancer incidence and mortality. However, recent trends shown here show a decreasing incidence of in situ lesions and may indicate either a real decrease or incomplete catchment. Thus, we suggest health policies should be re-considered and include sufficient screening and HPV vaccination strategies to avoid cervical cancer resurgence in the population.

COVID-19 and Cancer: Updating Epidemiological Issues / Covid-19 e Câncer: Atualização de Aspectos Epidemiológicos / Covid-19 y Cáncer: Actualización de Aspectos Epidemiológicos

Introduction: The disease caused by the new coronavirus (COVID-19) is currently a global public health issue. Advanced age, male gender, history of tobacco addiction and presence of comorbidities, among them cancer, were reported in the literature as factors associated to the worse prognosis of the disease. Objectives: To review the literature about the new coronavirus infection in individuals with malignant neoplasms and to update the epidemiological aspects of the disease in oncologic patients. Method: Literature review on articles published in scientific journals that addressed the epidemiologic aspects of the infection by coronavirus in oncologic patients using the terms of the Medical Subject Headings (MeSH) and of the Health Sciences Descriptors (DeCs) in the MEDLINE/PubMed database. Results: Patients with cancer have worse clinical results when compared to the general population. Conclusion: Elderly oncologic patients with lung cancer or patients who have submitted to recent cancer surgery or chemotherapy when diagnosed with COVID-19 were more susceptible to the development of severe infection.

Introdução: A doença causada pelo novo coronavírus (Covid-19) é atualmente um problema mundial de saúde pública. A idade avançada, sexo masculino, histórico de tabagismo e presença de comorbidades, entre as quais, o câncer, foram relatados na literatura como fatores associados ao pior prognóstico da doença. Objetivos: Revisar a literatura acerca da infecção pelo novo coronavírus em indivíduos portadores de neoplasias malignas e atualizar os aspectos epidemiológicos da doença em pacientes oncológicos. Método: Revisão de trabalhos publicados em periódicos científicos que abordavam os aspectos epidemiológicos da infecção por coronavírus em pacientes oncológicos por meio de termos do Medical Subject Headings (MeSH) e dos Descritores em Ciências da Saúde (DeCs) na base de dados MEDLINE/PubMed. Resultados: Pacientes com câncer apresentam piores resultados clínicos quando comparados à população geral. Conclusão: Pacientes oncológicos idosos, portadores de câncer de pulmão, ou que se submeteram à cirurgia oncológica ou à quimioterapia recentes ao diagnóstico de Covid-19 apresentaram maior suscetibilidade ao desenvolvimento da infecção grave

Introducción: La enfermedad causada por coronavirus (Covid-19) es actualmente un problema de salud pública. Las personas con enfermedades crónicas como el cáncer, el sexo masculino, los pacientes con antecedentes de tabaquismo y los ancianos tienen un mayor riesgo de adquirir formas graves, desarrollar complicaciones y morir por la enfermedad. Objetivos: Revisar la literatura sobre la infección con el nuevo coronavirus en individuos con neoplasias malignas y sintetizar los aspectos epidemiológicos de la enfermedad en pacientes con cáncer. Método: Revisión de la literatura como artículos publicados en revistas científicas utilizando los términos médicos (MeSH) y Descriptores en Ciencia de la Salud (DeCs) en la base de datos MEDLINE/PubMed. Resultados: Los pacientes con cáncer tienen peores resultados clínicos en comparación con la población general. Conclusiones: Pacientes oncológicos ancianos, portadores de cáncer de pulmón, o que se sometieron a cirugía de cáncer o a quimioterapia reciente al diagnóstico de Covid-19 fueron más susceptibles al desarrollo de infección severa.

Assessing trends of breast cancer and carcinoma in situ to monitor screening policies in developing settings.

There have been arguments about the role of breast cancer screening at the population level, and some points of controversy have arisen, such the establishment of organized screening policies and the age at which to begin screening. The real benefit of screening has been questioned because the results of this practice may increase the diagnosis of indolent lesions without decreasing mortality due to breast cancer. The authors have proposed a study of incidence and mortality trends for breast cancer in a developing setting in Brazil to monitor the effectiveness of the official recommendations that prioritize the age group from 50 to 69 years. The database of the Cancer Registry and the Mortality Information System was used to calculate age-standardized and age-specific rates, which were then used to calculate incidence and mortality trends using the Joinpoint Regression Program. The results showed stability in trends across all ages and age-specific groups in both incidence and mortality. In conclusion, we found that incidence and mortality rates are compatible with those in regions with similar human development indexes, and trends have demonstrated stabilization. Thus, we do not endorse changes in the official recommendations to conduct screening for ages other than 50 to 69 years, nor should policy makers implement organized screening strategies.

Strain Analysis of Left Ventricular Function in the Association of Hypertrophic Cardiomyopathy and Systemic Arterial Hypertension / Avaliação da Função Ventricular Esquerda na Associação de Cardiomiopatia Hipertrófica e Hipertensão Arterial Sistêmica pela Técnica de Strain

Abstract Background: Hypertrophic cardiomyopathy (HCM) is the most common heart disease of genetic origin in the world population, with a prevalence of at least 1/500. The association with systemic arterial hypertension (SAH) is not uncommon, as it affects approximately 25% of the world population. Most studies aim at the differential diagnosis between these diseases, but little is known about the magnitude of this association. Objective: To compare left ventricular global longitudinal strain (GLS) in HCM patients with and without associated SAH. Methods: Retrospective cross-sectional study that included 45 patients with HCM and preserved ejection fraction, with diagnosis confirmed by magnetic resonance imaging, including 14 hypertensive patients. Transthoracic echocardiography was performed, with emphasis on left ventricular myocardial strain analysis using GLS. In this study, p < 0.05 was considered statistically significant. Results: Left ventricular strain was significantly lower in hypertensive individuals compared to normotensive individuals (-10.29 ± 2.46 vs. -12.35% ± 3.55%, p = 0.0303), indicating greater impairment of ventricular function in that group. Mean age was also significantly higher in hypertensive patients (56.1 ± 13.9 vs. 40.2 ± 12.7 years, p = 0.0001). Diastolic dysfunction was better characterized in hypertensive patients (p = 0.0242). Conclusion: Myocardial strain was significantly lower in the group of patients with HCM and SAH, suggesting greater impairment of ventricular function. This finding may be related to a worse prognosis with early evolution to heart failure. Prospective studies are required to confirm this hypothesis.

Resumo Fundamentos: A cardiomiopatia hipertrófica (CMH) é a doença cardíaca de origem genética mais frequente na população mundial, com prevalência de, pelo menos, 1/500. A associação com hipertensão arterial sistêmica (HAS) não é incomum, uma vez que esta acomete aproximadamente 25% da população mundial. A maioria dos estudos objetiva o diagnóstico diferencial entre essas doenças, mas pouco se sabe sobre a magnitude dessa associação. Objetivo: Comparar o strain longitudinal global (SLG) do ventrículo esquerdo em pacientes portadores de CMH com e sem HAS associada. Métodos: Estudo transversal retrospectivo que incluiu 45 pacientes portadores de CMH e fração de ejeção preservada, com diagnóstico confirmado por ressonância magnética, sendo 14 hipertensos. Realizada avaliação ecocardiográfica transtorácica com ênfase na análise da deformação miocárdica do ventrículo esquerdo por meio do SLG. Valores de p < 0,05 foram considerados estatisticamente significativos. Resultados: A deformação do ventrículo esquerdo foi significativamente menor nos hipertensos quando comparada aos normotensos (-10,29 ± 2,46 vs. -12,35% ± 3,55%, p = 0,0303), indicando maior comprometimento da função ventricular naquele grupo. A média de idade também foi significativamente maior nos hipertensos (56,1 ± 13,9 vs. 40,2 ± 12,7 anos, p = 0,0001). A disfunção diastólica foi melhor caracterizada nos pacientes hipertensos (p = 0,0242). Conclusão: A deformação miocárdica foi significativamente menor no grupo de pacientes com CMH e HAS, sugerindo maior comprometimento da função ventricular. Esse achado pode estar relacionado a um pior prognóstico com evolução precoce para insuficiência cardíaca. Estudos prospectivos são necessários para confirmar essa hipótese.

Incidence and mortality of myeloid malignancies in children, adolescents and Young adults in Brazil: A population-based study.

BACKGROUND: Myeloid malignancies (MM) are heterogeneous when it comes to incidence rates and pathogenesis. These variation rates are important to generate hypotheses on causal aetiology. This study aimed to describe incidence and mortality patterns of MM among children, adolescents and young adults (cAYA) in Brazil and to evaluate trends in incidence and mortality rate overtime. METHODS: Data were extracted from a dataset of 15 Population-based Cancer Registries located in five Brazilian geographical regions and calculated by age-specific, crude, and age-standardized incidence (ASR) and mortality rates per million persons. Joinpoint regression analyses were performed for trends evaluations, regionally. Annual Percent Change (APC) and Average Annual Percent Change (AAPC) were also estimated. RESULTS: The overall ASR for incidence and mortality of MM in Brazil was 14.57 and 8.83 per million, respectively. The AML (non-APL AML and APL) incidence rate is 8.18 per million, whereas other MM subtypes altogether have an incidence rate of 2.62 per million, and not otherwise specified (NOS) is 3.70 per million. The analysis of incidence trends (AAPC) showed a significant decline in Manaus (-5.6%) and São Paulo (-4.7%), and a significant increase was observed in Fortaleza (5.8%). Mortality trends steadily declined in all registries, with significant declines occurring in Goiânia (-1.5%), Belo Horizonte (-2.3%), São Paulo (-2.5%), Curitiba (-2.8%) and Porto Alegre (-4.1%). CONCLUSION: Our findings showed differences in the incidence and mortality rates of MM in cAYA in Brazil, geographically. Infants-AML have the highest incidence within the cAYA population (17.42 per million). There was a substantial decrease in mortality rate observed, which was interpreted as an improvement in MM recognition and therapeutic approach.

Incidence and mortality of bone cancer among children, adolescents and young adults of Brazil.

OBJECTIVES: Bone cancers occur frequently in children, adolescents, and young adults aging 15 to 29 years. Osteosarcoma and Ewing sarcoma are the most frequent subtypes in this population. The aim of this study was to describe incidence and mortality trends of bone cancers among Brazilian children, adolescents and young adults. METHODS: Incidence information was obtained from 23 population-based cancer registries. Mortality data were extracted from the Atlas of Cancer Mortality from 1979 to 2013. Specific and adjusted rates per million were analyzed according to gender, morphology and age at diagnosis. Median rates were used as a measure of central tendency. Joinpoint regression was applied to analyze trends. RESULTS: Median incidence rates were 5.74 and 11.25 cases per million in children and young adults respectively. Osteosarcoma in the 15-19 years aged group had the highest incidence rates. Stable incidence rates were observed among five registries in 0-14 year's age group. Four registries had a decreased incidence trend among adolescents and young adults. Median mortality rates were 1.22 and 5.07 deaths per million in children and young adults respectively. Increased mortality was observed on the North and Northeast regions. Decreased mortality trends were seen in the South (children) and Southeast (adolescents and young adults). CONCLUSION: Osteosarcoma and Ewing Sarcoma are the most incident bone cancers in all Brazilian regions. Bone cancers showed incidence and mortality patterns variation within the geographic regions and across age groups, although not significant. Despite limitations, it is crucial to monitor cancer epidemiology trends across geographic Brazilian regions.

Incidence and mortality of bone cancer among children, adolescents and young adults of Brazil

OBJECTIVES: Bone cancers occur frequently in children, adolescents, and young adults aging 15 to 29 years. Osteosarcoma and Ewing sarcoma are the most frequent subtypes in this population. The aim of this study was to describe incidence and mortality trends of bone cancers among Brazilian children, adolescents and young adults. METHODS: Incidence information was obtained from 23 population-based cancer registries. Mortality data were extracted from the Atlas of Cancer Mortality from 1979 to 2013. Specific and adjusted rates per million were analyzed according to gender, morphology and age at diagnosis. Median rates were used as a measure of central tendency. Joinpoint regression was applied to analyze trends. RESULTS: Median incidence rates were 5.74 and 11.25 cases per million in children and young adults respectively. Osteosarcoma in the 15-19 years aged group had the highest incidence rates. Stable incidence rates were observed among five registries in 0-14 year's age group. Four registries had a decreased incidence trend among adolescents and young adults. Median mortality rates were 1.22 and 5.07 deaths per million in children and young adults respectively. Increased mortality was observed on the North and Northeast regions. Decreased mortality trends were seen in the South (children) and Southeast (adolescents and young adults). CONCLUSION: Osteosarcoma and Ewing Sarcoma are the most incident bone cancers in all Brazilian regions. Bone cancers showed incidence and mortality patterns variation within the geographic regions and across age groups, although not significant. Despite limitations, it is crucial to monitor cancer epidemiology trends across geographic Brazilian regions.

Incidência e Mortalidade por Câncer entre Crianças e Adolescentes: uma Revisão Narrativa / Cancer Incidence and Mortality among Children and Adolescents: a Narrative Review / Incidencia y mortalidad por Cáncer entre Niños e Adolescentes: una Revisión Narrativa

Introdução: o câncer em crianças e adolescentes com idade entre 0-19 anos configura-se como um problema de saúde pública tanto nos países desenvolvidos como nos países em desenvolvimento. é considerado raro e distinto quando comparado com o câncer em adultos. apresenta padrões de incidência e mortalidade que variam em todo mundo, sendo que aproximadamente 80% dos cânceres infantis ocorrem nos países com baixo índice de desenvolvimento humano, com acesso aos serviços de cuidado à saúde de baixa qualidade. Objetivo: apresentar um panorama geral do câncer em crianças e adolescentes com idade entre 0-19 anos com ênfase na descrição dos resultados de estudos de base populacional para incidência e mortalidade nas diferentes regiões geográficas no Mundo e no Brasil. Resultados: as taxas de incidência gerais para o câncer em crianças e adolescentes com idade entre 0-19 variaram entre 50 e 200 casos por milhão por ano em diferentes países e continentes. no Brasil, a mediana das taxas a incidência foi de 154,3 por milhão. a mortalidade apresentou declínio em várias partes do mundo, sendo considerada a segunda causa de morte em países desenvolvidos. Conclusão: as informações dos registros de câncer são indispensáveis no enfrentamento do câncer na população pediátrica, principalmente nos países em desenvolvimento, onde o impacto do câncer é pouco conhecido, ao passo que seu efeito sobre a população está aumentando. Melhorias na adoção de estratégias de tratamento integrado devem ser consideradas para melhorar as taxas de mortalidade por câncer em crianças e adolescentes no Brasil e no Mundo.

Introduction: cancer in children and adolescents aged 0-19 years is a public health problem in both developed and developing countries. it is considered rare and distinct when compared to cancer in adults. They present patterns of incidence and mortality vary throughout the world, with approximately 80% of childhood cancers occurring in low human development countries, with access to poor quality health care services. Objective:to present an overview of cancer in children and adolescents aged 0-19 years, with an emphasis on describing the results of population-based studies for incidence and mortality in different geographic regions in the World and Brazil. Results: overall cancer incidence rates in children and adolescents aged 0-19 years old ranged from 50 to 200 cases per million per year in different countries and continents. in Brazil, the median incidence rates were 154.3 per million. Mortality declined in several parts of the world, being considered the second cause of death in developed countries. Conclusion: The information from the cancer registries are indispensable in coping with cancer in the pediatric population, especially in developing countries, where the impact of cancer is poorly understood, while its effect on the population is increasing. improvements in the adoption of integrated treatment strategies should be considered to improve cancer mortality rates in children and adolescents in Brazil and in the World

Introducción: e l cáncer en niños y adolescentes de entre 0-19 años se configura como un problema de salud pública tanto en los países desarrollados y en los países en desarrollo. se considera raro y distinto cuando se compara con el cáncer en adultos. se presentan patrones de incidencia y mortalidad que varían en todo el mundo, siendo que aproximadamente el 80% de los cánceres infantiles ocurren en los países con bajo índice de desarrollo humano, con acceso a los servicios de cuidado de la salud de baja calidad. Objetivo: Presentar un panorama general del cáncer en niños y adolescentes con edad entre 0-19 años con énfasis en la descripción de los resultados de estudios de base poblacional para incidência y mortalidad en las diferentes regiones geográficas en el Mundo y en Brasil. Resultados:las tasas de incidencia general para el cáncer en niños y adolescentes de entre 0-19 varían entre 50 y 200 casos por millón por año en diferentes países y continentes. en Brasil, la mediana de las tasas la incidencia fue de 154,3 por millón. la mortalidad ha disminuido en varias partes del mundo, siendo considerada la segunda causa de muerte en los países desarrollados. Conclusión: la información de los registros de cáncer es indispensable en el enfrentamiento del cáncer en la población pediátrica, principalmente en los países en desarrollo, donde el impacto del cáncer es poco conocido, mientras que su efecto sobre la población está aumentando. las mejoras en la adopción de estrategias de tratamiento integrado deben ser consideradas para mejorar las tasas de mortalidad por cáncer en niños y adolescentes en Brasil y en el Mundo.

Mother and child characteristics at birth and early age leukemia: a case-cohort population-based study / Características mãe-filho ao nascer e leucemias na primeira infância: um estudo de caso-coorte de base populacional no Brasil

Abstract Objective: The population-based cancer registries (PBCR) and the Information System on Live Births in Brazil (Sistema de Informações sobre Nascidos Vivos [SINASC]) have information that enables the test for risk factors associated with leukemia at an early age. The aim of this study was to identify maternal and birth characteristics associated with early-age acute leukemia (EAL) in Brazil. Methods: A case-cohort study was performed using secondary dataset information of PBCR and SINASC. The risk association variables were grouped into (i) characteristics of the child at birth and (ii) characteristics of maternal exposure during pregnancy. The case-control ratio was 1:4. Linkage was performed using R software; odds ratio (OR) and 95% confidence interval (CI) were calculated by logistic regression models. Results: EAL was associated with maternal occupational exposure to chemicals (agricultural, chemical, and petrochemical industry; adjOR: 2.18, 95% CI: 1.16-4.10) and with birth defects (adjOR: 3.62, 95% CI: 1.19-11.00). Conclusions: The results of this study, with the identification of EAL risk factors in population-based case-cohort study, strengthen the knowledge and improve databases, contributing to investigations on risk factors associated with childhood leukemia worldwide.

Resumo Objetivos: Os registros de câncer de base populacional (RCBP) e o Sistema Nacional de Nascidos Vivos (SINASC) possuem informações que possibilitam testar hipóteses sobre fatores de riscos associados às leucemias. O objetivo principal deste projeto é identificar quais as características ao nascimento das crianças que estariam associadas ao risco de desenvolver Leucemia Aguda (LA) na primeira infância. Métodos: Foram utilizadas informações de 12 RCBP e do Sistema de Informação de Nascidos Vivos das mesmas localidades. Foram elegíveis 272 casos e 1.088 controles no período de 1996 a 2010. As associações de riscos de LA foram agrupadas em, (i) características da criança ao nascer, e (ii) características de exposição materna durante a gestação da criança. A relação de casos e controles foi de 1:4. As análises para padronização, estruturação do banco de dados e análises estatísticas foram realizadas através dos aplicativos Excel, R-Studio e SPSS 21. Resultados: Houve associação entre anomalias congênitas (RC 3,62, IC95% 1,19-11,00) e exposição ocupacional materna a produtos químicos (OR 2,18, p 0,002) com o risco do desenvolvimento de LA. Conclusão: A utilização de banco de dados secundários populacionais para a identificação de fatores de risco para LA fortaleceu o intercâmbio de conhecimentos e melhoria das bases de dados, e contribuiu para investigações sobre as associações de riscos nas leucemias agudas em contexto mundial.

Mother and child characteristics at birth and early age leukemia: a case-cohort population-based study.

OBJECTIVE: The population-based cancer registries (PBCR) and the Information System on Live Births in Brazil (Sistema de Informações sobre Nascidos Vivos [SINASC]) have information that enables the test for risk factors associated with leukemia at an early age. The aim of this study was to identify maternal and birth characteristics associated with early-age acute leukemia (EAL) in Brazil. METHODS: A case-cohort study was performed using secondary dataset information of PBCR and SINASC. The risk association variables were grouped into (i) characteristics of the child at birth and (ii) characteristics of maternal exposure during pregnancy. The case-control ratio was 1:4. Linkage was performed using R software; odds ratio (OR) and 95% confidence interval (CI) were calculated by logistic regression models. RESULTS: EAL was associated with maternal occupational exposure to chemicals (agricultural, chemical, and petrochemical industry; adjOR: 2.18, 95% CI: 1.16-4.10) and with birth defects (adjOR: 3.62, 95% CI: 1.19-11.00). CONCLUSIONS: The results of this study, with the identification of EAL risk factors in population-based case-cohort study, strengthen the knowledge and improve databases, contributing to investigations on risk factors associated with childhood leukemia worldwide.

Incidence and survival of childhood leukemia in Recife, Brazil: A population-based analysis.

BACKGROUND: Leukemia is the most common pediatric cancer with incidence rates of around 48 per million for children under 15 years of age. The median age-adjusted incidence rate (AAIR) in children aged 0-14 years in Brazil is 53.3 per million. While overall survival rates for children with leukemia have improved significantly, data for incidence, trends, and relative survival among children and adolescents with leukemia in Recife, Brazil, remain incomplete, which hampers our analyses and provision of the best healthcare. The objective of this report is to provide that data. METHODS: Data from the Population-Based Cancer Registry of Recife were analyzed from 1998 to 2007. Our analyses included frequencies and AAIR, together with age-specific incidence rates for all leukemias, acute lymphoblastic leukemia, and acute myeloid leukemia. To evaluate incidence trends, joinpoint regression, including annual average percent change, were analyzed. Relative survival was calculated using the life-table method. RESULTS: One hundred seventy-five cases were identified, 51% in females. The review reduced the not otherwise specified (NOS) leukemia category by 50% and diagnosis by death certificate only from 5.7% to 1.1%. The AAIR for leukemia was 41.1 per million, with a peak among children aged 1-4 (78.3 per million). Incidence trends during the period were stable. The five-year relative survival rate was 69.8%. CONCLUSIONS: These data represent the incidence rate and survival of childhood leukemia in Recife, located in the northeast region of Brazil, using a high-quality database.

Maternal and Birth Characteristics and Childhood Embryonal Solid Tumors: A Population-Based Report from Brazil.

BACKGROUND: Several maternal and birth characteristics have been reported to be associated with an increased risk of many childhood cancers. Our goal was to evaluate the risk of childhood embryonal solid tumors in relation to pre- and perinatal characteristics. METHODS: A case-cohort study was performed using two population-based datasets, which were linked through R software. Tumors were classified as central nervous system (CNS) or non-CNS-embryonal (retinoblastoma, neuroblastoma, renal tumors, germ cell tumors, hepatoblastoma and soft tissue sarcoma). Children aged <6 years were selected. Adjustments were made for potential confounders. Odds ratios (OR) with 95% confidence intervals (CI) were computed by unconditional logistic regression analysis using SPSS. RESULTS: Males, high maternal education level, and birth anomalies were independent risk factors. Among children diagnosed older than 24 months of age, cesarean section (CS) was a significant risk factor. Five-minute Apgar ≤8 was an independent risk factor for renal tumors. A decreasing risk with increasing birth order was observed for all tumor types except for retinoblastoma. Among children with neuroblastoma, the risk decreased with increasing birth order (OR = 0.82 (95% CI 0.67-1.01)). Children delivered by CS had a marginally significantly increased OR for all tumors except retinoblastoma. High maternal education level showed a significant increase in the odds for all tumors together, CNS tumors, and neuroblastoma. CONCLUSION: This evidence suggests that male gender, high maternal education level, and birth anomalies are risk factors for childhood tumors irrespective of the age at diagnosis. Cesarean section, birth order, and 5-minute Apgar score were risk factors for some tumor subtypes.

Early childhood leukemia incidence trends in Brazil.

Incidence rates of childhood leukemia vary between different regions of the world. The objective of this study was to test possible trends in incidence rate of early childhood leukemia (children <5 years old at the diagnosis) in Brazil. Data from 18 population-based cancer registries (PBCRs) were analyzed (period 1999-2010). The analysis consisted of frequencies, age-adjusted incidence rates, and joinpoint regression results, including annual average percent change (AAPC) in incidence rates and 95% confidence intervals (CIs). The median age-adjusted incidence rate (AAIR) of overall early childhood leukemia was 61 per million. The AAIR for acute lymphoid leukemia (ALL) was 44 per million and nonlymphoid acute leukemia (NLAL) was 14 per million. The median ALL/NLAL ratio was 3.0, suggesting higher incidence rate of NLAL in these settings. The joinpoint analysis demonstrated increased leukemia incidence rate in João Pessoa (AAPC = 20; 95% CI: 3.5, 39.4) and Salvador (AAPC = 8.68; 95% CI: 1.0, 16.9), respectively, whereas incidence rate in São Paulo PBCR decreased (AAPC = -4.02%; 95% CI: -6.1%, -1.9%). Correlation between ALL AAIR and selected variables of socioeconomic (SES) factors was not observed. Increased AAIR regionally overtime was observed. However, the interpretation for such phenomenon should be cautious because it might reflect the access to health care, diagnosis procedures, and improvement of PBCR´s quality. The observed trend supports the necessity of further ecological studies.

Childhood cancer mortality trends in Brazil, 1979-2008.

OBJECTIVES: Childhood cancer mortality has substantially declined worldwide as a result of significant advances in global cancer care. Because limited information is available in Brazil, we analyzed trends in childhood cancer mortality in five Brazilian regions over 29 years. METHODS: Data from children 0-14 years old were extracted from the Health Mortality Information System for 1979 through 2008. Age-adjusted mortality rates, crude mortality rates, and age-specific mortality rates by geographic region of Brazil and for the entire country were analyzed for all cancers and leukemia. Mortality trends were evaluated for all childhood cancers and leukemia using joinpoint regression. RESULTS: Mortality declined significantly for the entire period (1979-2008) for children with leukemia. Childhood cancer mortality rates declined in the South and Southeast, remained stable in the Middle West, and increased in the North and Northeast. Although the mortality rates did not unilaterally decrease in all regions, the age-adjusted mortality rates were relatively similar among the five Brazilian regions from 2006-2008. CONCLUSIONS: Childhood cancer mortality declined 1.2 to 1.6% per year in the South and Southeast regions.

Childhood cancer mortality trends in Brazil, 1979-2008

OBJECTIVES: Childhood cancer mortality has substantially declined worldwide as a result of significant advances in global cancer care. Because limited information is available in Brazil, we analyzed trends in childhood cancer mortality in five Brazilian regions over 29 years. METHODS: Data from children 0-14 years old were extracted from the Health Mortality Information System for 1979 through 2008. Age-adjusted mortality rates, crude mortality rates, and age-specific mortality rates by geographic region of Brazil and for the entire country were analyzed for all cancers and leukemia. Mortality trends were evaluated for all childhood cancers and leukemia using joinpoint regression. RESULTS: Mortality declined significantly for the entire period (1979-2008) for children with leukemia. Childhood cancer mortality rates declined in the South and Southeast, remained stable in the Middle West, and increased in the North and Northeast. Although the mortality rates did not unilaterally decrease in all regions, the age-adjusted mortality rates were relatively similar among the five Brazilian regions from 2006-2008. CONCLUSIONS: Childhood cancer mortality declined 1.2 to 1.6% per year in the South and Southeast regions.

Lymphoma subtype incidence rates in children and adolescents: first report from Brazil

Lymphoma is the third most common pediatric malignancy. The purpose of this study was to analyze the incidence rates of lymphoma in children and adolescents in Brazil. All cases of Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), and Burkitt lymphoma (BL) were extracted from 14 population-based cancer registries (PBCRs) from 2000 to 2005, and included children and adolescents 0-19 years old. Analyses included age-adjusted incidence rates (AAIRs) and age-specific incidence rates (ASIRs) by each PBCR. A social exclusion index (SEI) was built and used as proxy for socioeconomic status (SES) levels. Correlations between SES and incidence rates were investigated using Spearman's test. The median incidence of lymphoma was 22.7/million. AAIRs of lymphomas varied from 12.9 (Salvador) to 34.5 per million (São Paulo). Median AAIR was 8.8/million, 9.8/million, and 2.9/million for NHL, HL, and BL, respectively. In all PBCRs except that of Recife, AAIR was slightly higher in males than females. The median ASIR was highest for HL (18.5/million) at 15-19 years for both genders. For NHL there were two peaks for ASIR: 11.1/million (1-4 years of age) and 13.2/million (15-19 years of age). The median ASIR for BL was highest among children aged 1-4 years (4.7/million) and in males. Higher SEI correlated with higher incidence of HL (P = 0.06), whereas rates of NHL and BL did not correlate with SEI. Borderline different incidence rates were observed in HL correlated with cities with higher SEIs. Incidence rates of lymphomas in Brazil do not differ compared to rates reported worldwide, although SES differences deserve further investigation

Estimates of thyroid cancer incidence in Brazil: an approach using polynomial models.

This study aimed to estimate thyroid cancer incidence in Brazil in 2006 using polynomial models that take age and birth cohort effects into account in the estimation process. Estimates were based on new cases of thyroid cancer in nine Brazilian cities (Manaus, Palmas, Natal, Recife, Cuiabá, Belo Horizonte, São Paulo, Porto Alegre, and Curitiba) and the Federal District from 1997 to 2001. We estimated 6,066 new cases, of which 1,065 in men and 5,001 in women. The incidence rates were, respectively, 1.16 and 5.27 per 100,000 inhabitants. Rates increased with age in both genders, especially after 30 years. The size and profile of rates according to age and gender indicate that the method yields plausible estimates.