Prevalencia y caracterización de las neoplasias malignas en personas viviendo con VIH en Colombia / Prevalence and characterization of cancer in people living with HIV in Colombia

INTRODUCCIÓN: En el síndrome de inmunodeficiencia adquirida las neoplasias han jugado un papel preponderante, y con el advenimiento del tratamiento antirretroviral (TAR), la infección por VIH se ha transformado en una enfermedad crónica, siendo los tumores malignos una causa importante de morbilidad y mortalidad. OBJETIVO: Describir las características demográficas, clínicas y de laboratorio de las personas que viven con VIH (PVVIH) y han sido diagnosticadas con cáncer en Colombia y comparar los grupos de neoplasias definitorias y no definitorias de Sida. MÉTODOS: Revisión multicéntrica retrospectiva, en la que se recolectó y analizó datos relacionados con la infección por VIH y de diagnóstico de cáncer y tipo. Incluyó PVVIH diagnosticadas con neoplasias malignas atendidas en 23 centros de atención de pacientes con VIH en 11 ciudades de Colombia desde 1986 hasta 2018. RESULTADOS: En 23.189 pacientes, se identificaron 650 casos de malignidad (prevalencia de 2,8 % [IC de 95%: 2,6-2,9]). La neoplasia definitoria de Sida (NDS) sigue siendo el tipo de cáncer prevalente (71,1%), las neoplasias malignas más frecuentes fueron sarcoma de Kaposi (n: 330; 50,8%), linfoma no Hodgkin (n: 110; 16,9%), cáncer de piel (n: 48; 7,4%) y linfoma de Hodgkin (n: 25; 3,8%). Los pacientes con NDS tenían más probabilidades de ser HSH y estar en un estadio CDC 3, un recuento de linfocitos T CD4 < 200/μL y una carga viral del VIH ≥ 50 copias/mL al momento del diagnóstico de malignidad. Las personas con neoplasias no definitorias de Sida (NNDS) eran significativamente mayores y tenían más probabilidades de ser fumadores. CONCLUSIONES: Estos hallazgos son relevantes considerando la creciente carga de cáncer en las PVVIH que envejecen y las causas cambiantes de morbilidad y mortalidad. La presentación tardía a la atención del VIH y el retraso en el inicio del TAR son probablemente factores que contribuyen al cambio más lento hacia NNDS en comparación con las regiones de altos ingresos donde hay un acceso más rápido y temprano al TAR. El conocimiento de las tendencias epidemiológicas actuales y el perfil del cáncer en las PVVIH es fundamental para mejorar los esfuerzos de prevención y tratamiento del cáncer en el contexto de la atención integral del VIH.

BACKGROUND: In the acquired immunodeficiency syndrome, neoplasms have played a preponderant role, and with the advent of antiretroviral treatment (ART), HIV has become a chronic disease, with malignant tumors being an important cause of morbidity and mortality. AIM: To describe the demographic, clinical, and laboratory characteristics of people living with HIV (PLHIV) who have been diagnosed with cancer in Colombia and to compare the groups of AIDS-defining (ADC) and non-AIDS-defining neoplasms (NADC). METHODS: Retrospective, multicenter study that included people living with HIV/AIDS (PLHIV) diagnosed with malignancies treated at 23 HIV care centers located in 11 Colombian cities from 1986 to 2018. Data related to HIV infection and cancer diagnosis were collected and analyzed. RESULTS: Among 23,189 patients, 650 malignancy cases were identified (prevalence of 2.8% [95% CI 2.6-2.9]). AIDS-defining neoplasm remains the most prevalent type of cancer (71.1%), The most frequent individual malignancies were Kaposi sarcoma (n: 330; 50.8%), non-Hodgkin lymphoma (n: 110; 16.9%), skin cancer (n: 48; 7.4%), and Hodgkin lymphoma (n: 25; 3.8%). Compared people with NADC, with ADC were more likely to be MSM and have a CDC HIV stage 3, CD4 T cell count < 200/μL, and HIV viral load ≥ 50 copies/mL at the time of malignancy diagnosis. PLHIV and with NADC were significantly older and were more likely to be smokers. CONCLUSIONS: These findings are relevant considering the increasing burden of cancer in the aging PLHIV and the changing causes of morbidity and mortality. Late presentation to HIV care and delayed ART initiation are likely factors contributing to the slower shift toward NADCs compared with high-income regions where access to ART is better. Knowledge of the current epidemiological trends and profile of cancer in PLWHA is critical to improve cancer prevention and treatment efforts in the context of comprehensive HIV care.

Perfil clínico-epidemiológico de pacientes pediátricos de um centro de oncohematologia de pernambuco / Clinical-epidemiological profile of pediatric patients at a center of oncohematology in Pernambuco / Perfil clínico-epidemiológico de pacientes pediátricos en un centro de oncohematología de Pernambuco

ntrodução:O câncer infantojuvenil corresponde a um grupo de várias doenças que têm em comum a proliferação descontrolada de células anormais e que pode ocorrer em qualquer local do organismo. Objetivo:Identificar os tipos de neoplasias mais frequentes na infância e adolescência e analisar o perfil clínico-epidemiológicodos pacientes. Metodologia:Estudo de transversal exploratório, de natureza aplicada com análise documental, realizado no Centro de Oncohematologia Pediátrica do Hospital Universitário Oswaldo Cruz, Recife, Pernambuco.Foram incluídos crianças e adolescentes diagnosticados com neoplasia e tratados por terapia antineoplásica.Os critérios de exclusão foram crianças e adolescentes normorreativas e/ou com doenças sistêmicas; prontuários ilegíveis ou com falta de informações clínicas.Resultados:Identificou-se que 54,21% dos pacientes eram dosexo feminino, seguido por 44,86% do sexo masculino.A faixa etária prevalente no estudo foi o de crianças de 5 a 14 anos (54,21%), ainda sobre o perfil dos pacientes, identificou-se que população autodeclarada como negra foi a mais prevalente representando 44,86% do total, seguido dos brancos com 43,93%. O diagnóstico que prevaleceu foi o de Leucemia Linfoide Aguda(23,36%), seguido pela Retinoblastoma (7,48%) e pela Rabdomiossarcoma embrionário (6,54%), e consequentemente o local da neoplasia primária que prevaleceu foi a Medula óssea (27,10%) seguido do olho (10,28%), deste total nota-se que o tratamento antineoplásico mais utilizado foi a quimioterapia (40,19%) seguido da quimioterapia associada à radioterapia(12,15%) e pela quimioterapia associada a cirurgia (10,28%). Conclusões:A leucemia linfoide aguda foi a neoplasia mais frequente na infância e adolescência, com prevalência na idade entre 5 e 14 anos, no sexo feminino e na etnia negra. A terapia antineoplásica mais utilizada foi a quimioterapia, seguida da associação entre quimioterapia e radioterapia (AU).

Introduction:Childhood cancer correspondsto a group of several diseases that have in common the uncontrolled proliferation of abnormal cells and that can occur anywhere in the body. Objective:Identify the most frequent types of neoplasms in childhood and adolescence and analyze the clinical-epidemiological profile of patients. Methodology:Exploratory cross-sectional study, applied in nature with document analysis, carried out at the Pediatric Oncohematology Center of Oswaldo Cruz University, Recife, Pernambuco. Children and adolescents diagnosed with neoplasia and treated with antineoplastic therapy were included. Exclusion criteria were normoreactive children and adolescents and/or with systemic diseases; illegible medical records or lacking clinical information. Results:It was identified that54.21% of the patients were female, followed by 44.86% male. The prevalent age group in the study was children from 5 to 14 years old (54.21%), still regarding the patients'profile , it was identified that the population self-declared as black was the most prevalent, representing 44.86% of the total, followed by of whites with 43.93%. The diagnosis that prevailed was Acute Lymphoid Leukemia (23.36%), followed by Retinoblastoma (7.48%) and Embryonic Rhabdomyosarcoma (6.54%), and consequently,the site of the primary neoplasm that prevailed was Bone marrow (27.10%) followed by the eye (10.28%), of this total it is noted that the most used anticancer treatment was chemotherapy (40.19%) followed by chemotherapy associated with radiotherapy (12.15% ) and chemotherapy associated with surgery (10.28%). Conclusions:Acute lymphoblastic leukemia was the most frequent neoplasm in childhood and adolescence, with a prevalence between 5 and 14 years of age, in females,and black ethnicity. The most used antineoplastic therapy was chemotherapy, followed by the association between chemotherapy and radiotherapy (AU).

ntroducción: El cáncer infantil corresponde a un grupo de varias enfermedades que tienen en común la proliferación descontrolada de células anormales y que pueden presentarse en cualquier parte del cuerpo. Objetivo: Identificar los tipos de neoplasias más frecuentes en la infancia y la adolescencia y analizar el perfil clínico-epidemiológico de los pacientes. Metodología: Estudio transversal exploratorio, aplicado en la naturaleza con análisis de documentos, realizado en el Centro de Oncohematología Pediátrica del Hospital Universitario Oswaldo Cruz, Recife, Pernambuco. Se incluyeron niños y adolescentes con diagnóstico de neoplasia y tratados con terapia antineoplásica. Los criterios de exclusión fueron niños y adolescentes normorreactivos y/o con enfermedades sistémicas; registros médicos ilegibles o carentes de información clínica. Resultados: Se identificó que el 54,21% de los pacientes eran del sexo femenino, seguido del 44,86% del masculino. El grupo etario prevalente en el estudio fueron los niños de 5 a 14 años (54,21%), en cuanto al perfil de los pacientes, se identificó que la población autodeclarada afrodescendiente fue la más prevalente, representando el 44,86% del total, seguido de los blancos con un 43,93%. El diagnóstico que predominó fue Leucemia Linfoide Aguda (23,36%), seguido de Retinoblastoma (7,48%) yRabdomiosarcoma Embrionario (6,54%), y en consecuencia el local de la neoplasia primaria que predominó fue Médula Ósea (27,10%) seguido de ocular (10,28%), de este total se destaca que el tratamiento anticancerígeno más utilizado fue la quimioterapia (40,19%) seguida de la quimioterapia asociada a radioterapia (12,15%) y la quimioterapia asociada a cirugía (10,28%). Conclusiones: La leucemia linfoblástica aguda fue la neoplasia más frecuente en la infancia y la adolescencia, con prevalencia entre los 5 y los 14 años, en el sexo femenino y en la etnia negra. La terapia antineoplásica más utilizada fue la quimioterapia, seguida de la asociación entre quimioterapia y radioterapia (AU).

Incidence and survival of neuroendocrine neoplasms in China with comparison to the United States / 中华医学杂志(英文版)

BACKGROUND@#Neuroendocrine neoplasms (NENs) are rare tumors characterized by variable biology and delayed diagnosis. However, the nationwide epidemiology of NENs has never been reported in China. We aimed to estimate the incidence and survival statistics of NENs in China, in comparison to those in the United States during the same period.@*METHODS@#Based on the data from 246 population-based cancer registries covering 272.5 million people of China, we calculated age-specific incidence on NENs in 2017 and multiplied by corresponding national population to estimate the nationwide incidence in China. The data of 22 population-based cancer registries were used to estimate the trends of NENs incidence from 2000 to 2017 through the Joinpoint regression model. We used the cohort approach to analyze the 5-year age-standardized relative survival by sex, age group, and urban-rural area between 2008 and 2013, based on data from 176 high-quality cancer registries. We used data from the Surveillance, Epidemiology, and End Results (SEER) 18 program to estimate the comparable incidence and survival of NENs in the United States.@*RESULTS@#The overall age-standardized rate (ASR) of NENs incidence was lower in China (1.14 per 100,000) than in the United States (6.26 per 100,000). The most common primary sites were lungs, pancreas, stomach, and rectum in China. The ASRs of NENs incidence increased by 9.8% and 3.6% per year in China and the United States, respectively. The overall 5-year relative survival in China (36.2%) was lower than in the United States (63.9%). The 5-year relative survival was higher for female patients than male patients, and was higher in urban areas than in rural areas.@*CONCLUSIONS@#The disparities in burden of NENs persist across sex, area, age group, and site in China and the United States. These findings may provide a scientific basis on prevention and control of NENs in the two countries.

Diagnosis and treatment of adult tumor patients with COVID-19 / 中华肿瘤杂志

After the first outbreak of corona virus disease 2019 (COVID-19) at the end of 2019, it has caused multiple rounds of transmission in many countries around the world. Cancer patients are mainly elderly people, and the immunosuppression state caused by the tumor itself and anti-tumor treatment, more accompanying underlying diseases, and more hospital environmental exposure leading to a higher incidence of COVID-19 infection. The proportion of severe cases after infection is high, and the mortality is high. Therefore, based on the domestic and foreign research and clinical practice, the Expert Committee of Geriatric Cancer Prevention and Treatment of Chinese Society of Clinical Oncology launched a discussion based on the characteristics of cancer patients, including the epidemiology, clinical manifestations, differential diagnosis, definition and risk factors of severe cases, diagnosis and treatment recommendations, recovery of anti-tumor treatment and vaccination recommendations. To provide the corresponding suggestions for the clinical diagnosis and treatment of such patients.

Progress on development and application of the diet-related inflammatory index in cancer epidemiological studies / 中华流行病学杂志

Cancer is a major public health problem worldwide, causing an more serious burden of disease. Inflammation is considered a predisposing factor for cancer with close relationship with its incidence. In recent years, the public and epidemiologists has paid more attention to the association between nutrition and cancer and other chronic diseases in the perspective of inflammation. This paper summarizes the development and application of the diet-related inflammatory index in cancer epidemiological studies based on the literature retrieval of common diet-related inflammatory index. Firstly, we highlight the common diet-related inflammatory indices and their construction methods, such as the Dietary Inflammatory Index, a literature-derived diet-related inflammatory index, and the Empirical Dietary Inflammatory Index, an empirically derived diet-related inflammatory index, and so on. Secondly, the epidemiological research progress on the commonly used diet-related inflammatory indices is briefly introduced. Finally, the advantages and disadvantages of the two types of this inflammatory indices are also briefly described for the purpose of providing reference for nutrition epidemiological studies of cancer and other chronic diseases in China.

Incidência de neoplasias malignas em Porto Alegre e Salvador em 2020 de acordo com o DATASUS / Incidence of malignant neoplasms in Porto Alegre and Salvador in 2020 according to DATASUS / Incidencia de neoplasias malignas en Porto Alegre y Salvador en 2020 según DATASUS

Objetivo: analisar a incidência de neoplasias malignas em 2020. Métodos: estudo ecológico com análise comparativa entre as populações de Porto Alegre e Salvador. Foram extraídos dados do DATASUS, analisados em tabelas e apresentados em gráficos. Resultados: A incidência de neoplasias malignas em mulheres entre 30 a 34 anos é maior em Porto Alegre que em Salvador, sendo quase o dobro de casos de mulheres em relação aos homens. Entre 65 a 69 anos, mulheres representaram 20 casos a mais em Porto Alegre, e, em Salvador, o sexo masculino apresentou 28 casos a mais. As mulheres realizaram mais quimioterapias e os homens mais cirurgias. Conclusão: Houve diferença entre a incidência de neoplasias nas cidades podendo associar variáveis determinantes como sexo biológico feminino ao tipo de câncer e idade avançada. A maior incidência de casos na região sul pode estar associada aos hábitos de vida como alimentação e cultura desta região.

Objective: to analyze the incidence of malignant neoplasms in 2020 in two Brazilian cities. Methods: this is an ecological study with comparative analysis between the populations of the cities of Porto Alegre, and Salvador. Data were extracted from the DATASUS, analyzed in tables and presented in descriptive. Results: The incidence of malignant neoplasms in women aged 30 to 34 years is higher of Porto Alegre than in Salvador, with almost double the number of cases in women compared to men in both cities. In the age 65 to 69, women accounted for 20 more cases in Porto Alegre, and in Salvador, males had 28 more cases. Women underwent more chemotherapy and men more surgical in both cities. Conclusion: Differences were observed between the incidence of neoplasms for the cities compared, which could associate determinant variables such as female biological sex with the type of cancer and advanced age. In addition, there is evidence that the southern region of Brazil has a higher incidence than the northeast region, which may be associated with lifestyle habits such as food and culture in the region.

Objetivo: analizar la incidencia de neoplasias malignas en 2020 en dos ciudades brasileñas. Métodos: se trata de un estudio ecológico con análisis comparativo entre las poblaciones de Porto Alegre y Salvador. Los datos fueron extraídos del DATASUS, analizados en tablas y presentados en gráficos. Resultados: La incidencia de neoplasias malignas en mujeres de 30 a 34 años es mayor en Porto Alegre que en Salvador, con casi el doble de casos en mujeres que en hombres. Entre 65 a 69 años, las mujeres representaron 20 casos más en Porto Alegre, y en Salvador, los hombres tuvieron 28 casos más. Las mujeres se sometieron más a quimioterapia y los hombres más a quirúrgias. Conclusión: Se observaron diferencias entre la incidencia de neoplasias, que podrían asociar variables determinantes como el sexo biológico femenino con el tipo de cáncer y la edad avanzada. Existe evidencia de que la región sur de Brasil tiene una mayor incidencia que la región noreste, lo que puede estar asociado con hábitos de estilo de vida como la alimentación y la cultura en la región.

Incidência de neoplasias malignas em Porto Alegre e Salvador em 2020 de acordo com o DATASUS / Incidence of malignant neoplasms in Porto Alegre and Salvador in 2020 according to DATASUS / Incidencia de neoplasias malignas en Porto Alegre y Salvador en 2020 según DATASUS

Objetivo: analisar a incidência de neoplasias malignas em 2020. Métodos: estudo ecológico com análise comparativa entre as populações de Porto Alegre e Salvador. Foram extraídos dados do DATASUS, analisados em tabelas e apresentados em gráficos. Resultados: A incidência de neoplasias malignas em mulheres entre 30 a 34 anos é maior em Porto Alegre que em Salvador, sendo quase o dobro de casos de mulheres em relação aos homens. Entre 65 a 69 anos, mulheres representaram 20 casos a mais em Porto Alegre, e, em Salvador, o sexo masculino apresentou 28 casos a mais. As mulheres realizaram mais quimioterapias e os homens mais cirurgias. Conclusão: Houve diferença entre a incidência de neoplasias nas cidades podendo associar variáveis determinantes como sexo biológico feminino ao tipo de câncer e idade avançada. A maior incidência de casos na região sul pode estar associada aos hábitos de vida como alimentação e cultura desta região.

Objective: to analyze the incidence of malignant neoplasms in 2020 in two Brazilian cities. Methods: this is an ecological study with comparative analysis between the populations of the cities of Porto Alegre, and Salvador. Data were extracted from the DATASUS, analyzed in tables and presented in descriptive. Results: The incidence of malignant neoplasms in women aged 30 to 34 years is higher of Porto Alegre than in Salvador, with almost double the number of cases in women compared to men in both cities. In the age 65 to 69, women accounted for 20 more cases in Porto Alegre, and in Salvador, males had 28 more cases. Women underwent more chemotherapy and men more surgical in both cities. Conclusion: Differences were observed between the incidence of neoplasms for the cities compared, which could associate determinant variables such as female biological sex with the type of cancer and advanced age. In addition, there is evidence that the southern region of Brazil has a higher incidence than the northeast region, which may be associated with lifestyle habits such as food and culture in the region.

Objetivo: analizar la incidencia de neoplasias malignas en 2020 en dos ciudades brasileñas. Métodos: se trata de un estudio ecológico con análisis comparativo entre las poblaciones de Porto Alegre y Salvador. Los datos fueron extraídos del DATASUS, analizados en tablas y presentados en gráficos. Resultados: La incidencia de neoplasias malignas en mujeres de 30 a 34 años es mayor en Porto Alegre que en Salvador, con casi el doble de casos en mujeres que en hombres. Entre 65 a 69 años, las mujeres representaron 20 casos más en Porto Alegre, y en Salvador, los hombres tuvieron 28 casos más. Las mujeres se sometieron más a quimioterapia y los hombres más a quirúrgias. Conclusión: Se observaron diferencias entre la incidencia de neoplasias, que podrían asociar variables determinantes como el sexo biológico femenino con el tipo de cáncer y la edad avanzada. Existe evidencia de que la región sur de Brasil tiene una mayor incidencia que la región noreste, lo que puede estar asociado con hábitos de estilo de vida como la alimentación y la cultura en la región.

Tendência e magnitude da mortalidade por câncer no Brasil e sua relação com condições socioeconômicas e provisão de serviços de saúde / Trend and magnitude of cancer mortality in Brazil and its relationship with socioeconomic conditions and health care provision

Introdução: A Organização Mundial de Saúde estima 10 milhões de óbitos devidos a neoplasias em 2019, totalizando 17% de todas as causas de morte do planeta. Desigualdades na mortalidade por câncer podem estar relacionadas aos determinantes socioeconômicos da incidência da doença, assim como à efetividade e resiliência de serviços de saúde. Objetivos: Estimar a tendência e a magnitude da mortalidade por câncer no Brasil, explorar a relação desses desfechos com indicadores socioeconômicos e de provisão de serviços de saúde e, por fim, discutir a resiliência e funcionalidade do sistema de saúde brasileiro frente à pandemia de COVID-19. Métodos: Dados sobre o Índice de Desenvolvimento Humano Municipal são disponibilizados pelo Programa das Nações Unidas para o Desenvolvimento. Informações a respeito de provisões de saúde e registro de óbitos foram extraídas das bases de acesso público do Ministério da Saúde. Demais dados demográficos foram informados pelos recenseamentos gerais, com estimativas para os anos intercensitários fornecidas pela Fundação Instituto Brasileiro de Geografia e Estatística. A mortalidade foi calculada com ajuste por sexo e idade pelo método direto e tomando o padrão de população proposto pela Organização Mundial de Saúde. Para as análises de tendência foi utilizada a regressão de Prais-Winsten. Para demais dados descritivos foi utilizada a variação percentual relativa. Resultados: Tendências de cânceres aumentaram no Norte e Nordeste e mantiveram-se majoritariamente decrescentes ou estacionárias no Sul, Sudeste e Centro-Oeste. A variação de tendências entre regiões intermediárias foi mais pronunciada no Norte e Nordeste. Regiões intermediárias com alto índices de desenvolvimento humano, gastos de saúde e leitos hospitalares obtiveram tendências crescentes menores do que as regiões com valores baixos desses indicadores para a maior parte dos grupos de câncer estudados. Em 2018, as macrorregiões mais ricas do país, Sul e Sudeste, aplicaram mais verbas em saúde na média por habitante e puderam dispor mais leitos e realizar mais internações hospitalares e atendimentos ambulatoriais per capita. Quando essas variáveis foram medidas nas regiões intermediárias, também foi verificado o mesmo padrão de melhores resultados para as áreas com IDH mais elevado. O governo brasileiro não levou em consideração que estados mais vulneráveis estavam mais suscetíveis aos impactos da pandemia de COVID-19. A falta de planejamento acarretou a redução de 25% dos procedimentos SUS. Conclusões: Tendências crescentes de mortalidade em regiões de baixa-renda podem refletir sobrecarga de seus sistemas de saúde locais já fragilizados. Aumentar o volume de provisões de serviços de saúde e reduzir disparidades socioeconômicas pode prevenir um aumento nas tendências de mortalidade por câncer em regiões marginalizadas do país. Macrorregiões e a maioria das regiões intermediárias do país são desigualmente preparadas para atender às necessidades gerais de saúde de suas populações, o que foi exposto e agravado pela pandemia de COVID-19. A falta de planejamento governamental para aumentar a resiliência do SUS resultou no aumento das disparidades do sistema de saúde no território brasileiro.

Introduction: The World Health Organization estimates 10 million deaths due to neoplasms in 2019, which accounts for a total of 17% of all causes of death on the planet. Inequalities in cancer mortality may be related to socioeconomic determinants of cancer incidence, as well as to the effectiveness and resilience of health services. Objectives: To estimate the trend and magnitude of cancer mortality in Brazil, to explore the relationship of these outcomes with socioeconomic indicators and health care provisions and services and, finally, to discuss the resilience and functionality of the Brazilian health system in the face of the COVID-19 pandemic. Methods: Data on the Municipal Human Development Index are made available by the United Nations Development Program. Information about health care provisions and death records were extracted from the public access databases of the Ministry of Health. Other demographic data were reported by the general censuses, with estimates for the intercensal years provided by the Brazilian Institute of Geography and Statistics. Mortality was calculated by standardizing by gender and age using the population demographic profile proposed by the World Health Organization. Prais-Winsten regression was used for trend analyses. For other descriptive data, the relative percentage variation was used. Results: Cancer trends increased in the North and Northeast and remained mostly decreasing or stationary in the South, Southeast and Midwest. The variation of trends between intermediate regions was more pronounced in the North and Northeast. Intermediate regions with high rates of human development, health expenditures and hospital beds had lower increasing trends than the regions with low values of these indicators for most cancer groups studied. In 2018, the richest macroregions of the country, South and Southeast, applied more health funds on average per inhabitant and were able to increase the number of hospital beds and perform more hospital admissions and outpatient care procedures per capita. When these variables were measured in the intermediate regions, the same pattern of better outcomes was also verified for areas with higher HDI. The Brazilian government did not take into account that more vulnerable states were more susceptible to the impacts of the COVID-19 pandemic. The lack of planning led to a 25% reduction in SUS procedures. Conclusions: Increasing mortality trends in low-income regions may overload their already fragile local health system. Increasing the volume of health service provisions and reducing socioeconomic disparities may be able to prevent an increase in cancer mortality trends in marginalized regions of the country. Macroregions and most of the intermediate regions of the country are unequally prepared to meet the general health needs of their populations, which was exposed and aggravated by the COVID-19 pandemic. The lack of government planning to increase the resilience of SUS resulted in increased disparities in the Brazilian health system.

Características clínico-patológicas de los pacientes asistidos en el Centro Docente Asociado de Oncología Médica en el Hospital Departamental de Soriano durante su primer año de funcionamiento / Clinical-pathological characteristics of patients assisted at the Associated Teaching Center of Medical Oncology at Soriano Departmental Hospital during its first year of operation / Características clínico-patológicas dos pacientes atendidos no Centro Docente Associado de Oncologia Médica no Hospital Departamental de Soriano durante seu primeiro ano de funcionamento

Introducción: Según el Ministerio de Salud las muertes por cáncer constituyen un cuarto del total de las defunciones registradas en Uruguay cada año. Objetivo: Conocer el perfíl epidemiológico de los pacientes diagnosticados de cáncer asistidos en el Hospital Departamental de Soriano. Material y métodos: Estudio observacional, retrospectivo y descriptivo que incluyó a los pacientes diagnosticados de cáncer asistidos en el Hospital Departamental de Soriano durante el 2022. Se mantuvo el anonimato de los pacientes en el análisis estadístico y se contó con la aprobación del Comité de Ética del Hospital de Clínicas. Resultados: Se incluyeron 113 pacientes nuevos; 53.1% fueron hombres, siendo la mediana de edad al diagnóstico de 69 años. Los 4 tumores más frecuentes para ambos sexos reunidos fueron: mama, próstata, pulmón y colo-recto; la distribución por estadio fue la siguiente: E IV 48.6% pacientes; EIII 22.5%; EII 26.5%; y EI 2.6%. En el 79.6% de las pacientes se contaba con la confirmación del diagnóstico mediante anatomía patológica. El tiempo entre el diagnóstico y el primer tratamiento oncológico fue ≤ 3 meses para el 88.2% de los pacientes. El total de los pacientes con EIV fueron contactados con la Unidad de Cuidados Paliativos. Únicamente el 15% de los casos fueron discutidos en Comité de Tumores. Conclusiones: Los datos analizados permitieron caracterizar el perfil epidemiológico del cáncer de los pacientes procedente de Soriano asistidos en el ámbito público y pueden contribuir a la implementación de políticas públicas orientadas a la prevención y por ende a la mejora en la asistencia pacientes asistidos.

Introduction: According to the Ministry of Health, cancer deaths constitute a quarter of the total deaths registered in Uruguay each year. Objective: To identify the epidemiological profile of patients diagnosed with cancer treated at the Departmental Hospital of Soriano. Materials and Methods: An observational, retrospective and descriptive study that included patients diagnosed with cancer attended at the Departmental Hospital of Soriano during 2022. The anonymity of the patients was maintained in the statistical analysis and approval was obtained from the Ethics Committee of the Hospital de Clínicas. Results: A total of 113 new patients were included; 53.1% were men, with a median age at diagnosis of 69 years old. The four most frequent tumors for both sexes were: breast, prostate, lung and colorectal; the distribution by stage was as follows: Stage IV 48.6% patients; Stage III 22.5%; Stage II 26.5%; and Stage I 2.6%. In 79.6% of the patients the diagnosis was confirmed by pathological anatomy. The time between diagnosis and first oncological treatment was ≤ 3 months for 88.2% of patients. The total number of patients with Stage IV were contacted by the Palliative Care Unit. Only 15% of the cases were discussed in the Tumor Committee. Conclusions: The data analyzed made it possible to characterize the epidemiological profile of cancer in patients from Soriano assisted in the public sector and may contribute to the implementation of public policies aimed at prevention and, therefore, at improving patient care.

Introdução: Segundo o Ministério da Saúde, as mortes por câncer constituem um quarto de todas as mortes registradas no Uruguai a cada ano. Objetivos: Conhecer o perfil epidemiológico dos pacientes diagnosticados com câncer atendidos no Hospital Departamental de Soriano. Material e Métodos: Estudo observacional, retrospectivo e descritivo que incluiu pacientes diagnosticados com câncer atendidos no Hospital Departamental de Soriano durante o ano de 2022. O anonimato dos pacientes foi mantido na análise estatística e foi aprovado pelo Comitê de Ética do Hospital de Clínicas. Resultados: foram incluídos 113 novos pacientes; 53,1% eram homens, com mediana de idade ao diagnóstico de 69 anos. Os 4 tumores mais frequentes para ambos os sexos combinados foram: mama, próstata, pulmão e colorretal; a distribuição por estágio foi a seguinte: E IV 48,6% pacientes; EIII 22,5%; EII 26,5%; EI 2,6%. Em 79,6% dos pacientes houve confirmação do diagnóstico pela patologia. O tempo entre o diagnóstico e o primeiro tratamento oncológico foi ≤ 3 meses para 88,2% dos pacientes. Todos os doentes com DIV foram contactados com a Unidade de Cuidados Paliativos. Apenas 15% dos casos foram discutidos no Comitê de Tumores. Conclusões: Os dados analisados ​​permitiram caracterizar o perfil epidemiológico do câncer em pacientes de Soriano atendidos na esfera pública e podem contribuir para a implementação de políticas públicas voltadas para a prevenção e, consequentemente, para a melhoria na assistência aos pacientes atendidos.

Social inequalities in male cancer in a metropolis in the Southeast region of Brazil / Desigualdades sociais em câncer no sexo masculino em uma metrópole da região Sudeste do Brasil

ABSTRACT OBJECTIVE To analyze inequalities in incidence, mortality, and estimated survival for neoplasms in men according to social vulnerability. METHODS Analysis of cases and deaths of all neoplasms and the five most common in men aged 30 years or older in the city of Campinas (SP), between 2010 and 2014, using data from the Population-Based Cancer Registry (RCBP) and the Mortality Information System (SIM). The areas of residence were grouped into five social vulnerability strata (SVS) using São Paulo Social Vulnerability Index. For each SVS, age-standardized incidence and mortality rates were calculated. A five-year survival proxy was calculated by complementing the ratio of the mortality rate to the incidence rate. Inequalities between strata were measured by the ratios between rates, the relative inequality index (RII) and the angular inequality index (AII). RESULTS RII revealed that the incidence of all neoplasms (0.66, 95%CI 0.62-0.69) and colorectal and lung cancers were lower among the most socially vulnerable, who presented a higher incidence of stomach and oral cavity cancer. Mortality rates for stomach, oral cavity, prostate and all types of cancer were higher in the most vulnerable segments, with no differences in mortality for colorectal and lung cancer. Survival was lower in the most social vulnerable stratum for all types of cancer studied. AII showed excess cases in the least vulnerable and deaths in the most vulnerable. Social inequalities were different depending on the tumor location and the indicator analyzed. CONCLUSION There is a trend of reversal of inequalities between incidence-mortality and incidence-survival, and the most social vulnerable segment presents lower survival rates for the types of cancer, pointing to the existence of inequality in access to early diagnosis and effective and timely treatment.

RESUMO OBJETIVO Analisar as desigualdades segundo a vulnerabilidade social na incidência, mortalidade e estimativa de sobrevida de neoplasias no sexo masculino. MÉTODOS Foram analisados os casos e as mortes do total de neoplasias e das cinco mais incidentes em homens com 30 anos ou mais no município de Campinas (SP), entre 2010 e 2014, utilizando dados do Registro de Câncer de Base Populacional (RCBP) e do Sistema de Informação sobre Mortalidade (SIM). As áreas de residência foram agrupadas em cinco estratos de vulnerabilidade social (EVS) utilizando o Índice Paulista de Vulnerabilidade Social. Para cada EVS, foram calculadas as taxas de incidência e de mortalidade padronizadas por idade. Um proxy de sobrevida em cinco anos foi calculado pelo complemento da razão da taxa de mortalidade pela taxa de incidência. As desigualdades entre os estratos foram mensuradas pelas razões entre taxas, pelo índice relativo de desigualdade (IRD) e pelo índice angular de desigualdade. RESULTADOS O IRD revelou que a incidência do total de neoplasias (0,66, IC95% 0,62-0,69) e dos cânceres colorretal e de pulmão foram menores entre os socialmente mais vulneráveis, que apresentaram maior incidência dos cânceres de estômago e da cavidade oral. As taxas de mortalidade por câncer de estômago, cavidade oral, próstata e por todas as neoplasias foram superiores nos segmentos mais vulneráveis, sem diferenças na mortalidade por câncer colorretal e de pulmão. A sobrevida foi menor no estrato de maior vulnerabilidade social para todos os cânceres estudados. O índice angular de desigualdade (IAD) mostrou o excesso de casos nos menos vulneráveis e de óbitos nos mais vulneráveis. As desigualdades sociais revelaram-se distintas conforme a localização do tumor e o indicador analisado. CONCLUSÃO Constata-se uma tendência de inversão das desigualdades entre incidência e mortalidade e sobrevida, sendo esta última desfavorável ao segmento de maior vulnerabilidade social para os tipos de câncer, apontando a existência de inequidade no acesso ao diagnóstico precoce e ao tratamento efetivo e oportuno.

Epidemiologia do câncer em crianças e adolescentes no Município de São Paulo, 1997 a 2016 / Epidemiology of cancer in children and adolescents in the city of São Paulo, 1997 to 2016

Introdução: Estima-se que o câncer em crianças e adolescentes (0 a 19 anos) corresponda até 3% de todos os tumores malignos. É uma das principais causas de óbito nesta faixa etária, e representa um importante problema de saúde pública. Nas últimas décadas, diversos países apresentaram aumento ou estabilidade das taxas de incidência, e queda nas taxas de mortalidade. Objetivo: Analisar as tendências das taxas de incidência e mortalidade do câncer em crianças e adolescentes no Município de São Paulo, e estimar os efeitos de idade, período e coorte de nascimento. Métodos: Trata-se de estudo ecológico de séries temporais. Os casos novos de câncer, entre 1997 e 2016, foram obtidos através do Registro de Câncer de Base Populacional do Município de São Paulo, e os óbitos, entre 1997 e 2021, a partir do Sistema de Informação de Mortalidade. Dados populacionais foram acessados através da página eletrônica da Prefeitura de São Paulo. Foram calculadas taxas de incidência e mortalidade brutas, específicas e padronizadas por sexo e idade. Para avaliar a tendência temporal do câncer, foram ajustados modelos de regressão múltipla, segundo sexo e faixa etária. Para avaliar a influência da idade, período e coortes de nascimento na tendência da incidência e mortalidade, foi utilizado o modelo idade-período-coorte. Resultados: Foram registrados 13.065 casos de câncer entre 1997 e 2016 e 4.130 óbitos entre 1997 e 2021. As taxas de incidência e mortalidade padronizadas por idade foram 195,2 por milhão e 49,7 por milhão, respectivamente. Durante todo o período, as taxas permaneceram maiores em crianças de 0 a 4 anos e adolescentes, ambos do sexo masculino. Os grupos diagnósticos mais comuns foram as leucemias (21,9%), linfomas (15,3%) e tumores do sistema nervoso central (11,8%). O grupo mais frequente em crianças de 0 a 14 anos foi a leucemia, em adolescentes do sexo masculino os linfomas, e do sexo feminino as neoplasias epiteliais e outros melanomas. Enquanto a proporção de linfomas e neoplasias epiteliais aumentou com a idade, a dos neuroblastomas, tumores renais e leucemias diminuiu, para ambos os sexos. O período entre 1997 e 2005 foi marcado pelo aumento das taxas de incidência em crianças de 0 a 4 anos do sexo masculino (12,7 casos por milhão ao ano; IC = 9,0 : 16,3) e feminino (3,4 casos por milhão por ano; IC = -0,7 : 7,6) e entre 5 e 9 anos, em ambos os sexos (4,2 casos por milhão por ano; IC = 1,4: 6,9). A partir de 2005, a tendência foi de queda, para todas as faixas etárias. Entre 1997 e 2006, a taxa de mortalidade apresentou aumento apenas em crianças de 5 a 9 anos, em ambos os sexos (0,9 casos por milhão por ano; IC = -0,1 : 1,9). Após esse período, houve declínio contínuo das taxas para todas as faixas etárias. Foi identificado um componente importante deste comportamento, determinado pela coorte de nascimento. Conclusões: O câncer apresenta características específicas em crianças e adolescentes; as tendências de incidência e mortalidade contém diferentes componentes determinados por sexo, idade, período e coorte de nascimento.

Introduction: It is estimated that cancer in children and adolescents (0 to 19 years old) accounts for up to 3% of all malignant tumors. It is one of the main causes of death in this age group, and represents an important public health problem. In recent decades, several countries have shown an increase or stability in incidence rates, and a drop in mortality rates. Objective: To analyze trends in cancer incidence and mortality rates in children and adolescents in the city of São Paulo, and to estimate the effects of age, period and birth cohort. Methods: This is an ecological time series study. New cases of cancer, between 1997 and 2016, were obtained through the Population-Based Cancer Registry of the Municipality of São Paulo, and deaths, between 1997 and 2021, from the Mortality Information System. Population data were accessed through the São Paulo City Hall website. Crude, gender-specific, and age-standardized incidence and mortality rates were calculated. To assess the temporal trend of cancer, multiple linear regression models were adjusted according to sex and age group. To assess the influence of age, period and birth cohorts on the trend of incidence and mortality, the age-period-cohort model was used. Results: 13,065 cases of cancer were recorded between 1997 and 2016 and 4,130 deaths between 1997 and 2021. The age-standardized incidence and mortality rates were 195.2 per million and 49.7 per million, respectively. Throughout the period, rates remained higher in children aged 0 to 4 years and adolescents, both males. The most common diagnostic groups were leukemias (21.9%), lymphomas (15.3%) and central nervous system tumors (11.8%). The most common group in children aged 0 to 14 years was leukemia, in male adolescents lymphomas, and in female adolescents epithelial neoplasms and other melanomas. While the proportion of lymphomas and epithelial neoplasms increased with age, that of neuroblastomas, renal tumors and leukemias decreased, for both sexes. The period between 1997 and 2005 was marked by an increase in incidence rates in male (12.7 cases per million per year; CI = 9.0: 16.3) and female (3.4 cases per million per year; CI = -0.7: 7.6) and between 5 and 9 years, in both sexes (4.2 cases per million per year; CI = 1.4: 6.9). From 2005 onwards, the trend was downward, for all age groups. Between 1997 and 2006, the mortality rate increased only in children aged 5 to 9 years, in both sexes (0.9 cases per million per year; CI = -0.1 : 1.9). After this period, there was a continuous decline in rates for all age groups. An important component of this behavior, determined by birth cohort, was identified. Conclusions: Cancer has specific characteristics in children and adolescents; incidence and mortality trends contain different components determined by sex, age, period and birth cohort.

Câncer, disparidades sociais e acesso aos serviços de saúde / Cancer, social disparities and access to health services

O crescimento desordenado de células no organismo, que pode invadir tecidos adjacentes ou órgãos em outras regiões do corpo, é denominado câncer (WHO, 2022a). A nomenclatura da doença corresponde ao local de foco inicial, e assim, os cânceres de mama, próstata, pulmão, colorretal, colo uterino e estômago são os mais frequentes. Globalmente, uma em cada seis mortes são relacionadas à doença, que configura a segunda principal causa de morte. E os tipos de câncer que mais evoluem para óbito são pulmão, mama, colorretal, fígado, próstata e estômago (WHO, 2022b)

The disordered growth of cells in the body, which can invade adjacent tissues or organs in other regions of the body, is called cancer (WHO, 2022a). The disease nomenclature corresponds to the initial focus site, and thus, breast, prostate, lung, colorectal, uterine cervix and stomach cancers are the most frequent. Globally, one in every six deaths are related to the disease, which is the second leading cause of death. And the types of cancer that most evolve to death are lung, breast, colorectal, liver, prostate and stomach (WHO, 2022b)

Relación entre la diabetes mellitus y el cáncer / Relationship between Diabetes Mellitus and Cancer

Introducción: La diabetes mellitus y el cáncer son dos problemas de salud que afectan a la población mundial. Considerar previamente el riesgo de desarrollo de cáncer en pacientes con diabetes mellitus puede contribuir de manera significativa a su prevención en este grupo de riesgo. Objetivo: Describir la relación existente entre la diabetes mellitus y el cáncer. Métodos: Se realizó una revisión bibliográfica, entre septiembre de 2019 y marzo de 2020. Se consultaron artículos científicos en Pubmed; la estrategia de búsqueda fue: diabetes mellitus [Mesh] OR diabetes mellitus[TIAB] OR diabetes mellitus, type 2[Mesh] OR type 2 diabetes mellitus[TIAB] OR obesity[Mesh] OR obesity[TIAB] OR hyperglycemia[Mesh] OR hyperglycemia[TIAB]) AND (cancer[Mesh] OR cancer[TIAB] OR neoplasia[Mesh] OR neoplasia[TIAB] OR neoplasias[Mesh] OR neoplasias[TIAB] OR neoplasm[Mesh] OR neoplasm[TIAB] OR tumors[Mesh] OR tumors[TIAB] OR tumor[Mesh] OR tumor[TIAB] OR cancers[Mesh] OR cancers[TIAB]). Se consultaron además artículos de SCOPUS, Scielo, LILACS, Biblioteca Virtual de Salud de Cuba y Google Scholar. Se seleccionaron artículos publicados a partir de 2005, con 63 por ciento de los últimos cinco años (2016‒2020). Se trabajó con 51 publicaciones. Conclusiones: Existe consenso sobre la relación entre la diabetes y el cáncer. La diabetes mellitus es un factor de riesgo para el desarrollo de cáncer, fundamentalmente en las localizaciones de páncreas, riñón, colon y recto y cuerpo uterino, ovarios y mama en la mujer; y factor protector para el cáncer de próstata en hombres. Ambas enfermedades comparten factores de riesgo no modificables (edad y sexo), modificables (dieta, actividad física, alcoholismo, entre otros) y condiciones biológicas (hiperglucemia e hiperinsulinemia)(AU)

Introduction: Diabetes mellitus and cancer are two health problems affecting the world population. Prior consideration of the risk for cancer development in patients with diabetes mellitus can contribute significantly to its prevention in this risk group. Objective: To describe the relationship between diabetes mellitus and cancer. Methods: A literature review was carried out between September 2019 and March 2020. Scientific articles were consulted in Pubmed; the search strategy was defined as it follows: diabetes mellitus[Mesh] OR diabetes mellitus[TIAB] OR diabetes mellitus, type 2[Mesh] OR type 2 diabetes mellitus[TIAB] OR obesity[Mesh] OR obesity[TIAB] OR hyperglycemia[Mesh] OR hyperglycemia[TIAB]) AND (cancer[Mesh] OR cancer[TIAB] OR neoplasia[Mesh] OR neoplasia[TIAB] OR neoplasias[Mesh] OR neoplasias[TIAB] OR neoplasm[Mesh] OR neoplasm[TIAB] OR tumors[Mesh] OR tumors[TIAB] OR tumor[Mesh] OR tumor[TIAB] OR cancers[Mesh] OR cancers[TIAB]). Articles from SCOPUS, Scielo, LILACS, the Virtual Health Library of Cuba, and Google Scholar were also reviewed. Articles published from 2005 onwards were selected, with 63 percent from the last five years (2016-2020). Fifty-one publications were analyzed. Conclusions: There is consensus regarding the relationship between diabetes and cancer. Diabetes mellitus is a risk factor for the development of cancer, fundamentally in the locations of pancreas, kidney, colon and rectum, as well as the uterine body, ovaries and breast in women; while being a protective factor for prostate cancer in men. Both diseases share nonmodifiable risk factors (age and sex), modifiable risk factors (diet, physical activity, alcoholism, among others) and biological conditions (hyperglycemia and hyperinsulinemia)(AU)

Prediction of disease burden caused by malignant cancer in the context of risk factor control in China, 2030 / 中华流行病学杂志

Objective: To predict the number of deaths, standardized mortality and probability of premature mortality caused by malignant cancer in the context of risk factor control at different levels in China in 2030, and assess the possibility of achieving the target of reducing the probability of premature mortality of malignant cancer. Methods: According to the risk factor control standard for malignant cancer used both at home and abroad, the results of China from Global Burden of Disease Study 2015 were used to calculate the population attributable fraction of the risk factors. Based on the comparative risk assessment theory, the deaths of malignant cancer were classified as attributable deaths and un-attributable deaths. Proportional change model was used to predict risk factor exposure and un-attributable deaths of malignant cancer in the future, then the number of deaths, standardized mortality rate and probability of premature mortality of malignant cancer in 2030 was estimated. Data analyses were performed by using software R 3.6.1. Results: If the risk factor exposure level during 1990-2015 remains, the number of deaths, standardized mortality rate, and probability of premature mortality of malignant cancer would increase to 3.62 million, 153.96/100 000 and 8.92% by 2030, respectively. If the risk factor exposure control level meets the requirement, the probability of premature mortality from cancer in people aged 30-70 years would drop to 7.57% by 2030. Conclusions: The control of risk factor exposure will play an important role in reducing deaths, standardized mortality rate and probability of premature mortality of malignant cancer. But more efforts are needed to achieve the goals of Health China Action.

Distribution and risk factors of self-reported cancer cases in adults in China, 2015 / 中华流行病学杂志

Objective: To analyze the prevalence and risk factors of self-reported cancer in adults in China in 2015. Methods: The data used in this study were from China Chronic Disease and Risk Factors Surveillance in 2015. The frequency and proportion of the classified variables were analyzed by descriptive statistics, the disordered classified variables were compared by χ2 test, and the possible risk factors of cancer patients were screened by univariate and multivariate logistic regression analyses. Results: In 2015, there were 1 809 self-reported tumors patients in China, including 689 males (0.63%), 1 120 females (1.03%), 769 (0.71%) in the eastern region, 465 (0.43%) in the central region and 575 (0.53%) in the western region. The patients were mainly distributed in people aged 45- and 55- years old, being overweight or obese, living in eastern urban area, having low education level, being married, having low annual household income and being occupational population. The results of multivariate logistic regression showed that compared with the western region, the prevalence rate of cancer was higher in the eastern region (OR=1.05, 95%CI: 1.04-1.06), while lower in the central region (OR=0.94, 95%CI: 0.93-0.95); the risk for cancer in people with family history of malignancy was higher than that in people without family history of malignancy (OR=1.95, 95%CI:1.94-1.96) the risk for cancer in people with an annual household income of less than 10 000 yuan or between 10 000 and 50 000 yuan was higher than that in people with an annual household income of more than 50 000 yuan (<10 000 yuan: OR=1.59, 95%CI: 1.58-1.60; between 10 000 and 50 000 yuan: OR=1.27, 95%CI: 1.26-1.28); and the risk for cancer in people living urban areas was lower than that in people living in rural areas (OR=0.98, 95%CI: 0.97-0.99). In terms of personal behavior and diet, the risk for cancer in smokers was 1.25 times higher than that in non-smokers (OR=1.25, 95%CI: 1.24-1.26), and the risk for cancer in alcoholics was 1.16 times higher than that in non-alcoholics (OR=1.16, 95%CI: 1.15-1.17), the risk for cancer in people with insufficient vegetable and fruit intakes was 1.29 times and 1.03 times higher than those in people with sufficient intakes of vegetables and fruits, respectively (OR=1.29, 95%CI: 1.28-1.30;OR=1.03,95%CI: 1.02-1.04). People with low frequency of high-intensity exercise had a higher risk for cancer compared with those with high frequency of high-intensity exercise (OR=1.32, 95%CI: 1.31-1.33), the risk for cancer was higher in people with low frequency of moderate exercise than in people with high frequency of moderate exercise (OR=1.08, 95%CI: 1.07-1.09). The risk for cancer in people with sedentary time less than 2 hours was higher than that in those with sedentary time more than 2 hours (OR=1.69, 95%CI: 1.68-1.70), and the risk for cancer in people who ate moderate amount of red meat was lower than that in people who ate excessive amount of red meat (OR=0.86, 95%CI: 0.85-0.87). Conclusions: The number of female self-reported cancer was more than that in males, and the number of self-reported cancer in the eastern region was higher than that in the central and western regions. Living in eastern region, with family history of malignancy, having low annual household income, smoking, drinking, insufficient vegetable intake, insufficient fruit intake and low frequency of high-intensity exercise and low frequency of moderate intensity exercise were the main risk factors for cancer, while living in central region, living in urban area and low red meat intake were protective factors.

Cancer statistics in China and United States, 2022: profiles, trends, and determinants / 中华医学杂志(英文版)

BACKGROUND@#The cancer burden in the United States of America (USA) has decreased gradually. However, China is experiencing a transition in its cancer profiles, with greater incidence of cancers that were previously more common in the USA. This study compared the latest cancer profiles, trends, and determinants between China and USA.@*METHODS@#This was a comparative study using open-source data. Cancer cases and deaths in 2022 were calculated using cancer estimates from GLOBOCAN 2020 and population estimates from the United Nations. Trends in cancer incidence and mortality rates in the USA used data from the Surveillance, Epidemiology, and End Results program and National Center for Health Statistics. Chinese data were obtained from cancer registry reports. Data from the Global Burden of Disease 2019 and a decomposition method were used to express cancer deaths as the product of four determinant factors.@*RESULTS@#In 2022, there will be approximately 4,820,000 and 2,370,000 new cancer cases, and 3,210,000 and 640,000 cancer deaths in China and the USA, respectively. The most common cancers are lung cancer in China and breast cancer in the USA, and lung cancer is the leading cause of cancer death in both. Age-standardized incidence and mortality rates for lung cancer and colorectal cancer in the USA have decreased significantly recently, but rates of liver cancer have increased slightly. Rates of stomach, liver, and esophageal cancer decreased gradually in China, but rates have increased for colorectal cancer in the whole population, prostate cancer in men, and other seven cancer types in women. Increases in adult population size and population aging were major determinants for incremental cancer deaths, and case-fatality rates contributed to reduced cancer deaths in both countries.@*CONCLUSIONS@#The decreasing cancer burden in liver, stomach, and esophagus, and increasing burden in lung, colorectum, breast, and prostate, mean that cancer profiles in China and the USA are converging. Population aging is a growing determinant of incremental cancer burden. Progress in cancer prevention and care in the USA, and measures to actively respond to population aging, may help China to reduce the cancer burden.

Abstaining from annual health check-ups is a predictor of advanced cancer diagnosis: a retrospective cohort study

BACKGROUND@#Cancer prevention is a crucial challenge in preventive medicine. Several studies have suggested that voluntary health check-ups and recommendations from health professionals are associated with increased participation in cancer screening. In Japan, it is recommended that individuals aged 40-74 years should undergo annual health check-ups; however, the compliance to this recommendation is approximately <50%. According to the national survey, individuals who do not undergo annual health check-ups are at a higher risk for cancer. However, to the best of our knowledge, no previous study has investigated the association between the use of health check-ups and the incidence rate of cancer. We hypothesised that not undergoing periodic health check-ups and/or less use of outpatient medical services are predictors for advanced cancer.@*METHODS@#To explore the relationship between health check-up or outpatient service utilisation and cancer incidence, this retrospective cohort study used data at two time points-baseline in 2014 and endpoint in 2017-from the National Health Insurance (NHI) claims and cancer registry. A multivariable logistic regression analysis was performed to investigate whether cancer diagnosis was associated with health check-up or outpatient service utilisation.@*RESULTS@#A total of 72,171 participants were included in the analysis. The results of the multivariable logistic regression showed that individuals who skipped health check-ups had a higher risk of cancer diagnosis (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.04-1.40). Moreover, not undergoing health check-ups increased the risk of advanced-stage cancer (OR, 1.78; 95% CI, 1.29-2.44). Furthermore, increased rate of outpatient service utilisation was negatively associated with advanced cancer diagnosis.@*CONCLUSIONS@#This is the first study reporting that not undergoing health check-ups is a predictor of cancer diagnosis and advanced cancer stage. Primary prevention strategies for NHI members who do not undergo health check-ups must be reassessed. Moreover, future research should examine secondary prevention strategies, such as health education and recommendations from health professionals to facilitate adequate utilisation of preventive health services.