Sociodemographic and clinical factors affecting body image, sexual function and sexual satisfaction in women with breast cancer.

AIMS AND OBJECTIVES: To evaluate the effect of sociodemographic and clinical factors on body image, sexual function and sexual satisfaction in women following breast cancer treatment. BACKGROUND: Women with breast cancer may experience a wide range of symptoms associated with body image and sexuality that can severely affect their quality of life. Therefore, the health care professional's ability to understand the patient's complaints and her sexual history is highly relevant in specialised multidisciplinary care. DESIGN: A cross-sectional survey. METHODS: Seventy-seven participants were included. Body image, sexual function and sexual satisfaction were evaluated using the EORTC QLQ-BR23 questionnaire. Results were shown as means, standard deviations, frequencies and percentages. Cronbach's alpha was calculated. Spearman's correlation test, the chi-square test and multivariate logistic regression were used in the statistical analysis, conducted using the spss statistical software package, version 17.0. RESULTS: Low scores were found in the desire (34·63), frequency (32·03) and sexual satisfaction (45·91) domains, while body image scores were higher (63·57). No strong correlation was found between body image and any of the other domains. Patients without a steady partner experienced more sexual desire (p < 0·04) and more frequent sexual activity (p < 0·01). Sexual activity was also more frequent (p < 0·03) in women with a higher education level and in those using aromatase inhibitors. CONCLUSIONS: Sexual function and satisfaction were affected to a greater extent than body image. No association was found between body image and sexual performance. The effect of marital status and education level on sexual function merits particular attention. RELEVANCE TO CLINICAL PRACTICE: A well-trained multidisciplinary team should be available to evaluate women's need for support and to provide information on the disease, its treatment and its impact on their lives and on their sexuality.

Temporal trends in female breast cancer mortality in Brazil and correlations with social inequalities: ecological time-series study.

BACKGROUND: Breast cancer is the most common cause of death from cancer in women in less developed regions. Therefore, the objective of this study was to provide data on the temporal trends in female breast cancer mortality between 1990 and 2011 and to evaluate its association with the social inequalities present in Brazil. METHODS: Breast cancer mortality data and estimates for the resident population were obtained from the Brazilian National Health Service database for the 1990-2011 period. Age-standardized mortality rates were calculated (20-39, 40-49, 50-69 and ≥70 years) by direct standardization using the 1960 standard world population. Trends were modeled using joinpoint regression model and linear regression. The Social Exclusion Index and the Human Development Index were used to classify the 27 Brazilian states. Pearson's correlation was used to describe the association between the Social Exclusion Index and the Human DeveIopment and the variations in mortality rates in each state. RESULTS: Age-standardized mortality rates in Brazil were found to be stable (annual percent change [APC] = 0.3; 95% CI: -0.1 - 0.7) between 1994 and 2011. Considering the Brazilian states, significant decreases in mortality rates were found in Rio Grande do Sul, Rio de Janeiro and São Paulo. Increases in mortality rates were most notable in the states of Maranhão (APC = 11.2; 95 %CI: 5.8 - 16.9), Piauí (APC = 9.8; 95% CI: 7.6 - 12.1) and Paraíba (APC = 9.3; 95% CI: 6.0 - 12.8). There was a statistically significant correlation between Social Exclusion Index and a change in female breast cancer mortality rates in the Brazilian states between 1990 and 2011 and between Human Development Index and mortality between 2001 and 2011. CONCLUSIONS: Female breast cancer mortality rates are stable in Brazil. Reductions in these rates were found in the more developed states, possibly reflecting better healthcare.

[Female breast cancer mortality in Brazil according to color]. / Mortalidade por câncer de mama feminino no Brasil de acordo com a cor.

PURPOSE: To describe the mortality of female breast cancer in Brazil according to color, in the years 2000 and 2010. METHODS: A descriptive study in which demographic data were obtained from the Brazilian Institute of Geography and Statistics (IBGE). The breast cancer death information in Brazil was collected from the Ministry of Health through the Mortality Information System (SIM). The crude mortality rates for female breast cancer were calculated according to color and age group, up to 49 years and ≥50 years. The results obtained were distributed into five geographical regions of the country (North, Northeast, Midwest, South and Southeast). RESULTS: In Brazil, in women aged 50 or more, the highest crude mortality rates of breast cancer in 2000 were 62.6/100,000, 46.0/100,000 and 29.7/100,000 among yellow, white and black women, respectively. In women under 50 years in 2000, the crude mortality ranged from 2.0/100,000 among indigenous women to 6.8/100,000 among white women. After ten years, in women over 50 years, the crude mortality rate among yellow, white and black women was 21.5, 53.2 and 40.4 per 100,000, respectively. In the country's regions, the highest mortality rates of breast cancer were observed in white and black women from the South and Southeast. In the Northeast, mortality rates in black and brown women doubled in 2010. CONCLUSION: Breast cancer mortality rates show ethnic and geographical variations. However, it is not possible to exclude the possibility that large variations have occurred as a result of improvement in the quality of information on mortality in the country.

Estudo sobre a mortalidade dos tipos de câncer mais comuns na infância em Goiânia / Mortality study of the most common types of cancer in childhood in Goiânia

Objetivo ­ Estudar a mortalidade dos tipos de câncer mais comuns em crianças residentes em Goiânia, analisar a tendência temporal das taxas de mortalidade, no período de 2000 a 2015, de acordo com o gênero e faixa etária. Métodos ­ Trata-se de um estudo ecológico de série temporal (2000 a 2015), observacional do tipo série histórica, de base populacional na cidade de Goiânia. Os dados de mortalidade foram extraídos do Sistema de Informações de Mortalidade (SIM). Os casos foram estratificados por faixas etárias, em três grupos: 0 a 4 anos; 5 a 9 anos e 10 a 14 anos. Nas análises de tendência utilizou-se o modelo regressão linear de Poisson. Resultados ­ Ocorreram 187 mortes por Leucemia, linfoma e câncer do sistema nervoso central no período de 2000 a 2015. As taxas de mortalidade foram de 12,59 óbitos por 1.000.000 de crianças para ambos os sexos, por ano. Destas, 117 (15,14 por 1.000.000) eram do sexo masculino e 70 (18,80 por 1.000.000) do sexo feminino. Nos meninos, por faixa etária, a maior frequência foi observada nas crianças de 5 a 9 anos (39,31%). Nas meninas, a maior frequência também ocorreu nas crianças de 5 a 9 anos, de 36%. Conclusão ­ O câncer mais letal foi a leucemia nos meninos. Verificou-se a priori que a mortalidade nos meninos é maior do que nas meninas. Na análise de tendência por gênero foi observado que houve aumento de mortalidade, para o sexo feminino de 2,5% e para o sexo masculino estabilização de 0,4% ao ano.

Objective ­ To study the mortality of the most common cancers in children in Goiânia, analyze the temporal trend of the mortality rates for the period from 2000 to 2015, according to the gender and age group. Methods ­ The study of ecological time series (2000 to 2015), observational, historic series type of population base in the city of Goiânia. The mortality data were extracted from the Mortality information system. The cases were stratified by age, into three groups: 0 to 4 years; 5 to 9 years and 10 to 14 years. Trend analyses using Poisson regression model. Results ­ There were 187 deaths from Leukemia, lymphoma and cancer of the central nervous system in the period of 2000 to 2015. Standardized mortality rates of 12.59 1 million deaths were of children for both sexes, by year. Of these, 117 (15.14 per 1 million) were male and 70 (18.80 per 1 million). In boys, 28.20% of children from 0 to 4 years died from 2000 to 2015 of pediatric cancer, 32.47% between 10 and 14 years and the increased frequency was observed in children from 5 to 9 years (39.31%). In boys, 28.20% of children from 0 to 4 years died from 2000 to 2015 of pediatric cancer, 32.47% between 10 and 14 years and the increased frequency was observed in children from 5 to 9 years (39.31%). In girls, as often occurred in children aged 5 to 9 years, 36%. Conclusion ­ The most deadly cancer was leukemia in boys. It was verified a priori that the mortality in children is greater than in girls. On trend analysis by gender it was observed that there was an increase of mortality, females of 2.5% for males and stabilization of 0.4% per year.

Cervical cancer mortality trends in Brazil: 1980-2009.

The objective was to describe time trends in cervical cancer mortality rates in Brazil as a whole and in the country's major geographic regions and States from 1980 to 2009. This was an ecological time series study using data recorded in the Mortality Information System (SIM) and census data collected by the Brazilian Institute of Geography and Statistics (IBGE). Analysis of mortality trends was performed using Poisson regression. Cervical cancer mortality rates in Brazil tended to stabilize. In the geographic regions, a downward trend was observed in the South (-4.1%), Southeast (-3.3%), and Central-West (-1%) and an upward trend in the Northeast (3.5%) and North (2.7%). The largest decreases were observed in the States of São Paulo (-5.1%), Rio Grande do Sul, Espírito Santo, and Paraná (-4.0%). The largest increases in mortality trends occurred in Paraíba (12.4%), Maranhão (9.8%), and Tocantins (8.9%). Cervical cancer mortality rates stabilized in the country as a whole, but there was a downward trend in three geographic regions and 10 States, while two geographic regions and another 10 States showed increasing rates.

Disparities in female breast cancer mortality rates in Brazil between 1980 and 2009.

OBJECTIVE: To describe the temporal trends in female breast cancer mortality rates in Brazil in its macro-regions and states between 1980 and 2009. METHODS: This was an ecological time-series study using data on breast cancer deaths registered in the Mortality Data System (SIM/WHO) and census data on the resident population collected by the Brazilian Institute of Geography and Statistics (IBGE/WHO). Joinpoint regression analyses were used to identify the significant changes in trends and to estimate the annual percentage change (APC) in mortality rates. RESULTS: Female breast cancer mortality rates in Brazil tended to stabilize from 1994 onward (APC = 0.4%). Considering the Brazilian macro-regions, the annual mortality rates decreased in the Southeast, stabilized in the South and increased in the Northeast, North, and Midwest. Only the states of Sao Paulo (APC = -1.9%), Rio Grande do Sul (APC = -0.8%) and Rio de Janeiro (APC = -0.6%) presented a significant decline in mortality rates. The greatest increases were found in Maranhao (APC=12%), Paraiba (APC=11.9%), and Piaui (APC=10.9%). CONCLUSION: Although there has been a trend toward stabilization in female breast cancer mortality rates in Brazil, when the mortality rate of each macro-region and state is analyzed individually, considerable inequalities are found, with rate decline or stabilization in states with higher socioeconomic levels and a substantial increase in those with lower socioeconomic levels.

Mortalidade por câncer de mama feminino no Brasil de acordo com a cor / Female breast cancer mortality in Brazil according to color

Descrever a mortalidade por câncer de mama feminino no Brasil segundo a cor, nos anos de 2000 e 2010.

To describe the mortality of female breast cancer in Brazil according to color, in the years 2000 and 2010.

Mortalidade por câncer de mama em mulheres indígenas brasileira / Breast cancer mortality among Brazilian indigenous women

Objetivo: Avaliar a mortalidade por câncer de mama em mulheres indígenas do Brasil, nos anos de 2000 e de 2010. Métodos: Trata-se de um estudo retrospectivo, realizado por meio de coleta de número de óbitos por câncer de mama em mulheres indígenas brasileiras, nos anos de 2000 e de 2010. Os dados foram obtidos por meio do Instituto Brasileiro de Geografia e Estatística e do Sistema de Informações sobre Mortalidade. Foram calculadas as taxas de mortalidade bruta e a razão de risco (RR) entre a mortalidade observada entre mulheres de cor branca e indígenas, considerando um intervalo de confiança de 95% (IC95%). Para o teste do ?2 com correção de Yates, valores de p<0,05 foram considerados significativos. Resultados: No Brasil, a taxa bruta de mortalidade para mulheres indígenas foi de 4,72/100.000 em 2000, e de 2,23/100.000 em2010. Na distribuição por macrorregiões, observou-se que de 10 óbitos registrados em 2000, oito ocorreram na região Sudeste. Já em 2010, entre os cinco óbitos registrados, três ocorreram na região Norte. As mulheres indígenas brasileiras apresentaram menor risco de mortalidade em relação às mulheres de cor branca, tanto em 2000 (RR: 0,25; IC95% 0,138?0,47; p<0,001) quanto em 2010 (RR: 0,094; IC95% 0,03?0,22; p<0,001). Conclusão: A taxa de mortalidade por câncer de mama em mulheres indígenas no Brasil foi significantemente inferior ao observado em mulheres brancas, possivelmente em decorrência de variações étnicas, geográficas esocioculturais. Esses dados podem contribuir para o desenvolvimento de estratégias direcionadas ao controle da neoplasia mamária na população indígena brasileira.

Objective: To evaluate mortality from breast cancer in Indigenous women in Brazil, in 2000 and 2010. Methods: This was a retrospective study, by means of collecting the number of breast cancer deaths among Brazilian women in the years 2000 and 2010. Data were obtained from the Brazilian Instituteof Geography and Statistics and Mortality Information System. The crude mortality rates were calculated and the risk ratio (RR) of mortality observed among white women and indigenous women were calculated. It was used a confidence interval of 95% (CI95%). For the ?2 test with Yates correction, p<0.05 were considered significant. Results: The crude mortality rate for indigenous women was 4.72/100,000 in 2000 and 2.23/100,000 in 2010. In the distribution by geographical regions, it was observed that out of 10 deaths recorded in 2000, eight occurred in the Southeast Region. In 2010, among the five reported deaths, three occurred in the North Region. Brazilian indigenous women had lower risk of breast cancer mortality compared to white women, both in 2000 (RR: 0.25; 95%CI 0.138?0.47; p<0.001) and in 2010 (RR: 0.094, 95%CI 0.03?0.22; p<0.001). Conclusion: The mortality rate from breast cancer among indigenous women in Brazil was significantly lower than in white women, possibly due to ethnic,geographic and socio-cultural variations. This data can contribute to the development of strategies aimed at controlling the breast cancer in Brazil?s indigenous population.

Cervical cancer mortality trends in Brazil: 1980-2009 / Tendência da mortalidade por câncer do colo do útero no Brasil: 1980 a 2009 / Tendencia de la mortalidad por cáncer del cuello de útero en Brasil: 1980 a 2009

The objective was to describe time trends in cervical cancer mortality rates in Brazil as a whole and in the country's major geographic regions and States from 1980 to 2009. This was an ecological time series study using data recorded in the Mortality Information System (SIM) and census data collected by the Brazilian Institute of Geography and Statistics (IBGE). Analysis of mortality trends was performed using Poisson regression. Cervical cancer mortality rates in Brazil tended to stabilize. In the geographic regions, a downward trend was observed in the South (-4.1%), Southeast (-3.3%), and Central-West (-1%) and an upward trend in the Northeast (3.5%) and North (2.7%). The largest decreases were observed in the States of São Paulo (­5.1%), Rio Grande do Sul, Espírito Santo, and Paraná (-4.0%). The largest increases in mortality trends occurred in Paraíba (12.4%), Maranhão (9.8%), and Tocantins (8.9%). Cervical cancer mortality rates stabilized in the country as a whole, but there was a downward trend in three geographic regions and 10 States, while two geographic regions and another 10 States showed increasing rates.

O objetivo deste estudo foi fornecer um quadro quanto à tendência da mortalidade por câncer do colo de útero no Brasil, em suas regiões e estados, entre 1980 e 2009. Estudo ecológico de série temporal, com uso de informações sobre óbitos (Sistema de Informações sobre Mortalidade - SIM) e base demográfica (Instituto Brasileiro de Geografia e Estatística - IBGE). Foram realizadas análises das tendências da mortalidade por meio da regressão de Poisson. Houve estabilização nas taxas de mortalidade no Brasil. Nas regiões, houve queda no Sul (-4,1%), Sudeste (-3,3%) e Centro-Oeste (-1%); aumento no Nordeste (3,5%) e Norte (2,7%). As maiores reduções foram observadas em São Paulo (-5,1%), Rio Grande do Sul, Espírito Santo e Paraná (-4,0%). Os maiores aumentos foram observados na Paraíba (12,4%), Maranhão (9,8%) e Tocantins (8,9%). No Brasil, houve estabilização na mortalidade por câncer do colo do útero. No entanto, houve redução em 3 regiões e em 10 estados, enquanto, em 2 regiões e em outros 10 estados, a mortalidade segue aumentando. Uma das razões para essa disparidade pode ser o menor acesso ao tratamento para as pacientes de áreas menos desenvolvidas.

El objetivo fue analizar la mortalidad por cáncer de cuello de útero en Brasil, en sus macrorregiones y estados en el período de 1980 a 2009. Se trata de un estudio ecológico de serie temporal, con uso de información sobre óbitos del Sistema de Información sobre Mortalidad (SIM), y base demográfica del Instituto Brasileño de Geografía y Estadística (IBGE). Se realizaron análisis de las tendencias de la mortalidad, mediante la regresión de Poisson. En Brasil se observó la estabilización en las tasas de mortalidad. En las macrorregiones, hubo caída en el Sur (-4,1%), Sudeste (-3,3%) y Centro-Oeste (-1%); aumento en el Nordeste (3,5%) y Norte (2,7%). En los estados, las principales caídas fueron observadas en São Paulo (-5,1%), Rio Grande do Sul, Espírito Santo y Paraná (-4%). Los mayores aumentos se observaron en Paraíba (12,4%), Maranhão (9,8%) y Tocantins (8,9%). Conclusión: Brasil presenta estabilización en las tasas de mortalidad. No obstante, hubo una reducción en 3 macrorregiones y en 10 estados, mientras que en 2 macrorregiones y en 10 estados la mortalidad sigue aumentando. Una de las razones para esa disparidad puede ser el menor acceso al tratamiento para las pacientes de áreas menos desarrolladas.

Disparities in female breast cancer mortality rates in Brazil between 1980 and 2009

OBJECTIVE: To describe the temporal trends in female breast cancer mortality rates in Brazil in its macro-regions and states between 1980 and 2009. METHODS: This was an ecological time-series study using data on breast cancer deaths registered in the Mortality Data System (SIM/WHO) and census data on the resident population collected by the Brazilian Institute of Geography and Statistics (IBGE/WHO). Joinpoint regression analyses were used to identify the significant changes in trends and to estimate the annual percentage change (APC) in mortality rates. RESULTS: Female breast cancer mortality rates in Brazil tended to stabilize from 1994 onward (APC = 0.4%). Considering the Brazilian macro-regions, the annual mortality rates decreased in the Southeast, stabilized in the South and increased in the Northeast, North, and Midwest. Only the states of Sao Paulo (APC = -1.9%), Rio Grande do Sul (APC = -0.8%) and Rio de Janeiro (APC = -0.6%) presented a significant decline in mortality rates. The greatest increases were found in Maranhao (APC=12%), Paraiba (APC=11.9%), and Piaui (APC=10.9%). CONCLUSION: Although there has been a trend toward stabilization in female breast cancer mortality rates in Brazil, when the mortality rate of each macro-region and state is analyzed individually, considerable inequalities are found, with rate decline or stabilization in states with higher socioeconomic levels and a substantial increase in those with lower socioeconomic levels.