Progressive multifocal leukoencephalopathy and spectrum of predisposing conditions: a 20-year retrospective cohort study in a tertiary center in São Paulo, Brazil.

BACKGROUND: Epidemiological studies on predisposing conditions and outcomes of progressive multifocal leukoencephalopathy (PML) cases have been carried out exclusively in high-income countries. We aim to report and compare the main characteristics and outcomes of patients with PML and several underlying diseases in a referral center in a middle-income country. METHODS: We performed a retrospective cohort study of PML cases admitted to a tertiary care hospital in São Paulo, Brazil during 2000-2022. Demographic and PML-specific variables were recorded. One-year case-fatality rate and factors associated with death were identified using a multivariate Cox proportional hazards regression model. RESULTS: Ninety-nine patients with PML were included. HIV infection (84.8%) and malignancy (14.1%) were the most prevalent underlying conditions. Other predisposing diseases were autoimmune/inflammatory diseases (5.1%) and solid organ transplantation (1.0%). One (1.0%) patient had liver cirrhosis and another (1.0%) patient was previously healthy. Focal motor deficits (64.2%) and gait instability (55.1%) were the most common signs. The one-year case-fatality rate was 52.5% (95% CI 42.2-62.7). The one-year case-fatality rate (95% CI) in patients with or without malignancy (85.7%, 95% CI 57.2-98.2% and 47.1%, 95% CI 36.1-58.2%, respectively) were statistically different (P = 0.009). Crude and adjusted Cox regression models identified malignancy as independently associated with death (adjusted HR = 3.92, 95% CI 1.76-8.73, P = 0.001). CONCLUSIONS: HIV/AIDS was the predisposing condition in 84.8% of PML cases. The one-year case-fatality rate was 52.5% and having a malignancy was independently associated with death. This study reports emerging data on the epidemiology and outcome of PML in a middle-income country.

Association between visceral adiposity index and cancer risk in the UK Biobank cohort.

BACKGROUND: The visceral adiposity index (VAI) is a marker of visceral fat accumulation and metabolic dysfunction, but there is limited evidence of its association with cancer. The objective of this study was to investigate associations between the VAI and both incident cancer at 23 sites and all-cause cancer. METHODS: In total, 385,477 participants (53.3% women; mean age, 56.3 years) from the UK Biobank prospective cohort were included in this study. The median follow-up was 8.2 years (interquartile range, 7.3-8.9 years). The VAI was calculated using formula the published by Amato et al. and was categorized into sex-specific tertiles. Twenty-four incident cancers were the outcomes. Cox proportional hazard models were adjusted for sociodemographics, lifestyle factors, and multimorbidity counts. RESULTS: Over the follow-up period, 47,882 individuals developed cancer. In the fully adjusted models, the VAI was associated with a higher risk of six cancer sites. Individuals in the highest tertile, compared with those in the lowest tertile, had higher risks of uterine (hazard ratio [HR], 2.09; 95% confidence interval [CI], 1.76-2.49), gallbladder (HR, 1.83; 95% CI, 1.26-2.66), kidney (HR, 1.39; 95% CI, 1.18-1.64), liver (HR, 1.25; 95% CI, 1.00-1.56), colorectal (HR, 1.14; 95% CI, 1.05-1.24), and breast (HR, 1.11; 95% CI, 1.03-1.19) cancers and of all-cause cancer (HR, 1.05). There was no evidence of a nonlinear association between the VAI and cancer risk. CONCLUSIONS: The VAI was associated with six cancer sites and with all-cause cancer. The prognostic and etiologic roles of visceral fat accumulation and dysfunction in cancer warrant further research.

Geographical disparities in cancer and occupational exposure to pesticides in a French-West Indies territory (2006-2019).

BACKGROUND: In the French West Indies, previous studies have reported findings on pesticide exposure and cancer incidence. A new exploratory geographical study, including a more sensitive soil contamination indicator, will provide more detailed information on the link between cancer incidence and organochlorine pesticide exposure. This study aims to investigate the association between incident cases of cancer and chlordecone soil contamination at an IRIS scale over the period 2006-2019 in Martinique. METHODS: Data on the 18 most frequent cancer sites were collected from the Martinique Population Based Cancer Registry. First, smoothed standardized incidence ratios at the level of the 141 IRIS were estimated, and then regression models including the smoothed standardized ratios  were performed between cancer incidence and soil contamination index by sex and cancer site, using the Besag, York and Mollié models. Models were adjusted using an index of social deprivation. RESULTS: 23,218 cancer cases were eligible for this study, with 21,920 cases included in the final analysis. Soil contamination was associated with a higher relative risk of cancer in women than in men, but no significant correlation was found for breast cancer in women or for prostate cancer. Lung, thyroid, stomach and rectal cancers in women, and melanoma in men, all increase significantly with the level of contamination. There was a significant increasing gradient in the incidence of multiple myeloma in men, from reference to highly contaminated areas. CONCLUSION: Integrating the latest available data on soil contamination and cancer incidence will extend on-going knowledge of chlordecone exposure and cancer incidence, which remains a major environmental concern in Martinique. Unexpectedly, our results show that the female population of Martinique is the most affected by chlordecone soil contamination.

A snapshot of cancer in Chile II: an update on research, strategies and analytical frameworks for equity, innovation and national development.

INTRODUCTION: Chile has achieved developed nation status and boasts a life expectancy of 81 + years; however, the healthcare and research systems are unprepared for the social and economic burden of cancer. One decade ago, the authors put forward a comprehensive analysis of cancer infrastructure, together with a series of suggestions on research orientated political policy. OBJECTIVES: Provide an update and comment on policy, infrastructure, gender equality, stakeholder participation and new challenges in national oncology. Assess the funding and distribution of cancer investigation. Present actions for the development of oncology research, innovation and patient care. METHODS: Triangulating objective system metrics of economic, epidemiological, private and public sector resources together with policy analysis, we assessed cancer burden, infrastructure, and investigation. We analyzed governmental and private-sector cancer databases, complemented by interviews with cancer stakeholders. RESULTS: Governmental policy and patient advocacy have led to the recognition of cancer burden, a cancer law, and a national cancer plan. Cancer has become the leading cause of death in Chile (59,876 cases and 31,440 cancer deaths in 2022), yet only 0.36% gross domestic product (GDP) is directed to research and development. Inequalities in treatment regimens persist. Prevention policy has lowered tobacco consumption, sugar intake via soft drinks and offered a high coverage of HPV vaccines. A high-quality cancer research community is expanding, and internationally sponsored clinical oncology trials are increasing. CONCLUSIONS: The cancer law has facilitated advancement in policy. Prevention policies have impacted tobacco and sugar intake, while gender equality and care inequality have entered the public forum. Cancer research is stagnated by the lack of investment. Implementation of a cancer registry and biobanking, reinforcement of prevention strategies, development of human resources, promotion of clinical trial infrastructure and investment in new technologies must be placed as a priority to permit advancements in innovation and equitable cancer care.

Low Incidence of Cancer Recorded in the Galapagos Archipelago.

BACKGROUND: Cancer incidence in the Galapagos archipelago is unknown. AIM: In 2021, a task force including Ecuadorian and Italian researchers was established to estimate cancer incidence among the 25 244 Galapagos residents. METHODS: Registration covered all malignancies, including malignant melanoma and non-melanoma skin cancers; case recording was based on the International Classification of Diseases for Oncology. The data collection involved an active search across all relevant health institutions on the islands and the mainland. Mortality data were obtained from the Ecuador national mortality registry. RESULTS: From January 2013 and December 2019, 174 new cancer cases were recorded, including 134 malignancies (M:F = 58:76) and 40 non-melanoma skin cancers. The mean age at diagnosis was 48 years for males and 56 years for females. Prostate, gastric, and melanocytic malignancies were most incident among males; breast, thyroid, and cervical cancers prevailed in females. The age-standardized incidence rates (ASR) were 80.39 for males and 99.24 for females with a mortality-to-incidence ratio 0.43. These ASRs were significantly lower than those reported in continental Ecuador and other South American countries. CONCLUSIONS: This pilot cancer registration initiative in the Galapagos record a low incidence of malignancies and requires validation with temporal expansion of cancer registration. The environmental etiology of some of the most common cancers warrants strategic primary and secondary prevention efforts.

Increased Early-Mortality in Children With Solid Tumors During the COVID-19 Pandemic in a Middle-Income Country.

BACKGROUND: Measures to control COVID-19 transmission disrupted childhood cancer care. Data on the effects of the COVID-19 pandemic on childhood cancer mortality are lacking. This study describes the impact of the pandemic on childhood cancer early-mortality (≤ 24 months). METHODS: A multicenter prospective cohort was conducted in 10 Colombian cities. Children with newly diagnosed cancer registered in the Childhood Cancer Clinical Outcomes Surveillance System (VIGICANCER) were included. Our primary outcome was cumulative mortality at 3, 6, 12, and 24 months. The exposed cohort (EC = March 25, 2020-December 31, 2021) was compared with a historic cohort (HC = January 1, 2017-March 24, 2020). Covariates included sociodemographics, place of residence, health insurance type, and tumor classification. RESULTS: The cohort included 4124 children, comprised of 1627 children in the EC and 2497 children in the HC. Hematolymphoid, central nervous system, and extracranial solid tumors represented 57%, 15%, and 28% of patients, respectively. Participants' median age was 6.7 years (IQR, 3.2-11.3), 54% were male, 7% were Afro-descendant, and 47% had public insurance. In the EC, the 6-month and 24-month mortality adjusted hazard ratio (aHR) in children with solid tumors was 1.7 (95% CI, 1.1-2.7) and 1.3 (95% CI, 1.0-1.7), respectively, and in children with bone tumors 4.0 (95% CI, 1.2-13.0) and 2.1 (95% CI, 1.2-3.6), respectively. These associations persisted after accounting for metastatic disease. Six-month mortality aHRs for retinoblastoma, bone tumors, and soft tissue sarcomas due to progressive disease were 4.3 (95% CI, 1.3-14.5), 4.0 (95% CI, 1.4-11.3), and 5.4 (95% CI, 2.2-13.5), respectively. In the EC, the adjusted odds ratio (aOR) for metastatic solid tumors vs. nonmetastatic was 1.4 (95% CI, 1.0-1.8) and in children with retinoblastoma and public insurance the 24-month mortality aHR was 4.9 (95% CI, 1.1-21.7). CONCLUSIONS: We observed increased early-mortality for solid tumors, particularly bone tumors and retinoblastoma, likely attributed to more advanced-stage presentation and loss of treatment effectiveness due to healthcare disruptions. Early-mortality was higher in patients with public insurance, a vulnerable population that warrants attention.

Incidence of Neoplasms in Endemic Fight Agents: Results of a Retrospective Cohort.

OBJECTIVE: The aim of the study is to measure cancer's incidence in endemic fight agents in a Brazil's Northeast state. METHODS: This is a historical cohort with 1053 endemic fight agents. A survival analysis was performed using Kaplan-Meier method. RESULTS: The overall neoplasm incidence rate has been 5508 cases per 105, and 4843 cases per 105 when nonmelanoma skin tumors were excluded. The increase in incidence of neoplasms occurred in 2019 and has conferred a risk of neoplasms 20 times higher than the national and state incidence. CONCLUSIONS: We believe in an occupational factor for these results: the chronic exposure to insecticides used in public health campaigns. The peak incidence of neoplasms, in 2019, may corroborate with long induction period of these compounds, in addition to consistency with specialized literature.

Cancer epidemiology in pathology of a hospital in eastern Mexico / Epidemiología del cáncer en patología de un hospital del oriente de México

Background: Cancer is one of the leading causes of death in the world. In Mexico, its incidence has increased, and differences have been reported regarding the regions of the country. Objective: To study the epidemiology of malignant neoplasms diagnosed in the Pathology department of a hospital in eastern Mexico. Material and methods: We studied the different cancer types diagnosed in Pathology of the Hospital Centro Médico Nacional "General de División Manuel Ávila Camacho" during 2019. Results: In the region, women were more affected than men, presenting more cases. In the total population, we found a high proportion of breast and skin cancers and a decreased proportion of lung cancer, both compared with Mexico and the world (2020). In men, we found a decreased prostate cancer proportion compared to Mexico. We also observed a high proportion of skin cancer (higher than Mexico and the world) and a high percentage of higher digestive system cases, compared to Mexico. For women, we found a high percentage of breast and skin cancers compared to Mexico and the world; and a decreased percentage of cervical cancer when compared to data from Mexico. Conclusions: Knowing cancer epidemiology in the regions of Mexico can help implement cancer control, screening activities and to provide a timely treatment.

Introducción: el cáncer es una de las principales causas de muerte en el mundo. En México, la incidencia ha aumentado y se han reportado diferencias importantes entre las regiones del país. Objetivo: estudiar la epidemiología de las neoplasias malignas diagnosticadas en el servicio de Patología de un Hospital del oriente de México. Material y métodos: se estudió la proporción de los tipos de cáncer diagnosticados en Patología en el Hospital de Especialidades del Centro Médico Nacional (CMN) "General de División Manuel Ávila Camacho" durante el 2019. Resultados: en la región estudiada las mujeres fueron más afectadas, presentando un mayor número de casos que los hombres. En la población total, se encontró un alto porcentaje de cáncer de mama y piel y una baja proporción de casos en pulmón, ambas comparadas con México y el mundo (2020). En hombres, se encontró una menor proporción de cáncer de próstata que lo reportado en el país, una alta proporción de casos malignos en piel (más altas que en México y el mundo) y un alto porcentaje de casos de cáncer en tubo digestivo alto comparado con México. En mujeres, se encontró un alto porcentaje de cáncer de mama y piel, mayores a las cifras en México y el mundo y un bajo porcentaje de casos de cérvix comparadas con las cifras en México. Conclusiones: el conocer la epidemiología del cáncer en las regiones de nuestro país ayudará a implementar medidas de control, tamizaje y lograr tratamientos oportunos.

Clonal outbreak of Candida vulturna in a paediatric oncology ward in Maranhão, Brazil.

OBJECTIVE: To describe an outbreak due to Candida vulturna, a newly emerging Candida species belonging to the Candida haemulonii species complex in the Metschnikowiaceae family. METHODS: In this retrospective cohort study we genotyped 14 C. vulturna bloodstream isolates, occurring in a 4-month-period in paediatric cancer patients in a Brazilian hospital. To prove an outbreak, ITS sequence analysis and whole genome sequencing (WGS) was done. Antifungal susceptibility was performed with the reference CLSI method and the commercial Sensititre YeastOne (SYO) YO10 plates. A control C. vulturna isolate from another region in Brazil was included in all analyses. RESULTS: MALDI-TOF-MS identified isolates as C. pseudohaemulonii and C. duobushaemulonii albeit with low scores and therefore molecular methods were required for accurate identification. ITS sequence analyses clearly differentiated C. vulturna from other species in the C. haemulonii species complex. WGS proved the presence of a clonal outbreak with C. vulturna involving 14 paediatric patients. Antifungal susceptibility testing (AFST) with two methods showed the isolates had low MICs of commonly available antifungals. CONCLUSION: This study describes an outbreak due to the rare yeast C. vulturna, related to C. auris, during a four-month period in patients admitted to a paediatric oncology ward in a Brazilian hospital. In contrast to previous studies the yeast was susceptible to all antifungals and patient outcome was good.

Patterns of beverages consumption and prevalence of non-communicable chronic diseases.

Beverages consumption influences diet quality in general and has been associated with the development of non-communicable chronic diseases (NCCD). We aimed to verify the association between beverage consumption patterns and the prevalence of NCCD. A cross-sectional household and population-based study was conducted with 489 individuals aged 20 years and older. The presence of NCCD (arterial hypertension, diabetes, cancer and hypercholesterolemia) was obtained by self-report, while obesity was diagnosed by measuring body weight, height and waist circumference. Beverage consumption patterns were obtained by principal component analysis. The association between beverages patterns and the prevalence of NCCD was verified using Poisson regression, expressed as prevalence ratio (PR) and adjusted for potential confounding factors. Three beverage patterns were identified: 'ultra-processed beverages', 'alcoholic beverages' and 'healthy beverages'. Individuals with greater adherence to the Ultra-processed Beverages Pattern had a 2·77 times higher prevalence of cancer (PR: 3·77; 95 % CI 1·57, 9·07). Higher adherence to the Alcoholic Beverages Pattern was associated with a higher prevalence of obesity (PR: 1·97; 95 % CI 1·13, 3·44). In contrast, individuals in the second tertile of adherence to the Healthy Beverages Pattern had a 39 % lower prevalence of hypercholesterolemia (PR: 0·61; 95 % CI 0·40, 0·92), and individuals in the third tertile had a 10 % lower prevalence of abdominal obesity estimated by the waist-to-height ratio (PR: 0·90; 95 % CI 0·83, 0·97). Beverage consumption patterns may be associated with a higher prevalence of NCCD, regardless of other risk factors. It is therefore important to conduct more studies investigating the impact of beverages patterns on health.

Latent Archetypes of the Spatial Patterns of Cancer.

The cancer atlas edited by several countries is the main resource for the analysis of the geographic variation of cancer risk. Correlating the observed spatial patterns with known or hypothesized risk factors is time-consuming work for epidemiologists who need to deal with each cancer separately, breaking down the patterns according to sex and race. The recent literature has proposed to study more than one cancer simultaneously looking for common spatial risk factors. However, this previous work has two constraints: they consider only a very small (2-4) number of cancers previously known to share risk factors. In this article, we propose an exploratory method to search for latent spatial risk factors of a large number of supposedly unrelated cancers. The method is based on the singular value decomposition and nonnegative matrix factorization, it is computationally efficient, scaling easily with the number of regions and cancers. We carried out a simulation study to evaluate the method's performance and apply it to cancer atlas from the USA, England, France, Australia, Spain, and Brazil. We conclude that with very few latent maps, which can represent a reduction of up to 90% of atlas maps, most of the spatial variability is conserved. By concentrating on the epidemiological analysis of these few latent maps a substantial amount of work is saved and, at the same time, high-level explanations affecting many cancers simultaneously can be reached.

Impact of the COVID-19 pandemic on cancer mortality in Brazil.

BACKGROUND: In the first year of the COVID-19 pandemic, data projections indicated an increase in cancer mortality for the following years due to the overload of health services and the replacement of health priorities. The first studies published with data from mortality records have not confirmed these projections. However, cancer mortality is not an outcome that occurs immediately, and analyses with more extended follow-up periods are necessary. This study aims to analyze the impact of the COVID-19 pandemic on the mortality from all types and the five most common types of cancer in Brazil and investigate the relationship between the density of hospital beds and mortality from COVID-19 in cancer patients in Brazil's Intermediate Geographic Regions (RGIs). METHODS: The Brazilian Mortality Information System provided data on the deaths from trachea, bronchus, and lung, colorectal, stomach, female breast, and prostate cancer and all types of cancer, and from COVID-19 in individuals who had cancer as a contributing cause of death. Predicted rates for 2020-2022 were compared with the observed ones, through a rate ratio (RR). An association analysis, through multivariate linear regression, was carried out between mortality from COVID-19 in cancer patients, the rate of hospital beds per 100,000 inhabitants, and the Human Development Index of the 133 RGIs of Brazil. RESULTS: In 2020, 2021, and 2022, mortality from all cancers in Brazil was lower than expected, with an RR of 0.95, 0.94, and 0.95, respectively, between the observed and predicted rates. Stomach cancer showed the largest difference between observed and expected rates: RR = 0.89 in 2020 and 2021; RR = 0.88 in 2022. Mortality from COVID-19 in cancer patients, which reached its peak in 2021 (6.0/100,000), was negatively associated with the density of hospital beds in the public health system. CONCLUSIONS: The lower-than-expected cancer mortality during 2020-2022 seems to be partly explained by mortality from COVID-19 in cancer patients, which was probably underestimated in Brazil. The findings suggested a protective role of the availability of hospital care concerning deaths due to COVID-19 in this population. More extensive follow-up is needed to understand the impact of the COVID-19 pandemic on cancer mortality.

Implementation of cancer prevention practices in primary care: results of a cohort study in Chile 2018-2022.

OBJECTIVES: The burden of cancer is increasing rapidly in Latin America. Primary care has an essential role in cancer prevention, but implementation levels of prevention practices are not well known. This study evaluated implementation levels and associated factors of cancer preventive practices in primary care over time. STUDY DESIGN: The study incorporated a retrospective multicentre cohort study. METHODS: A population of 59,949 patients registered at three primary care clinics was followed from January 2018 to December 2022 in Santiago, Chile. We studied human papillomavirus (HPV) and hepatitis B virus (HBV) immunisation, brief counselling for smoking cessation and alcohol consumption, and cervical and breast cancer screening practices. Standardised electronic medical records were utilised as the source of information. Social, clinical, and organisational factors associated with prevention practices were studied. RESULTS: The cohort attrition level was 17.1%. Most of the population was of a low socioeconomic status, and 70% visited a primary health centre yearly. Implementation rates of immunisation practices were 90.84% for HPV and 80.94% for HBV in 2022. In contrast, brief counselling for smoking and alcohol consumption was below 20% during the study period. Cervical cancer screening decreased by 25.58% between 2018 and 2022, whereas breast cancer screening reached only 41.71% of the target population. Opportunistic medical visits were strongly associated with brief counselling and breast cancer screening. CONCLUSION: Implementation practices for cancer prevention in a Chilean primary care cohort are high for immunisation and very low for brief counselling and screening practices. A comprehensive non-medical-based model is needed to improve cancer prevention in primary care.

Neoplastic and non-neoplastic diseases associated with feline leukaemia virus (FeLV) in cats in southern Brazil.

The objective of this study was to categorise diseases associated with FeLV infection in cats. A total of 154 cats were submitted to necropsy, histopathology exam and anti-FeLV immunohistochemistry (IHC), and 83 (50.9 %) were IHC FeLV-positive. The cats age means of 4.1 years, including 3.6 % kittens, 34.9 % junior, 37.4 % prime, 18.1 % mature, 2.4 % senior, 3.6 % unknown age. Neoplastic diseases were most prevalent with leukaemia and lymphoma being most predominant, followed by viral diseases, bacterial, trauma, degenerative, intoxications, parasitic, malformation and others. FeLV+ cats were 5.73 times more likely to be diagnosed with neoplasms than other diseases. The odds ratio (OR) of FeLV+ cats developing leukaemia (OR = 7.75) and lymphoma (OR = 6.75) was higher than other neoplasms. FeLV infection was more prevalent in the mixed breed, junior to prime, male, with neoplastic diseases, including leukaemia and lymphoma. Therefore, understanding the diseases associated with FeLV is of paramount importance in Brazil due to its high prevalence, and it may encourage the implementation of prophylactic measures to reduce its dissemination.

Exploring the link between inflammatory myopathies and cancer: A comprehensive retrospective analysis in a Colombian cohort.

BACKGROUND: This study investigates the association between inflammatory myopathies (IM), and their correlation with cancer. There are several potential causes behind the association of cancer and inflammatory myopathies. The positivity of specific antibodies for myositis plays a significant role. Our objective is to describe cancer and inflammatory myopathies in Colombia, focusing on demographics, clinical characteristics, and laboratory data. METHODS: We retrospectively analyzed 112 IM patients diagnosed at Fundación Valle del Lili in Cali, Colombia, the cases met the EULAR/ACR criteria. Data included demographics, clinical signs, laboratory findings, and malignancy. Malignancy associations were explored using logistic regression. The survival analysis was assessed using Kaplan-Meier curves and the Log-Rank test. RESULTS: Dermatomyositis was the most common subtype (45.5%), with a female predominance (66.1%). Cancer diagnosis occurred in 11.6% of cases, predominantly thyroid cancer. The median time from myopathy onset to cancer diagnosis was 11 months, with 75% of cases within the first year. Bivariate analysis indicated associations between cancer and age, Gottron's papules, digital ulcers, and heliotrope rash. However, multivariate analysis identified age as the only significant malignancy risk factor. Survival analysis showed better rates in younger patients. CONCLUSION: This study provides into the link between IM and cancer in the Colombian population. Thyroid cancer predominated, with a slightly higher proportion of female cancer diagnoses. Age emerged as a significant risk factor for malignancy. Understanding this association is crucial for early detection and improving patient outcomes related to IM-associated malignancies.

Thromboembolic events in people with cancer during the COVID-19 pandemic: case-control study.

OBJECTIVE: to analyze the association between coronavirus disease infection and thromboembolic events in people with cancer in the first year of the pandemic. METHOD: case-control study carried out by collecting medical records. The selected cases were adults with cancer, diagnosed with a thromboembolic event, treated in the selected service units during the first year of the pandemic. The control group included adults with cancer without a diagnosis of a thromboembolic event. Pearson's chi-square test was applied to verify the association between risk factors and the outcome and logistic regression techniques were applied to identify the odds ratio for the occurrence of a thromboembolic event. RESULTS: there were 388 cases and 440 control cases included in the study (ratio 1/1). Females predominated, who were white, with mean age of 58.2 (±14.8) years. Antineoplastic chemotherapy was the most used treatment and coronavirus disease was identified in 11.59% of participants. In the case group, deep vein thrombosis was more prevalent. CONCLUSION: the study confirmed the hypothesis that coronavirus disease infection did not increase the chance of thromboembolic events in people with cancer. For the population studied, the factors that were associated with these events were those related to cancer and its treatment. HIGHLIGHTS: (1) Deep vein thrombosis was what prevailed in the studied population. (2) Chemotherapy increased the chance of thromboembolic events by 65%. (3) Thromboembolic events showed a significant association with a higher death rate as the outcome. (4) COVID-19 did not increase the risk of thromboembolic events in people with cancer.

Impact of the COVID-19 Pandemic on the Treatment of Cancer Patients at a Hospital in Peru.

BACKGROUND: The appearance of the new coronavirus, SARS-CoV-2, in Wuhan - China, in 2019 led to the declaration of a COVID-19 pandemic by the World Health Organization. Peru confirmed its first case on March 6, 2020, prompting a significant change in medical care. PURPOSE: Our objective was to determine the impact of the COVID-19 pandemic on cancer treatment in Peru. METHODS: A retrospective analysis of hospital data from the National Institute of Neoplastic Diseases revealed substantial decreases in oncological treatments in 2020 compared to 2019. RESULTS: Oncological treatments involving bone marrow transplantation had a greater impact between the months of April and September, at -100% (p=0.003). However, treatments involving surgery in April (-95% [p≤0.001]), radiotherapy in May (-76% [p=0.002]) and chemotherapy in June (-71% [p≤0.001]) also showed significant impacts. Comparative analysis with international data revealed similar trends in cancer care interruptions in different countries. However, variations in the magnitude of the impact were observed, influenced by regional health policies and the severity of the pandemic. CONCLUSIONS: The findings underscore the challenges cancer care providers face during public health crises, requiring adaptive strategies to ensure continued access to essential treatments. Addressing these challenges requires comprehensive public health responses to mitigate the impact of future crises on cancer care systems.

Bed demand and occupancy within the Brazilian National Health System for the most common types of cancer in Brazil, from 2018 to 2021: a cross-sectional study.

OBJECTIVE: To analyze bed demand and occupancy within the Brazilian National Health System (Sistema Único de Saúde - SUS) for the main types of cancer in Brazil, from 2018 to 2021. METHODS: This was a descriptive cross-sectional study, using data from the Hospital Information System. Queuing theory model was used for calculating average admission rate, average hospitalization rate, probability of overload, and average number of people in the queue. RESULTS: The Southeast and South regions showed the highest average hospitalization rates, while the North region showed the lowest rates. The Southeast region presented a high probability of surgical bed overload, especially in the states of São Paulo (99.0%), Minas Gerais (97.0%) and Rio de Janeiro (97.0%). São Paulo state showed an overload above 95.0% in all types of beds analyzed. CONCLUSION: There was a high probability of oncology bed occupancy within the Brazilian National Health System, especially surgical and medical beds, and regional disparities in bed overload. MAIN RESULTS: The study found a high demand for hospital admissions to oncological bed in the Southeast region and a high probability of system overload in the states of the Southeast and Northeast regions of Brazil, thus highlighting the inequities in access to healthcare services in the country. IMPLICATIONS FOR SERVICES: This study presents a methodology for the improved allocation of resources and management of surgical and medical bed flows in areas with the highest bed overload and regions with low service availability. PERSPECTIVES: It is necessary to promote public policies that ensure the equitable supply of beds for oncological treatment within the SUS, especially in states with bed overload and healthcare service gaps.

Multimorbidity in people living with HIV and cancer in Mexico.

BACKGROUND: The proportion of older people living with HIV (PLWH) has increased. Non-communicable diseases occur earlier in PLWH than in the general population. OBJECTIVE: The goal of this study was to estimate the prevalence of comorbidities in PLWH and cancer in a tertiary referral center in Mexico City. MATERIAL AND METHODS: In this retrospective study, we included PLWH > 40 years with a history of cancer, coming to Instituto Nacional de Cancerologia from 2010 through 2019. All patients needed to be on antiretrovirals for at least six months. Data collected included cancer type, comorbidities, frequency of polypharmacy, FRAX score and 10-year cardiovascular risk. Patients were evaluated for depression with the Beck Inventory Depression-II Scale. Variables associated to multimorbidity (2 or more comorbidities) were evaluated. RESULTS: Of 125 patients, 69% had at least one comorbidity; 32% had ≥ 2. Common comorbidities were dyslipidemia (54%), hypertension (19%), obesity (14%) and Diabetes (12%). In patients ≥ 50 years, 29 (62%) already undergone a densitometry and 9 (31%) had osteoporosis; 56 depression questionnaires were used: 30% had mild-to-severe depression. Being ≥ 50 years was associated with multimorbidity (aOR 2.57 (1.18-5.58), p = 0.017). CONCLUSIONS: A high prevalence of multimorbidity and poor screening of bone disease and mental health is reported in patients with PLWH and cancer. A holistic approach to the PLWH in the Infectious Diseases consultation is needed to improve the detection and management of non-communicable diseases, to go beyond viral suppression and towards an improved quality of life.

INTRODUCCIÓN: La proporción de personas mayores que viven con VIH (PVVIH) va en aumento, y las enfermedades no transmisibles ocurren antes en PVVIH comparado con la población general. OBJETIVO: El objetivo de este estudio fue estimar la prevalencia de las comorbilidades en PVVIH con cáncer de un centro de tercer nivel de la Ciudad de México. MÉTODOS: Este estudio retrospectivo incluyó todas las PVVIH > 40 años con cáncer, que acudieron al Instituto Nacional de Cancerología entre 2010 y 2019). Se incluyeron datos sobre el tipo de cáncer, comorbilidades y polifarmacia. Se calcularon la puntuación FRAX, el riesgo cardiovascular a 10 años, y se aplicó un cuestionario para evaluar depresión (Beck Inventory Depression-II Scale). RESULTADOS: De 125 pacientes, 69% tenía al menos una comorbilidad; 32% tenía ≥ 2. Las comorbilidades más comunes fueron dislipidemia (54%), hipertensión (19%), obesidad (14%) y diabetes (12%). En pacientes ≥ 50 años, 29% tenía una densitometría osea; 31% tenía osteoporosis. Se aplicaron 56 cuestionarios: 30% tenía algún grado de depresión. Tener ≥ 50 años se asoció con multimorbilidad (aOR 2.57, 1.18-5.58), p = 0.017. CONCLUSIONES: Se reporta una alta prevalencia de multimorbilidad en PVVIH y cancer, con pobre escrutinio de enfermedad ósea y salud mental. Se requiere un enfoque holístico para las PVVIH en la consulta de infectología, para mejorar el manejo de las enfermedades no transmisibles, yendo más alla de la supresión virológica.