Consumo de alimentos de origem animal e câncer de boca e orofaringe / Consumption of animal Consumption of animalderived oropharyngeal cancer

Objetivo. Avaliar a relação entre alimentos de origem animal e câncer de boca e orofaringe.Métodos. Estudo caso-controle, de base hospitalar, pareado por sexo e idade (± 5 anos) coma coleta de dados realizada entre julho de 2006 e junho de 2008. A amostra foi composta por296 pacientes com câncer de boca e orofaringe e 296 pacientes sem histórico de câncer atendidosem quatro hospitais da cidade de São Paulo (SP), Brasil. Foi aplicado um questionário semiestruturado,para a coleta de dados relativos à condição socioeconômica e aos hábitos deletérios(tabaco e bebidas alcoólicas). Para avaliação do consumo alimentar, utilizou-se um questionáriode frequência alimentar qualitativo. A análise se deu por meio de modelos de regressão logísticamultivariada, que consideraram a hierarquia existente entre as características estudadas.Resultados. Entre os alimentos de origem animal, o consumo frequente de carne bovina(OR = 2,73; IC95% = 1,27–5,87; P < 0,001), bacon (OR = 2,48; IC95% = 1,30–4,74;P < 0,001) e ovos (OR = 3,04; IC95% = 1,51–6,15; P < 0,001) estava relacionado ao aumentono risco de câncer de boca e orofaringe, tanto na análise univariada quanto na multivariada.Entre os laticínios, o leite apresentou efeito protetor contra a doença (OR = 0,41; IC95% =0,21–0,82; P < 0,001).Conclusões. O presente estudo sustenta a hipótese de que alimentos de origem animalpodem estar relacionados à etiologia do câncer de boca e orofaringe. Essa informação podeorientar políticas preventivas contra a doença, gerando benefícios para a saúde pública.

Objective. Evaluate the relationship between animal-derived foods and mouth andoropharyngeal cancer.Methods. Hospital-based case-control study matched by sex and age (± 5 years) withdata collected between July of 2006 and June of 2008. The sample contained 296 patientswith mouth and oropharyngeal cancer and 296 patients without a cancer history who weretreated in four hospitals in the City of São Paulo, State of São Paulo, Brazil. A semistructuredquestionnaire was administered to collect data regarding socioeconomic condition andharmful habits (tobacco and alcoholic beverage consumption). To assess eating habits,a qualitative questionnaire that asked about the frequency of food consumption wasused. The analysis was rendered by means of multivariate logistic regression models thatconsidered the existing hierarchy among the characteristics studied.Results. Among foods of animal origin, frequent consumption of beef (OR = 2.73;CI95% = 1.27–5.87; P < 0.001), bacon (OR = 2.48; CI95% = 1.30–4.74; P < 0.001) andeggs (OR = 3.04; CI95% = 1.51–6.15; P < 0.001) was linked to an increased risk ofmouth and oropharyngeal cancer, in both the univariate and multivariate analyses.Among dairy products, milk showed a protective effect against the disease (OR =0.41; CI95% = 0.21–0.82; P < 0.001).Conclusions. This study affirms the hypothesis that animal-derived foods can beetiologically linked to mouth and oropharyngeal cancer. This information can guidepolicies to prevent these diseases, generating public health benefits.

Perfil epidemiológico de casos incidentes de câncer de boca e faringe / Epidemiological profile of incident cases of oral and pharyngeal cancer

Objetivo: Avaliar o perfil epidemiológico de uma coorte de pacientes diagnosticados com câncer de boca e faringe de um Centro de Alta Complexidade em Oncologia nível II do município de Juiz de Fora, Minas Gerais, entre janeiro 2005 e dezembro 2007. Métodos: Estudo transversal, fundamentado na análise retrospectiva e descritiva de 101 prontuários médicos. Resultados: Dos 101 pacientes, 84,2% eram homens com baixo nível de escolaridade, bem como trabalhadores braçais (35,8%) e 15,8%, mulheres, donas-de-casa (5,5%). A razão de sexo foi 5,3:1; idade média de 56,5 anos, sendo que 49,5% dos casos apresentavam ao diagnóstico, idade inferior à média do grupo. Com relação aos hábitos de risco, 67,1% eram tabagistas e o etilismo foi descrito em 49,3% dos prontuários, sendo que o relato de consumo diário, sob forma de bebidas destiladas (47,3%), foi feito por 60% dos casos. O sítio anatômico mais prevalente foi a língua (32%), orofaringe (18,5%), assoalho de boca (12,4%). No estadiamento ao diagnóstico verificou-se maior número de tumores T4 (39,4%), N2 (38,3%), M0 (91,4%). Conclusão: O diagnóstico das lesões bucais malignas foi tardio, observando-se estadiamento T4 em 39,4% dos casos. Assim, para que oportunidades diagnósticas não sejam comprometidas é necessário o treinamento dos profissionais de saúde para abordagem dos fatores preventivos e do diagnóstico precoce e, finalmente a elaboração de rotinas programadas nos serviços de saúde para detecção de lesões suspeitas à inabilidade de alguns médicos e dentistas no reconhecimento do câncer. Contudo, para que oportunidades diagnósticas não sejam perdidas é necessário o treinamento dos profissionais de saúde para abordagem dos fatores preventivos e do diagnóstico precoce e, finalmente a elaboração de rotinas programadas nos serviços de saúde para detecção de lesões suspeitas.

Objective: The aim of this study was to evaluate the epidemiological profile of a cohort of patients diagnosed with oral or pharyngeal cancer in a High Complexity Oncology Center (level II) in Juiz de Fora, Minas Gerais, Brazil, from January 2005 to December 2007. Methods: This cross-sectional study was based on the retrospective and descriptive analysis of 101 medical records. Results: Of the 101 patients 84.2% were males with low education levels, of which 35.8% were blue-collar workers and 15.8% were females, of which 5.5% were homemakers. The gender ratio was 5.3:1 and the mean age of the sample was 56.5 years. The age of 49.5% of the individuals at diagnosis was below the mean age of the group. Regarding risk factors, 67.1% were smokers and 49.3% were alcoholics; 60% of the sample reported drinking distilled beverages (47.3%) daily. The most common sites were the tongue (32%), oropharynx (18.5%) and floor of mouth (12.4%). Staging at diagnosis revealed that 39.4% were T4, 38.3% were N2 and 91.4% were M0. Conclusion: The diagnosis of malignant oral lesions was late: 39.4% of the sample was in stage T4. Thus, for diagnostic opportunities not to be missed, it is necessary to train health professionals so that they can address the factors of prevention and early diagnosis. It is also necessary to develop routines in health services to detect suspicious lesions since some physicians and dentists are unable to recognize cancerous lesions.

Morbilidad y mortalidad por cáncer oral y faríngeo en Chile / Morbidity and mortality for oral and pharyngeal cancer in Chile

Background: Most oral cancers are squamous cell carcinomas (90%) which are two to four times more common in men than in women. The reasons for these differences are associated with exposure to factors such as tobacco and alcohol. Age is also considered as a risk factor (about 90% of the cases are diagnosed after 45 years of age). Aim: To analyze the frequency of oral cavity cancer during the last years in Chile. Material and methods: Mortality rates were obtained from death records of the "Instituto Nacional de Estadísticas" and publications of the World Health Organization, from 1955 to 2002. Morbidity from 1969 to 2002 was obtained from hospital discharge records of the Chilean Ministry of Health. Results: Oral cancer corresponded to 1.6% of total cancer cases in Chile, with a male:female ratio of 2.3 to 1. Deaths due to oral cancer was 1% of all cancer deaths, with a male:female ratio of 2.8 to 1. The morbidity rate for both genders increased while the mortality rate was relatively constant. However, we observed an increase in the mortality rate among women from 1980 to 2002, associated with more than 100% increase in the frecuency of smoking, between 1970 and 1998. The most common anatomical location was the tongue. Conclusions: The incidences of oral cancer is increasing in Chilean women, but men are more commonly affected.