Desigualdades regionais na mortalidade por câncer de colo de útero no Brasil: tendências e projeções até o ano 2030

O objetivo deste artigo é analisar a tendência temporal da mortalidade por câncer de colo de útero no Brasil e calcular uma projeção até o ano de 2030. Foram analisados os óbitos ocorridos no Brasil de 1996 a 2010 (Sistema de Informações sobre Mortalidade). Foram realizadas análises das tendências da mortalidade por meio da regressão Joinpoint, e para o cálculo das projeções foi utilizado o Nordpred. Para o Brasil, a tendência é de redução (APC = 1, 7% IC95%-2, 2; -1, 1 p < 0, 05), sendo significativa nas regiões centro oeste (APC = -1, 3% ao ano), sudeste (APC =-3, 3%) e sul (APC = -3, 9%). As regiões norte e nordeste apresntam tendência de estabilidade. Os estados do Acre (APC = -6, 5%) e Rio Grande do Sul (APC = -4, 1%) apresentaram as maiores tendências de redução. Na análise das projeções de mortalidade, haverá uma redução das taxas no Brasil a partir do primeiro período projetado, sendo mais marcante para a região sul. As taxas de mortalidade até o ano 2030 serão explicadas, em maior medida, pela redução dos risco para a doença. A mortalidade por câncer de colo de útero apresenta tendência de redução, todavia está desigualmente distribuída no Brasil, com as regiões norte e nordeste apresentando as maiores taxas. The scope of this article is to analyze the temporal trends of cervical cancer mortality in Brazil and calculate the projection of mortality through to the year 2030. Deaths that occurred within the 1996-2010 period were analyzed (Mortality Information System). Mortality trend analysis utilized the Joinpoint regression, while Nordpred was utilized for the calculation of projections. For Brazil, decreasing trends were identified (APC = 1.7% CI95%-2.2; -1.1 p < 0.05). The Midwest region presented a significant reduction trend (APC = -1.3% per year), along with the Southeast (APC = -3.3%) and South (APC = -3.9%) regions. The North and Northeast regions presented stable trends. The states of Acre (APC = -6.5%) and Rio Grande do Sul (APC = -4.1%) presented the most pronounced reduction trends. Analysis of the mortality projections revealed a reduction in mortality rates, starting from the first projected period, with a considerable reduction for the South region. Mortality rates through to the year 2030 are explained, principally, by reductions in the riskof the disease. Cervical cancer mortality presents reducing trends, however these are unequally distributed throughout the country, where the North and Northeast regions present the highest mortality rates

Evaluation of the virtual source/virtual destination-technique for available bit rate traffic in ATM-networks

Studies have shown that estrogen replacement therapy and estrogen plus progestin replacement therapy alter serum levels of total, LDL and HDL cholesterol levels. However, HDL cholesterol levels in women vary considerably in response to hormone replacement therapy (HRT). A significant portion of the variability of these levels has been attributed to genetic factors. Therefore, we investigated the influence of estrogen receptor-alpha (ESR1) gene polymorphisms on HDL levels in response to postmenopausal HRT. We performed a prospective cohort study on 54 postmenopausal women who had not used HRT before the study and had no significant general medical illness. HRT consisted of conjugated equine estrogen and medroxyprogesterone acetate continuously for 1 year. The lipoprotein levels were measured from blood samples taken before the start of therapy and after 1 year of HRT. ESR1 polymorphism (MspI C>T, HaeIII C>T, PvuII C>T, and XbaI A>G) frequencies were assayed by restriction fragment length polymorphism. A general linear model was used to describe the relationships between HDL levels and genotypes after adjusting for age. A significant increase in HDL levels was observed after HRT (P = 0.029). Women with the ESR1 PvuII TT genotype showed a statistically significant increase in HDL levels after HRT (P = 0.032). No association was found between other ESR1 polymorphisms and HDL levels. According to our results, the ESR1 PvuII TT genotype was associated with increased levels of HDL after 1 year of HRT.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de GinecologiaUniversidade de São Paulo Faculdade de Medicina Departamento de Obstetrícia e GinecologiaUNIFESP, EPM, Depto. de GinecologiaFAPESP: 03/04533-1FAPESP: 04/05281-9SciEL