Evaluation of the population based cancer registry of the municipality of Goiânia, Goiás state, Brazil

Os Registros de Câncer de Base Populacional (RCBP) constituem uma reconhecida ferramenta para vigilância e monitoramento das neoplasias, exercendo um papel fundamental para a Saúde Pública. Aplicar uma metodologia de avaliação permitirá dispor de informações relevantes quanto à qualidade e utilidade desses registros. A metodologia de avaliação aplicada foi baseada nas seguintes publicações: “Diretrizes para Avaliação de Sistemas de Vigilância”, dos Centers for Disease Control and Prevention (CDC) dos Estados Unidos da América; “Registros de Câncer: Princípios e Métodos” (manuais) e “Comparabilidade e Controle de Qualidade nos Registros de Câncer”, ambas da Agência Internacional para Pesquisa sobre o Câncer (IACR)/Organização Mundial da Saúde (OMS); e “Manual de Rotinas e Procedimentos para Registros de Câncer de Base Populacional”, do Instituto Nacional do Câncer do Ministério da Saúde (Inca/MS). O RCBP do Município de Goiânia, Estado de Goiás, Brasil, mostrou-se complexo em sua operacionalização, porém flexível, oportuno, útil e representativo. Os indicadores de qualidade aferidos validam a importância e o papel das informações geradas pelos RCBP enquanto subsídios à implementação de políticas públicas de prevenção e controle do câncer. _______________________________________________________________________________________ ABSTRACTPopulation Based Cancer Registries (RCBP) constitute a recognized tool for cancer surveillance and monitoring, and have a fundamental role in Public Health. The application of an evaluation methodology will generate valuable information with respect to the quality and usefulness of the registries. The applied evaluation methodology was based on the following publications: “Guidelines for Evaluating Surveillance Systems”, of the Centers for Disease Control and Prevention (CDC) of the United States of America; “Cancer Registry: Principles and Methods” (manuals), and the “Comparability and Quality Control of Cancer Registry”, both of the International Agency for Cancer Research (IACR)/World Health Organization (WHO); and “Routines and Procedures for Population-based Cancer Registrees”, of the National Institute of Cancer of the Ministry of Health of Brazil (Inca/MS). The RCBP of the Municipality of Goiânia, Goiás State, Brazil, showed to be complex in its operationalization, but flexible, timely, useful and representative. The measured quality indicators validate the importance and the role of the information generated by the registry as subsidies for implementation of public prevention and cancer control policies

Cancer Burden in Latin America and the Caribbean

Background: In Latin America and the Caribbean, the epidemiological transition has been occurring in an unequal manner. Infectious-contagious diseases share space with the increase of chronic nontransmissible diseases, such as cancer, which already represents the second most common cause of death, after cardiovascular illnesses. Objectives: This study provides a global picture of the burden of cancer in Latin America and the Caribbean, as well as the challenges faced when controlling this disease in these regions. Findings: Epidemiological information on cancer in Latin America originates mainly from mortality registries and from a limited number of population-based cancer registries. Estimates indicate increases of 72% in the incidence of cancer and 78% in the mortality of men between 2012 and 2030, and for women the rates are 62% and 74%, respectively. These increases in incidence rates, accompanied by disproportionally high mortality rates, when compared with other regions of the world, reveal the magnitude of the challenge of controlling cancer in Latin America and the Caribbean. Although neoplasms are among the main causes of death, the control strategies are faced with issues such as organization and development of the health system, and the public policy formulation mechanism. Conclusions: Establishing knowledge on the real impact of incidence, mortality, and survival in Latin America and the Caribbean is quite a challenge due to the lack of an updated and dynamic information system on mortality and incidence, although some improvement has been made in the information systems of some countries within the most recent decade. Other obstacles for cancer control are the uneven allocation of resources, lack of investments in equipment and infrastructure, and the concentration of health care professionals in large urban centers, which contribute to the reproduction of socioeconomic iniquities in the assistance of populations that suffer from cancer

Epidemiology and survival outcomes of lip, oral cavity, and oropharyngeal squamous cell carcinoma in a southeast Brazilian population

Lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC) represent a major health problem in the global scenario. In South America, the highest incidence rates are seen in Brazil. Therefore, the epidemiological and clinical profile and survival outcomes of lip, oral cavity, and oropharyngeal SCC was studied in São Paulo State, Brazil. The clinicopathological data of 12,099 patients with lip, oral cavity, and oropharyngeal SCC were obtained from hospital cancer registries of the Fundação Oncocentro de São Paulo, Brazil (2010?2015). Survival rates and other analyses were performed using SPSS software. A clear male predominance was observed, particularly for patients with oropharyngeal SCC (88.3%). The average age of patients was higher for lip cases (65 ± 13.5 years) compared to other sites. The schooling level was low for most patients, especially in lip cases (87.9%). Most of the patients with oral cavity (71.8%) and oropharyngeal (86.3%) SCC had advanced-stage (III?IV) disease. However, the majority of lip cases (83.3%) were at an early stage (I?II). Surgical excision was the main treatment for lip (72%) and oral cavity SCC (23.5%), and chemoradiotherapy was the main treatment for oropharyngeal SCC (40.2%). The 5-year overall survival (OS) for patients with lip, oral cavity, and oropharyngeal SCC were 66.3, 30.9, and 22.6%, respectively. Multivariate analysis revealed that the determinants of OS were different for lip, oral cavity, and oropharyngeal SCC, except for those at the clinical stage, which was an independent predictor for all sites. OS-independent determinants varied according to the affected site. Oral cavity and oropharyngeal SCC presented worse survival rates than those for lip SCC

Survival trends of patients with oral and oropharyngeal cancer treated at a cancer center in Sa˜o Paulo, Brazil

OBJECTIVE: We aimed to estimate the overall survival (OS) and conditional survival (CS) in patients diagnosed with oral and oropharyngeal squamous cell carcinoma (SCC) and to determine their survival trends. METHODS: The study included all consecutive patients treated at the A.C. Camargo Cancer Center for oral or oropharyngeal SCC between 2001 and 2012. Data were obtained from the Hospital Cancer Registry. OS and CS were analyzed using the Kaplan-Meier method to evaluate the probability of survival with Cox predictor models. RESULTS: Data of 505 oral and 380 oropharyngeal SCC patients obtained in 2001–2006 and 2007–2012 were analyzed. Most of the oral SCC (59%) and oropharyngeal SCC (90%) patients had stages III–IV SCC. The 5-year OS for patients with oral SCC was 51.7%, with no significant difference between the first and second periods. The CS rates in 2007–2012 were 65% after the first year and 86% up to the fifth year. For oropharyngeal SCC, the 5-year OS rate was 45.0% in the first period. The survival rate increased to 49.1% from 2007 to 2012, with a reduction in the risk of death (HR=0.69;0.52–09.2). The CS estimates from 2007 to 2012 were 59% after the first year and 75% up to the fifth year. CONCLUSION: Survival across the two time periods remained stable for oral SCC but showed a significant increase for oropharyngeal SCC, possibly because of improvements in the patients’ response to radiotherapy, such as intensity-modulated radiation therapy, and the use of more accurate diagnostic imaging approaches

Polimorfismo de TP53 nos Carcinomas Tiroideanos: estudo molecular e meta-análise

Resumo: nossa proposta foi avaliar o polimorfismo do gene TP5372 e a associação deste com o risco de desenvolvimento do câncer da tireóide. Para avaliar o papel de tal polimorfismo, 35 casos de câncer de tireóide foram comparados ao grupo controle de 134 indivíduos saudáveis. A determinação do polimorfismo do gene TP5372 foi feita por PCR e incluído na meta-análise de estudos caso-controle com pacientes com carcinomas tiroideanos utilizando o método de DerSimonian-Laird. A frequência do alelo p53Arg foi significativamente maior em ambos os grupos analisados. A comparação da frequência genotípica dos pacientes com o grupo controle demonstrou que genótipo p53Arg Arg apresenta menor risco para desenvolvimento de câncer, sugerindo que a presença do alelo arginina em homozigose possua um efeito protetor contra a carcinogênese tiroideana (OR:0,15;

A proteção dos dados pessoais na investigação e inovação em saúde

Investigação e inovação em saúde pressupõe o tratamento de dados pessoais sensíveis, protegidos pelo regulamento europeu de proteção de dados e pela legislação nacional. O presente estudo procura demonstrar a compatibilidade entre a investigação e inovação em saúde e as garantias de confidencialidade e proteção dos dados pessoais, indicando os pressupostos para tal, alertando para a fragilidade acrescida nos estudos internacionais. Metodologia: A abordagem tem por base a legislação europeia e nacional em vigor sobre proteção de dados pessoais e a Lei de investigação clínica, a compreensão sobre a mesma expressa pela Comissão Nacional de Proteção de Dados e pela Comissão de Acesso aos Documentos Administrativos, bem como o papel das comissões de ética, legalmente previsto.info:eu-repo/semantics/publishedVersio

A importância das Comissões de Ética nas Tecnologias da Saúde: a experiência da Escola Superior de Saúde do Instituto Politécnico do Porto

A Escola Superior de Saúde (ESS) do Instituto Politécnico do Porto (P.PORTO) completou recentemente o seu 40º aniversário de existência, enquanto instituição de ensino superior (IES) de referência na área da saúde. A evolução desta IES tem sido notória tanto ao nível da formação graduada, como pós-graduada, atividades de extensão à comunidade, onde se insere a recente Clínica Pedagógica, e criação de dois centros de investigação. A responsabilidade adstrita a todas estas atividades promoveu a criação de um mecanismo de implementação de boas práticas e sua monitorização. Esta perceção levou à criação de uma Comissão de Ética (CE) na IES, que conta já com 10 anos de existência e atividade contínua, tendo sido uma das primeiras a surgir no meio académico nacional. O recente Decreto-Lei n.º 80/2018 (15 /outubro), veio comprovar e validar a pertinência deste organismo nas IES, sobretudo naquelas que realizam investigação clínica.info:eu-repo/semantics/publishedVersio

Intake of Proton-Pump Inhibitors and Gastric Cancer within the Stomach Cancer Pooling (StoP) Project

Background: A potential association between proton-pump inhibitors (PPI) and gastric cancer remains undefined. Thus, we aimed to evaluate such association within the Stomach cancer Methods: Data from five case-control studies of the StoP Project were included (1,889 cases and 6,517 controls). We assessed the impact of different exposure definitions, specifically any reported use of PPIs and exposure definitions based on the duration of PPI intake. Additionally, we modeled the dose-response relationship between the cumulative duration of PPI intake and gastric cancer. Results: Significant associations between PPI intake and gastric cancer, both overall and in the stratified analyses, were limited to exposure definitions based on short durations of intake. The overall odds ratio (OR) for any reported PPI intake was 1.78 [95% confidence interval (CI): 0.76-4.14]. In the dose-response analysis, the ORs of gastric cancer were found to be higher for short durations of PPI intake (6 months: OR 3.26; 95% CI: 2.40-4.42; one year: OR 2.14; 95% CI: 1.69-2.70; 2 years: OR 1.50; 95% CI: 1.22-1.85; 3 years: OR 1.27; 95% CI: 1.03-1.56), with the association becoming not significant for durations longer than 3 years. Conclusions: Our findings suggest that the observed association between PPIs and gastric cancer might be mainly due to reverse causality. Impact: The results of this study suggest that PPIs area safe thera-peutic choice regarding their effect on the occurrence of gastric cancer. See related commentary by Richman and Leiman, p. 112

O Polimorfismo de CYP1A1 e a Susceptibilidade ao Carcinoma Oral

Resumo: estudos epidemiológicos mostram que o polimorfismo de CYP1A1 está associado ao processo de carcinogênese em diversos tumores. O presente estudo de caso-controle teve como objetivo analisar o polimorfismo de CYP1A1m1 e o risco de carcinoma oral por PCR-RFLP. As frequências alélicas para os alelos T e C foram de 63% e 37% para os pacientes com carcinomas orais, e de 43% e 57% para o grupo controle, respectivamente. A análise de risco por Odds ratio, sugere que o perfil genotípico não apresentou risco entre os pacientes com câncer de boca, nem mesmo quando associados às variáveis etilismo e tabagismo. O polimorfismo genético de CYP1A1m1 não está associado a susceptibilidade no carcinoma oral. Palavras-chave: Gene CYP1A1. Polimorfismo. Susceptibilidade. Carcinoma oral

Custos dos estudantes do ensino superior português - Relatório CESTES 2: Para a compreensão da condição social e económica dos estudantes do ensino superior

O relatório do projeto CESTES 2 apresenta os resultados de um questionário aplicado em 2015/2016 a uma amostra representativa e estratificada de estudantes do ensino superior a nível nacional, envolvendo estudantes do ensino público, privado, universitário e politécnico. Neste estudo encontram-se dados que permitem caracterizar a condição socioeconómica dos estudantes do ensino superior e conhecer os custos de educação e de vida que os estudantes enfrentam durante a frequência do Ensino Superior, tendo em conta o impacto do tipo de instituição, curso, área científica e região onde o estudante se encontra inscrito.The Project CESTES 2 is an Economics of Education research study, based on the cost sharing theory (Johnstone, 2004). It analyses the costs of the Portuguese higher education students in 2015/16, following similar studies developed by Cabrito (2000), Cerdeira (2005) and the 2010 CESTES 1 Project. Similarly to those previous studies, this research aimed to define the social and economic status of the Portuguese’s higher education students in 2015-16, collecting data on the Portuguese higher education students' costs of education and living, and understanding the relationship between those costs and the students' attendance in each type of Portuguese higher education institution, scientific area and geographic region. The project concludes that there has been a positive evolution in the Portuguese higher education in terms of number of enrolled students, number of graduates, and the quality and output of scientific research. However, some aspects are still restrictive, namely the students' availability to funding. The Portuguese higher education students and their families contribute with a significant portion to the financing of higher education, In comparison with their European colleagues, they are most penalized, and family budgets are heavily burdened with higher education attendance costs.info:eu-repo/semantics/publishedVersio