Development and validation of a simple questionnaire for the identification of hereditary breast cancer in primary care

<p>Abstract</p> <p>Background</p> <p>Breast cancer is a significant public health problem worldwide and the development of tools to identify individuals at-risk for hereditary breast cancer syndromes, where specific interventions can be proposed to reduce risk, has become increasingly relevant. A previous study in Southern Brazil has shown that a family history suggestive of these syndromes may be prevalent at the primary care level. Development of a simple and sensitive instrument, easily applicable in primary care units, would be particularly helpful in underserved communities in which identification and referral of high-risk individuals is difficult.</p> <p>Methods</p> <p>A simple 7-question instrument about family history of breast, ovarian and colorectal cancer, FHS-7, was developed to screen for individuals with an increased risk for hereditary breast cancer syndromes. FHS-7 was applied to 9218 women during routine visits to primary care units in Southern Brazil. Two consecutive samples of 885 women and 910 women who answered positively to at least one question and negatively to all questions were included, respectively. The sensitivity, specificity and positive and negative predictive values were determined.</p> <p>Results</p> <p>Of the 885 women reporting a positive family history, 211 (23.8%; CI95%: 21.5–26.2) had a pedigree suggestive of a hereditary breast and/or breast and colorectal cancer syndrome. Using as cut point one positive answer, the sensitivity and specificity of the instrument were 87.6% and 56.4%, respectively. Concordance between answers in two different applications was given by a intra-class correlation (ICC) of 0.84 for at least one positive answer. Temporal stability of the instrument was adequate (ICC = 0.65).</p> <p>Conclusion</p> <p>A simple instrument for the identification of the most common hereditary breast cancer syndrome phenotypes, showing good specificity and temporal stability was developed and could be used as a screening tool in primary care to refer at-risk individuals for genetic evaluations.</p

Mortalidade por câncer de cérvice uterina no Rio Grande do Sul, perído de 1979 a 1998

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Mortalidade por câncer de cérvice uterina no Rio Grande do Sul, perído de 1979 a 1998

Resumo não disponível

A evolução da mortalidade por câncer de colo de útero entre 1979 e 1998 no Rio Grande do Sul, Brasil

A mortalidade por câncer de colo de útero tem diminuído em países desenvolvidos. Entretanto, no Brasil, os dados apontam o câncer de colo de útero como uma das mais freqüentes causas de morte por neoplasia em mulheres, estando em quarto lugar no Rio Grande Sul. Este estudo do tipo série-temporal analisa a mortalidade por câncer de colo de útero e a evolução deste fenômeno no Rio Grande do Sul, no período entre 1979 e 1998. Os dados foram extraídos do Sistema de Informação sobre Mortalidade. Coeficientes de mortalidade padronizados foram analisados por meio de regressão linear simples. Estimou-se o impacto da mortalidade por esta causa sobre a duração de vida esperada para esta população utilizando-se o cálculo dos Anos Potenciais de Vida Perdidos (APVP). Observou-se uma tendência linear positiva dos coeficientes de mortalidade padronizados com incremento anual de 0,17, e o coeficiente anual médio dos óbitos no período foi de 7,58/ 100 mil. Esta doença foi responsável por uma média de 21,9±1,33 APVP. Assim, apesar do câncer de colo de útero ser uma doença prevenível e curável, observa-se um aumento de mortalidade por esta causa, sugerindo falhas nos programas de rastreamento desta doença.A decrease in uterine cervical cancer (CC) mortality has been observed in developed countries. However, mortality data in Brazil suggest that CC is one of the most frequent causes of cancer death in women; it is the fourth cause of death from cancer in women in Rio Grande Sul State. A time-trend ecological study was performed to analyze CC mortality trends in Rio Grande do Sul from 1979 to 1998. Data were collected from the Mortality Information System, Brazilian Ministry of Health (DATASUS). Standardized mortality ratios were calculated and linear regression was used for time-trend analysis. The impact of cervical cancer death on life expectancy was also estimated for the study population using potential years of life lost (PYLL). Standardized mortality ratios during the study period revealed a positive linear trend of 0.17, and the mean annual mortality rate was 7.58/100,000. Cervical cancer accounted for 21.9 ± 1.33 PYLL during the period. In conclusion, although CC is a preventable and curable disease, an increase is observed in mortality from this cause in Rio Grande do Sul State, which may suggest failure in screening programs for cervical cancer

A evolução da mortalidade por câncer de colo de útero entre 1979 e 1998 no Rio Grande do Sul, Brasil

A mortalidade por câncer de colo de útero tem diminuído em países desenvolvidos. Entretanto, no Brasil, os dados apontam o câncer de colo de útero como uma das mais freqüentes causas de morte por neoplasia em mulheres, estando em quarto lugar no Rio Grande Sul. Este estudo do tipo série-temporal analisa a mortalidade por câncer de colo de útero e a evolução deste fenômeno no Rio Grande do Sul, no período entre 1979 e 1998. Os dados foram extraídos do Sistema de Informação sobre Mortalidade. Coeficientes de mortalidade padronizados foram analisados por meio de regressão linear simples. Estimou-se o impacto da mortalidade por esta causa sobre a duração de vida esperada para esta população utilizando-se o cálculo dos Anos Potenciais de Vida Perdidos (APVP). Observou-se uma tendência linear positiva dos coeficientes de mortalidade padronizados com incremento anual de 0,17, e o coeficiente anual médio dos óbitos no período foi de 7,58/ 100 mil. Esta doença foi responsável por uma média de 21,9±1,33 APVP. Assim, apesar do câncer de colo de útero ser uma doença prevenível e curável, observa-se um aumento de mortalidade por esta causa, sugerindo falhas nos programas de rastreamento desta doença.A decrease in uterine cervical cancer (CC) mortality has been observed in developed countries. However, mortality data in Brazil suggest that CC is one of the most frequent causes of cancer death in women; it is the fourth cause of death from cancer in women in Rio Grande Sul State. A time-trend ecological study was performed to analyze CC mortality trends in Rio Grande do Sul from 1979 to 1998. Data were collected from the Mortality Information System, Brazilian Ministry of Health (DATASUS). Standardized mortality ratios were calculated and linear regression was used for time-trend analysis. The impact of cervical cancer death on life expectancy was also estimated for the study population using potential years of life lost (PYLL). Standardized mortality ratios during the study period revealed a positive linear trend of 0.17, and the mean annual mortality rate was 7.58/100,000. Cervical cancer accounted for 21.9 ± 1.33 PYLL during the period. In conclusion, although CC is a preventable and curable disease, an increase is observed in mortality from this cause in Rio Grande do Sul State, which may suggest failure in screening programs for cervical cancer

Caracterização de famílias em risco para câncer de mama hereditário no Rio Grande do Sul

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