ABSTRACT
ABSTRACT BACKGROUND: Colorectal cancer is among the three most frequent neoplasms in Brazil, being a public health problem. OBJECTIVE: To describe distribution pattern of colorectal cancer mortality in Brazil and regions, according to sex, between 1996 and 2015. METHODS: Values of standardized and stratified mortality rates by sex between 1996 and 2015 were used, through polynomial regression models and joinpoint analysis. RESULTS: It was observed that, for linear trends in mortality rates, for both sexes, there is a statistically significant trend increasing in both models, with rates and trends, and higher for men than for women, respectively, 7.3% per year (R2=0.95, P<0.001) and 6.5% per year (R2=0.87, P<0.001). It is observed a difference in magnitude and behavior of trend between the regions. CONCLUSION: It is understood that it is important to know the trend of rates in order to define priority populations for early interventions that increase survival and reduce mortality.
RESUMO CONTEXTO: O câncer de cólon e reto está entre as três neoplasias mais frequentes no Brasil, sendo um problema de saúde pública. OBJETIVO: Descrever o padrão de distribuição da mortalidade por câncer de cólon e reto no Brasil e regiões, por sexo, no período de 1996 a 2015. MÉTODOS: Utilizou-se os valores de taxas de mortalidade padronizadas e estratificadas por sexo entre 1996 e 2015, através dos modelos de regressão polinomial e análise por joinpoints. RESULTADOS: Foi observado que, para as tendências lineares das taxas de mortalidade, para ambos os sexos, há tendência de aumento linear estatisticamente significativa em ambos os modelos, sendo as taxas e as tendências maiores para homens do que para mulheres, respectivamente, 7,3% ao ano (R2=0,95; P<0,001) e 6,5% ao ano (R2=0,87; P<0,001). Observa-se diferença na magnitude e comportamento da tendência entre as regiões. CONCLUSÃO: Entende-se que é importante conhecer a tendência das taxas de forma a definir populações prioritárias para intervenções precoces que aumentem a sobrevida e reduzam a mortalidade.
Subject(s)
Humans , Male , Female , Colorectal Neoplasms/mortality , Time Factors , Brazil/epidemiology , Survival Rate , Regression Analysis , Mortality/trends , Sex Distribution , Middle AgedABSTRACT
Aims: To ascertain the risk of pre-cancerous treatment failure considering selected genetic, environmental, and clinical characteristics among Brazilian women. Study Design: A prospective study developed in a cohort of women treated for Cervical Intraepithelial Neoplasia (CIN) lesion. Place and Duration of Study: Gynecology Oncology day clinic of Brazilian National Cancer Institute, between October 2004 and May 2006. Methodology: We included 285 women (age range 18-75 years) with CIN submitted to lesion excision. All patients were interviewed at admission to identify epidemiological and clinical characteristics, having blood samples collected, and a colposcopic examination performed. TP53 polymorphism was ascertained using PCR-RFLP. After treatment, the study population was followed up with Pap-tests during two years. Treatment failure was evaluated using histological confirmation of any altered tissue. Kaplan-Meyer curves and Cox Proportional Risk Model were used for data analysis. Results: Frequencies of TP53 polymorphisms were: Arg72Pro genotype(Arg/Pro)- 177(62.1%); Arg72 genotype(Arg/Arg)-55(19.3%); Pro genotype (Pro/Pro)-53(18.6%). Women with endocervical margins involvement showed an HR 7.01(1.73-28.44). Current smoking was statistically related to CIN treatment failure (HR:3.90,95%CI:1.28-11.91). Comparatively to Arg/Arg, the risks for treatment failure were: HR 1.51(95%CI:0.23-9.80) for Arg/Pro women; and HR:1.41 (95%CI:0.31-6.52) for Pro/Pro. Conclusion: Surgical margins involvement and current tobacco smoking presented independent risks for CIN treatment failure among the studied population. Pro/Pro genotype seems to be associated with CIN treatment failure.