Prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros / Smoking prevalence and lung cancer morbimortality in Brazilian states / Prevalencia del tabaquismo y morbimortalidad por cáncer de pulmón en los estados brasileños

Introdução: O câncer de pulmão é uma doença grave, sendo a segunda maior causa de morte em todo o mundo, entretanto, em alguns países desenvolvidos, tornou-se já a primeira causa de morte. Cerca de 90% dos casos de neoplasia pulmonares são causados pela inalação da fumaça do cigarro. Objetivo: Correlacionar a prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros, além de demonstrar a associação destes com sexo e faixa etária. Métodos: Estudo de caráter ecológico acerca da prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros, nos períodos de 2013 e 2019, dividida por sexo e faixa etária. Foram utilizados bancos de coleta de dados como o Tabnet e Pesquisa Nacional de Saúde. Resultados: As maiores taxas de mortalidade e internações hospitalares foram do público masculino, em 2013, com taxa de 2,7 e 10, respectivamente, e em 2019 com 3,3 e 11,9, respectivamente. Ademais, a maior prevalência de tabagismo foi encontrada nos homens; entretanto seu índice tem caído, enquanto a quantidade de mulheres tabagistas tem aumentado. A Região Sul demonstrou maiores números de mortalidade em ambos os períodos estudados, com taxas de 4,9 e 5,8 por 100 mil habitantes, e morbidade hospitalar com 19,9 e 23,5 por 100 mil habitantes. Já a Região Norte se configurou com as menores prevalências: em 2013 apresentou taxa de óbito por câncer de pulmão de 1,0 e morbidade hospitalar de 3,5/100 mil habitantes, em 2019 apresentou taxa de mortalidade de 4,6 e internações de 1,6/100 mil habitantes. Os coeficientes de correlação de morbidade hospitalar e prevalência de tabagismo foram R2=0,0628, r=0,251 e p=0,042, enquanto os de mortalidade e prevalência de tabagismo foram R2=0,0337, r=0,183 e p=0,140. Conclusões: Na presente pesquisa, pode-se inferir que houve associação positiva na comparação entre taxa de morbidade hospitalar e prevalência de tabagismo; em contrapartida, não foi possível observar associação positiva na correlação da taxa de mortalidade por câncer de pulmão e prevalência de tabagismo.

Introduction: Lung cancer is a serious disease, being the second leading cause of death worldwide. Moreover, in some developed countries, it has already become the leading cause of death. About 90% of lung cancer cases are caused by cigarette smoking. Objective: To correlate the prevalence of smoking and lung cancer morbidity and mortality in Brazilian states, and to demonstrate their association with sex and age group as well. Methods: An ecological study on the prevalence of smoking and lung cancer morbidity and mortality in Brazilian states between 2013 and 2019, divided by sex and age group. The data collection databases Tabnet and National Health Survey were used. Results: The highest rates of mortality and hospital admissions were among men, in 2013 with a rate of 2.7 and 10, respectively, and in 2019 with 3.3 and 11.9, respectively. In addition, the highest prevalence of smoking was found in men, but this rate has fallen, while the number of women smokers has increased. The South region showed higher mortality rates in both periods studied, with rates of 4.9 and 5.8 per 100,000 inhabitants, and hospital morbidity with 19.9 and 23.5 per 100,000 inhabitants. The North region had the lowest prevalence, where in 2013, it had a death rate from lung cancer of 1.0 and hospital morbidity of 3.5/100 thousand inhabitants, and where in 2019, it had a mortality rate of 4.6 and hospitalizations of 1.6/100 thousand inhabitants. The correlation coefficients for hospital morbidity and smoking prevalence were R2=0.0628, r=0.251 and p=0.042, while for mortality and smoking prevalence, these were R2=0.0337, r=0.183 and p=0.140. Conclusions: In the present study, it can be inferred that there was a positive association between hospital morbidity rate and prevalence of smoking, while it was not possible to observe a correlation between lung cancer mortality rate and prevalence of smoking.

Introducción: El cáncer de pulmón es una enfermedad grave, siendo la segunda causa de muerte en todo el mundo, sin embargo, en algunos países desarrollados, ya se ha convertido en la primera causa de muerte. Alrededor del 90% de los casos de neoplasias pulmonares están causados por la inhalación del humo del cigarrillo. Objetivo: Correlacionar la prevalencia de tabaquismo y la morbimortalidad por cáncer de pulmón en los estados brasileños, además de demostrar la asociación de estos con el género y el grupo de edad. Métodos: estudio ecológico sobre la prevalencia de tabaquismo y morbimortalidad por cáncer de pulmón en los estados brasileños, dentro de los períodos 2013 y 2019, divididos por sexo y grupo de edad. Se utilizaron bancos de recogida de datos como Tabnet y la Encuesta Nacional de Salud. Resultados: las mayores tasas de mortalidad e ingresos hospitalarios se dieron en el público masculino, en 2013 con una tasa de 2,7 y 10, respectivamente, y en 2019 con 3,3 y 11,9, respectivamente. Además, la mayor prevalencia del tabaquismo se encontró en los hombres, sin embargo, su tasa ha disminuido, mientras que la cantidad de mujeres fumadoras ha aumentado. La región Sur presentó cifras más altas de mortalidad en ambos periodos estudiados, con tasas de 4,9 y 5,8 por 100.000 habitantes, y de morbilidad hospitalaria con 19,9 y 23,5 por 100.000 habitantes. Mientras que la región Norte se configuró con las prevalencias más bajas, en 2013 presentó una tasa de mortalidad por cáncer de pulmón de 1,0 y una morbilidad hospitalaria de 3,5/100.000 habitantes, en 2019 presentó una tasa de mortalidad de 4,6 y hospitalizaciones de 1,6/100.000 habitantes. Los coeficientes de correlación para la morbilidad hospitalaria y la prevalencia del tabaquismo fueron R2=0,0628, r=0,251 y p=0,042, mientras que para la mortalidad y la prevalencia del tabaquismo fueron R2=0,0337, r=0,183 y p=0,140. Conclusiones: En la presente investigación se puede inferir que existe una asociación positiva en la comparación entre la tasa de morbilidad hospitalaria y la prevalencia de tabagismo, en contrapartida, no fue posible observar una asociación positiva en la correlación de la tasa de mortalidad por cáncer de pulmón y la prevalencia de tabagismo.

Experimental carcinogenesis with 7, 12-dimethylbenz(a)anthrazene (DMBA) and its inhibition with isothi-ocyanates / Carcinogénesis experimental con 7, 12-dimetilbenzantraceno (DMBA) y su inhibición con isitiocianatos

Introduction: DMBA is a chemical carcinogen that induces carcinomas within a few weeks of its application. We developed an experimental model of carcinogenesis induced by DMBA dissolved in 0,5% paraffin oil (DMBA-PO), verifying the inhibitory effect of the carcinogenicity of phenyl isothiocyanate (PhITC), phenethyl (PhnITC) and benzyl isothiocyanate (BITC). Material and Methods: For this, 88 hamsters were distributed into three groups: one exposed to DMBA-PO (Group 1, n=12), three subgroups (n=12) exposed to PhITC, PhnITC, BITC and DMBA-PO (Group 2, n=36) and four control subgroups (n=10) that were not exposed to the carcinogen in which PO (paraffin oil) and isothiocyanates were applied (Group 3, n=40). Results: The experiment had a duration of 20 weeks, at the end of which the inhibitory effect was established by comparing the lesions developed in the groups that received isothiocyanates with the group that was only treated with DMBA-PO. The carcinogenic effect of DMBA-PO is 100% (35 carcinomas) and the inhibitory effect was 0, whereas in the presence of isothiocyanates the carcinogenic effect decreases, with an inhibitory effect of 86% for BITC (5 carcinomas) and 74% for PhITC (9 carcinomas). Conclusion: The inhibitory effect for PhnITC is 80% in relation to invasive OSCC (1 carcinoma).

Introducción: El DMBA es un carcinógeno químico que induce carcinomas a las pocas semanas de su aplicación. Desarrollamos un modelo experimental de carcinogénesis inducida por DMBA disuelto en aceite de parafina al 0,5% (DMBA-Ap) comprobando el efecto inhibidor de la carcinogénesis de los isotiocianatos fenil (PhITC), fenetil (PhnITC) y bencil isotiocianato (BITC). Material y Métodos: Para ello, se distribuyeron 88 hámsteres en 3 grupos: uno expuesto al DMBA-Ap (Grupo 1, n=12), tres subgrupos (n=12) expuestos a PhITC, PhnITC, BITC y DMBA-Ap (Grupo 2, n=36) y cuatro subgrupos controles (n=10), no expuestos al carcinógeno en el que se aplicaron Ap e isotiocianatos (Grupo 3, n=40). Resultados:El experimento tuvo una duración de 20 semanas, al final de la cual se establece de forma comparativa el efecto inhibidor comparando las lesiones desarrolladas en los grupos que recibieron isotiocianatos con respecto al grupo tratado sólo con DMBA-Ap. El efecto carcinógeno del DMBA-Ap es del 100% (35 carcinomas) y el efecto inhibidor 0, mientras que en presencia de isotiocianatos el efecto carcinógeno disminuye, con un efecto inhibidor del 86% para BITC (5 carcinomas) y del 74% para el PhITC (9 carcinomas). Conclusión:El efecto inhibidor del PhnITC es del 80% en relación con el COCE invasivo (1 carcinoma).

Avaliação da exposição a BTEX em postos de revenda de combustíveis no Rio de Janeiro, Brasil, e os riscos à saúde do trabalhador / Assessment of exposure to BTEX in vehicle filling stations in Rio de Janeiro, Brazil, and risks to workers' health / Evaluación de la exposición a BTEX en puestos de reventa de combustibles, en Río de Janeiro, Brasil, y riesgos para la salud del trabajador

A gasolina é uma mistura complexa de substâncias, dentre elas estão hidrocarbonetos como o benzeno, tolueno, etilbenzeno e xilenos (BTEX), sendo esses compostos emitidos para a atmosfera, com destaque ao benzeno, por ser comprovadamente carcinogênico. Objetivamos avaliar as concentrações de BTEX no ar de postos de revenda de combustíveis no Município do Rio de Janeiro, Brasil, e calcular o risco de câncer associado a estas exposições. Foram realizados dois tipos de amostragem (fixa e móvel) adaptadas da metodologia nº 1.501 do Instituto Nacional de Segurança e Saúde Ocupacional (Estados Unidos), em seis postos de revenda de combustíveis na Zona Oeste da cidade. A amostragem fixa foi feita próxima às bombas de combustível, enquanto a móvel foi realizada através da coleta do ar na zona respiratória dos trabalhadores (frentistas), conforme estes se deslocavam pelo posto. As amostras foram analisadas por cromatografia gasosa com detecção por ionização em chama. Com os resultados das amostragens foram feitos os cálculos de risco à saúde, usando os indicadores Quociente de perigo (HQ) e Risco de câncer (CR), para avaliar os possíveis efeitos não-carcinogênicos e carcinogênicos, respectivamente, nos trabalhadores dos postos de revenda de combustíveis. As concentrações ambientais para a maioria dos compostos BTEX foram abaixo dos limites preconizados, menos para o benzeno, um composto carcinogênico, que apresentou concentrações muito acima dos limites, levando a altos valores de risco de câncer. Os resultados demonstraram que há riscos à saúde dos trabalhadores de postos de revenda de combustíveis, principalmente o risco de desenvolver câncer, devido à exposição excessiva ao benzeno.

Gasoline is a complex mixture of substances, including aromatic hydrocarbons such as benzene, toluene, ethylbenzene, and xylenes (BTEX). These compounds are emitted into the air, with the special relevance of benzene since it is provenly carcinogenic. The study aimed to assess BTEX concentrations in filling stations in the city of Rio de Janeiro, Brazil, and to calculate the cancer risk associated with such exposures. Two types of sampling were performed (stationary and mobile), adapted from methodology n. 1,501 (U.S. National Institute for Occupational Safety and Health) for aromatic hydrocarbons, in six filling stations in the West Zone of Rio de Janeiro. Stationary sampling was done near the fuel pumps, while mobile sampling was done in the breathing zone of the workers (station attendants) as they moved around the station. The samples were analyzed with gas chromatography flame ionization detector. The sampling results were used to calculate the health risk, using the indicators Hazard quotient (HQ) and Cancer risk (CR) to assess the possible non-carcinogenic and carcinogenic effects, respectively, in filling station workers. Environmental concentrations for the most of the BTEX compounds were below the recommended limits, except for benzene, a carcinogenic compound, which displayed concentrations far above the limits, leading to high cancer risk values. The results showed that there are health risks for filling station attendants, especially the risk of developing cancer from excessive exposure to benzene.

La gasolina es una mezcla compleja de sustancias, entre ellas existen hidrocarburos como el benceno, tolueno, etilbenceno y xilenos (BTEX), emitiéndose estos compuestos a la atmósfera, donde se destaca el benceno, al tratarse de un carcinogénico comprobado. Los objetivos fueron evaluar las concentraciones de BTEX en el aire de puestos de reventa de combustibles, en el municipio de Río de Janeiro, Brasil, así como calcular el riesgo de cáncer asociado a estas exposiciones. Se realizaron dos tipos de muestra (fija y movible), adaptadas de la metodología nº 1.501 del Instituto Nacional de Seguridad y Salud Laboral (EE.UU.), en seis puestos de reventa de combustibles de la zona oeste de la ciudad. La muestra fija se realizó cerca de las bombas de combustible, mientras que la móvil se hizo mediante tomas de aire en la zona respiratoria de los trabajadores (de la gasolinera), a medida que estos se desplazaban por el lugar de trabajo. Las muestras se analizaron por cromatografía gaseosa con detección por ionización en llama. Junto a los resultados de las muestras, se realizaron cálculos de riesgo para la salud, usando los indicadores Cociente de peligro (HQ) y Riesgo de cáncer (CR), con el fin de evaluar los posibles efectos no-carcinogénicos y carcinogénicos, respectivamente, en los trabajadores de los puestos de reventa de combustibles. Las concentraciones ambientales para la mayoría de los compuestos BTEX estuvieron por debajo de los limites preconizados, menos en el caso del benceno, un compuesto carcinogénico, que presentó concentraciones muy por encima de los límites, llevando a altos valores de riesgo de cáncer. Los resultados demostraron que existen riesgos para la salud de los trabajadores de puestos de reventa de combustibles, principalmente, riesgo de desarrollar cáncer, debido a la exposición excesiva al benceno.

Factores etiológicos y caracterización de pacientes con cáncer de pulmón en el Instituto Nacional del Cáncer, Paraguay

RESUMEN Introducción: el cáncer de pulmón es un problema de Salud Pública en el mundo y en nuestro país por su alta mortalidad e incidencia. Los carcinógenos medioambientales y el tabaquismo están directamente relacionados como factores de riesgo. Objetivo: Caracterizar los factores etiológicos de fumador activo y carcinógenos medioambientales de los pacientes con cáncer de pulmón detectados durante 9 años en el Instituto Nacional del Cáncer, Paraguay. Metodología: estudio observacional retrospectivo descriptivo analítico de una base de datos del período 2004-2013. Las variables medidas fueron datos demográficos, carga tabáquica, tabaquismo, la exposición a carcinógenos medioambientales categoría I. Resultados: se incluyeron 478 pacientes con cáncer pulmonar, 88,1% de sexo masculino y 11,9% femenino. La edad promedio del sexo masculino fue 60±10 años y del sexo femenino 58±12 años. La prevalencia de exposición carcinógenos medioambientales categoría I fue 36,90%. La media del índice tabáquico fue 4,48±20. El modelo de regresión lineal múltiple entre exposición ambiental, tabaquismo y tipo histológico para predecir la severidad clínica fue 3,6%. En el análisis de regresión logística de la relación de tipos histológicos con tabaquismo, género y exposición ambiental no mejoran el modelo de predicción. Conclusiones: Los factores etiológicos relacionados con carcinógenos medioambientales estuvieron presentes en más de un tercio de la población, el hábito tabáquico es mayor en hombres que en mujeres. El tipo histológico más frecuente para ambos sexos, con y sin el hábito tabáquico, es el carcinoma de células no pequeñas.

ABSTRACT Introduction: Lung cancer is a public health problem in the world and in our country due to its high mortality and incidence. Environmental carcinogens and smoking are directly related as risk factors. Objective: To characterize the etiological factors of active smokers and environmental carcinogens of patients with lung cancer detected during 9 years at the National Cancer Institute, Paraguay. Methodology: Retrospective observational descriptive analytical study of a database for the period 2004-2013. The variables measured were demographic data, smoking load, smoking, exposure to category I environmental carcinogens. Results: Four hundred seventy-eight patients with lung cancer, 88.1% male and 11.9% female were included. The mean age of the male sex was 60±10 years and 58±12 years of the female age. The prevalence of exposure to category I environmental carcinogens was 36.90%. The mean smoking index was 4.48±20. The multiple linear regression model between environmental exposure, smoking and histological type to predict clinical severity was 3.6%. In the logistic regression analysis of the relationship of histological types with smoking, gender and environmental exposure, the prediction model was not improved. Conclusions: The etiological factors related to environmental carcinogens were present in more than one third of the population, and smoking was greater in men than in women. The most frequent histological type for both sexes, with and without the smoking habit, was non-small cell carcinoma.

Lung cancer related to occupational exposure: an integrative review / Cáncer de pulmón relacionado con la exposición ocupacional: revisión integrativa / Câncer de pulmão relacionado à exposição ocupacional: revisão integrativa

ABSTRACT Objective: To identify in the literature the carcinogenic agents found in the work environment, the occupations and the risk for lung cancer. Method: A descriptive and analytical study of the Integrative Literature Review type was carried out in national and international databases from the last ten years in the period from 2009 to 2018, concerning 32 studies referring to association between carcinogenic substances to which the worker is exposed and lung cancer. Results: Nine (28.1%) publications originated in China and only one in Brazil. The most exposed workers were from the secondary sector, 50% being from industry and 6.2% from construction, mostly male. Asbestos and silica stood out among the carcinogenic substances most associated with lung cancer risk, accounting for 37.5% and 28.1%, respectively. Conclusions: The association between occupational exposure and the risk for lung cancer was characterized in this research by the substantial scientific evidence from the described studies that confirm this association.

RESUMEN Objetivo: Identificar en la literatura los agentes cancerígenos presentes en el entorno laboral, las ocupaciones y el riesgo de cáncer de pulmón. Método: Estudio descriptivo y analítico de una revisión integradora realizada en una base de datos nacional e internacional de los últimos diez años, entre 2009 y 2018, que comprende 32 estudios referidos a la vinculación entre el cáncer de pulmón y las sustancias cancerígenas de exposición ocupacional. Resultados: Nueve (28,1%) publicaciones tuvieron su origen en China y solo una en Brasil. Los trabajadores más expuestos pertenecían al sector secundario, el 50% a la industria y un 6,2% a la construcción, siendo en su mayoría hombres. El asbesto y la sílice se destacaron entre las sustancias cancerígenas más asociadas con el riesgo de cáncer de pulmón, con índices de 37,5% y el 28,1%, respectivamente. Conclusiones: La vinculación entre la exposición ocupacional y el riesgo de cáncer de pulmón se caracterizó en esta investigación por la evidencia científica sustancial de los estudios descriptos que confirman esta asociación.

RESUMO Objetivo: Identificar na literatura os agentes carcinogênicos presentes no ambiente ocupacional, as ocupações e o risco do câncer de pulmão. Método: Estudo descritivo e analítico de revisão integrativa realizada em base de dados nacionais e internacionais dos últimos dez anos, entre 2009 e 2018, compreendendo 32 estudos referentes à associação entre câncer de pulmão e substâncias carcinogênicas de exposição ocupacional. Resultados: Nove (28,1%) publicações originadas na China e apenas uma brasileira. Os trabalhadores mais expostos foram do setor secundário, sendo 50% da indústria e 6,2% da construção civil, em sua maioria do sexo masculino. O amianto e a sílica sobressaíram-se entre as substâncias carcinogênicas mais associadas ao risco de câncer de pulmão correspondendo a 37,5% e 28,1%, respectivamente. Conclusões: A associação entre a exposição ocupacional e o risco de câncer de pulmão ficou caracterizada nesta pesquisa pelas substanciais evidências científicas dos estudos descritos que confirmam essa associação.

Carcinógenos ambientales asociados a cáncer infantil / Environmental carcinogens associated with childhood cancer

Resumen Introducción: La Sociedad Americana de Cáncer indica que al año se diagnostican 163.300 casos de cáncer infantil en el mundo. En Colombia fueron reportadas 300 muertes por esta causa en menores de edad durante el año 2015. Actualmente, las principales asociaciones etiológicas de cáncer infantil son la radiación ionizante y exposición a pesticidas, convirtiéndose en una prioridad emergente en la agenda mundial de salud infantil. Objetivo: Identificar factores carcinogénicos asociados al incremento de riesgo en la aparición de cáncer infantil. Materiales y métodos: Se realizó una revisión de artículos científicos en inglés y español en la base de datos PubMed, ScienceDirect, SciELO, y publicaciones estadísticas de la Organización Mundial de la Salud, Asociación Americana de Cáncer y el Instituto Nacional de Cancerología de Colombia. Resultados: Se describieron diferentes factores carcinogénicos como radiación ionizante, agentes biológicos, patrones dietéticos, exposición a pesticidas, tabaco y asbesto, destacando su asociación en el desarrollo de cáncer infantil. Conclusión: El reconocimiento de los agentes carcinogénicos frecuentemente asociados con cáncer infantil, permite identificar el impacto de estos sobre la salud, y generar medidas preventivas más eficaces que puedan reducir la carga global de la enfermedad.

Abstract Introduction: The American Cancer Society indicates that each year 163,300 cases of childhood cancer are diagnosed worldwide. In Colombia, 300 deaths were reported from this cause in minors during 2015. Currently, the main etiological associations of childhood cancer are ionizing radiation and exposure to pesticides, making it an emerging priority in the global agenda for children's health. Objective: To identify carcinogenic factors associated with the increased risk in the onset of childhood cancer. Materials and methods: A review of scientific articles in English and Spanish was carried out in PubMed, ScienceDirect, SciELO, and statistical publications of the World Health Organization, American Cancer Association and the National Cancer Institute of Colombia. Results: Different carcinogenic factors were described as ionizing radiation, biological agents, dietary patterns, exposure to pesticides, tobacco and asbestos, highlighting their association in the development of childhood cancer. Conclusion: The recognition of the carcinogenic agents frequently associated with childhood cancer, allows the identification of their impact on health, and generates more effective preventive measures that can reduce the worldwide burden of the disease.

Estabelecimento de agentes e atividades ocupacionais carcinogênicas prioritárias para a vigilância em saúde no Brasil / High-priority carcinogenic occupational agents and activities for health surveillance in Brazil

Os objetivos do artigo são apresentar uma lista de agentes carcinogênicos selecionados como prioritários para as ações de saúde do trabalhador no Brasil e descrever seu processo de validação. Foi realizada revisão bibliográfica sobre o tema, com o levantamento dos principais agentes carcinogênicos utilizados nas atividades ocupacionais no Brasil, a classificação de carcinogenicidade segundo a Agência Internacional de Pesquisa em Câncer (IARC) e respectivos tipos de câncer, considerando o contexto brasileiro, com validação e revisão final por especialistas. A lista final inclui agentes carcinogênicos, estabelecidos ou prováveis, presentes nos processos produtivos de algumas atividades econômicas no Brasil e fornece orientação para futuros estudos da carga do câncer por atividades econômicas.

The aims of the present study were to assemble a list of carcinogens considered as having high priority for occupational health actions in Brazil and to describe the process followed to validate it. Through a literature review we retrieved the main carcinogens used in production activities in Brazil, the carcinogenicity classification developed by the International Agency for Research on Cancer (IARC) and corresponding types of cancer relevant within the Brazilian context. The list thus assembled was reviewed and validated by an expert panel. It includes known and suspected carcinogens found in the production process of some industries in Brazil, and might serve as orientation for future studies on the burden of occupational cancer

To be or not to be a carcinogen; delving into the glyphosate classification controversy

The International Agency for Research on Cancer (IARC) placed the most widely used herbicide glyphosate (GLY) into the category 2A (probably carcinogenic to humans), a classification questioned by experts from academia and industry. This article critically appraised the epidemiological and experimental data that led the IARC working group (WG) to consider GLY a probable human carcinogen and the ensuing controversy. An association of GLY with non-Hodgkin lymphoma was suggested by some observational studies. A non-causal explanation for this weak association, however, cannot be excluded. Contrary to WG's view, long-term rodent assays yielded no convincing evidence that GLY is carcinogenic. The mechanistic evidence remains elusive as well. Bacterial reverse mutation tests (including tester strains sensitive to oxidative mutagens) were clearly negative, and so were rodent genotoxicity assays by oral route. Tests with mammalian cells in vitro yielded conflicting results at high (cytotoxic) concentrations of GLY-based formulations. Conflicting results were also obtained when high doses of GLY-based herbicides were administered to rodents by the intraperitoneal route. Such high doses are unlikely to be attained in realistic scenarios of exposure. Finally, the IARC classification is based on a conjectural hazard, and rational public health interventions must be based on estimated risks.

Health effects of exposure to radon: implications of the radon bed mattress incident in Korea / 한국역학회지

Radon is a naturally occurring radioactive material formed by the slow decay of uranium and thorium found in the earth's crust or construction materials. Internal exposure to radon accounts for about half of the natural background radiation dose to which humans are exposed annually. Radon is a carcinogen and is the second leading cause of lung cancer following smoking. An association between radon and lung cancer has been consistently reported in epidemiological studies on mine workers and the general population with indoor radon exposure. However, associations have not been clearly established between radon and other diseases, such as leukemia and thyroid cancer. Radiation doses are assessed by applying specific dose conversion coefficients according to the source (e.g., radon or thoron) and form of exposure (e.g., internal or external). However, regardless of the source or form of exposure, the effects of a given estimated dose on human health are identical, assuming that individuals have the same sensitivity to radiation. Recently, radiation exceeding the annual dose limit of the general population (1 mSv/yr) was detected in bed mattresses produced by D company due to the use of a monazite-based anion powder containing uranium and thorium. This has sparked concerns about the health hazards for mattress users caused by radiation exposure. In light of this event, this study presents scientific information about the assessment of radon and thoron exposure and its human implications for human health, which have emerged as a recent topic of interest and debate in society.

Health effects of exposure to radon: implications of the radon bed mattress incident in Korea / 한국역학회지

Radon is a naturally occurring radioactive material formed by the slow decay of uranium and thorium found in the earth's crust or construction materials. Internal exposure to radon accounts for about half of the natural background radiation dose to which humans are exposed annually. Radon is a carcinogen and is the second leading cause of lung cancer following smoking. An association between radon and lung cancer has been consistently reported in epidemiological studies on mine workers and the general population with indoor radon exposure. However, associations have not been clearly established between radon and other diseases, such as leukemia and thyroid cancer. Radiation doses are assessed by applying specific dose conversion coefficients according to the source (e.g., radon or thoron) and form of exposure (e.g., internal or external). However, regardless of the source or form of exposure, the effects of a given estimated dose on human health are identical, assuming that individuals have the same sensitivity to radiation. Recently, radiation exceeding the annual dose limit of the general population (1 mSv/yr) was detected in bed mattresses produced by D company due to the use of a monazite-based anion powder containing uranium and thorium. This has sparked concerns about the health hazards for mattress users caused by radiation exposure. In light of this event, this study presents scientific information about the assessment of radon and thoron exposure and its human implications for human health, which have emerged as a recent topic of interest and debate in society.

Diagnosis of new occupational lung tumor in Guangdong Province / 中国职业医学

OBJECTIVE: To summarize and analyze the diagnostic ideas of new occupational lung tumors in Guangdong Province.METHODS: According to the Law of the People′s Republic of China on the Prevention and Control of Occupational Disease and the GBZ 94-2002 Diagnostic Criteria of Occupational Cancer, the key diagnostic points of 6 new occupational lung tumors diagnosed in Guangdong Province from 2010 to 2011 were analyzed. RESULTS: There were 9 cases of 6 new kinds of new occupational tumors were diagnosed in Guangdong Province in 2010-2011. The cases included 3 occupational lung cancer of coke oven workers, 2 occupational lung cancer caused by asbestos, 1 occupational mesothelioma caused by asbestos, 1 occupational lung cancer caused by arsenate, 1 occupational lung cancer caused by chromate salt, and 1 occupational lung cancer caused by asphalt. During the process, the diagnosis was based on the principles of the comprehensive analysis and the attribution diagnosis, combined with occupational history, occupational disease hazard exposure history, clinical data and auxiliary examination results. If the patients were diagnosed with a primary tumor, the patients′ exposure history to occupational carcinogens should be tracked, traced and confirmed, and the diagnosis should be confirmed by referring to the list of occupational carcinogens and literature reports of the International Labor Organization, and not limited to only the personnel in a particular industry. CONCLUSION: During the diagnostic process of occupational tumors, attention should be paid to confirm the exposure history of occupational carcinogen. The key is to determine the exposure of corresponding occupational carcinogen, the route and the time of exposure and the incubation period.

Carcinogenicity of smokeless tobacco: Evidence from studies in humans & experimental animals

A Working Group of the Monographs programme of the International Agency for Research on Cancer has classified smokeless tobacco as carcinogenic to humans (Group 1). This review article summarizes the data that support the evaluations of sufficient evidence in humans and in experimental animals for the carcinogenicity of smokeless tobacco whether used alone or with betel quid. It also identifies compounds of smokeless tobacco relevant to carcinogenicity (prominently tobacco-specific nitrosamines) and addiction (nicotine). The epidemiological evidence is summarized for oral cancer, other cancers associated with smokeless tobacco and oral potentially malignant lesions with a focus on analytical studies from the SEARO Region. Studies on cancer in experimental animals are summarized with a focus on studies applying smokeless tobacco products typical for the regions, such as mishri and naswar.

Relación entre el proceso evolutivo del ser humano y su predisposición al cáncer / Relationship between the human being evolutionary process and cancer predisposition

El cáncer se ha convertido en la primera causa de morbimortalidad en numerosos países. En las últimas décadas se ha asistido a un cambio en el paradigma conceptual de las enfermedades neoplásicas, que ahora se enfoca hacia la perspectiva ecológica-evolutiva de estas. Con el objetivo de analizar, con elementos actualizados, la relación entre el proceso evolutivo del ser humano y su predisposición al cáncer, se realizó una revisión sistemática de la literatura, a partir de tres bases de datos, Medline, Scopus, y SciELO. Se tuvieron en cuenta atributos de consistencia de los artículos revisados, se excluyeron los estudios con niveles IV y V de evidencia y los de calidad insuficiente. Las búsquedas acumuladas actuales sugieren la necesidad de ver a las diversas neoplasias desde la perspectiva de la dinámica de sistemas complejos y sus implicaciones evolutivas. El proceso evolutivo humano posee particularidades biosociales que le predisponen a sufrir tumores malignos. La postura bípeda incrementó vulnerabilidad al efecto oncogénico de las radiaciones ultravioletas. La conducta sexual incrementó el riesgo de contraer infecciones por virus oncogénicos. El paso a una predominantemente cárnica y la introducción de la cocción, se tradujo en la incorporación de agentes xenobióticos cuyo metabolismo deriva agentes carcinógenos. La postergación del envejecimiento humano devino en un mayor tiempo para el acúmulo de mutaciones. Las modificaciones en el patrón sexual y reproductivo en la mujer han influido en su predisposición al cáncer de mama. En la génesis poblacional del cáncer subyacen fundamentos biosociales vinculados al proceso evolutivo de la especie(AU)

Cancer has become the leading cause of morbidity and mortality in many countries. In recent decades there has been a change in the conceptual paradigm of neoplastic diseases, which now focuses on the ecological-evolutionary perspective of these. With the aim of analyzing, with updated elements, the relationship between the evolutionary process of the human being and his predisposition to cancer, a systematic review of the literature was made, based on three databases, Medline, Scopus, and SciELO. Consistency attributes of the reviewed articles were taken into account, studies with levels IV and V of evidence and those of insufficient quality were excluded. The current accumulated searches suggest the need to see the various neoplasms from the perspective of the dynamics of complex systems and their evolutionary implications. The human evolutionary process has biosocial peculiarities that predispose it to suffer malignant tumors. Bipedal posture increased vulnerability to the oncogenic effect of ultraviolet radiation. Sexual behavior increased the risk of contracting oncogenic virus infections. The transition to a predominantly meat and the introduction of cooking, resulted in the incorporation of xenobiotic agents whose metabolism derives carcinogens. The postponement of human aging became in a longer time for the accumulation of mutations. Modifications in the sexual and reproductive pattern in women have influenced their predisposition to breast cancer. In the population genesis of cancer underlying biosocial foundations linked to the evolutionary process of the species(AU)

Animal models for colorectal cancer / Modelos animais de carcinogênese colorretal

ABSTRACT Introduction: Colorectal cancer is a very frequent sort of neoplasm among the population, with a high mortality rate. It develops from an association of genetic and environmental factors, and it is related to multiple cell signaling pathways. Cell cultures and animal models are used in research to reproduce the process of disease development in humans. Of the existing animal models, the most commonly used are animals with tumors induced by chemical agents and genetically modified animals. Objective: To present and synthesize the main animal models of colorectal carcinogenesis used in the research, comparing its advantages and disadvantages. Method: This literature review was performed through the search for scientific articles over the last 18 years in PubMed and Science Direct databases, by using keywords such as "animal models", "colorectal carcinogenesis" and "tumor induction". Results: 1,2-dimethylhydrazine and azoxymethane are carcinogenic agents with high specificity for the small and large intestine regions. Therefore, the two substances are widely used. Concerning the genetically modified animal models, there is a larger number of studies concerning mutations of the APC, p53 and K-ras genes. Animals with the APC gene mutation develop colorectal neoplasms, whereas animals with p53 and K-ras genes mutations are able to potentiate the effects of the APC gene mutation as well as the chemical inducers. Conclusion: Each animal model has advantages and disadvantages, and some are individually efficient as to the induction of carcinogenesis, and in other cases the association of two forms of induction is the best way to obtain representative results of carcinogenesis in humans.

RESUMO Introdução: O câncer de cólon e reto é bastante frequente na população e com elevado índice de mortalidade. Ele se desenvolve a partir da associação de fatores genéticos e ambientais e está relacionado a múltiplas vias de sinalização celular. Para o estudo da doença são utilizados cultivos celulares e modelos animais, que sejam capazes de reproduzir o processo de desenvolvimento da doença em humanos. Dos modelos existentes, os mais comumente utilizados são os animais induzidos ao desenvolvimento tumoral por agentes químicos e os animais geneticamente modificados. Objetivo: Apresentar e sintetizar os principais modelos animais de carcinogênese colorretal utilizados na pesquisa, comparando suas vantagens e desvantagens. Método: Para o desenvolvimento dessa revisão foi realizada uma busca por artigos científicos dos últimos 18 anos nas bases de dados PubMed e Science Direct, utilizando como palavras-chave "modelos animais", "carcinogênese colorretal" e "indução tumoral". Resultado: O 1,2 dimetilhidrazina e o azoximetano são agentes carcinógenos com alta especificidade para o intestino delgado e grosso. Por isso, as duas substâncias são amplamente utilizadas. Dos modelos animais geneticamente modificados observa-se maior quantidade de estudos referentes às mutações dos genes APC, p53eK-ras. Os animais com mutação do gene APC desenvolvem neoplasias colorretais, enquanto que animais com mutações dos genes p53 e K-ras são capazes de potencializar os efeitos da mutação do gene APC, bem como dos indutores químicos. Conclusão: Cada modelo animal apresenta vantagens e desvantagens, sendo que alguns são individualmente eficientes na indução da carcinogênese, e em outros casos a associação de duas formas de indução é a melhor maneira de se obter resultados representativos da carcinogênese em humanos.

The relationship between night work and breast cancer

BACKGROUND: Since the International Agency for Research on Cancer classified shift work that involves circadian disruption as “probably carcinogenic to humans,” there has been growing concern on the relationship between night work and breast cancer. In Korea, about 10–15% of workers are engaged in night-shift work, and breast cancer is one of the most common cancers in women. The purpose of this study was to review epidemiologic evidence on the relationship between night work and breast cancer. METHODS: We reviewed 21 original articles and 5 meta analyses on relationship between nightwork and breast cancer, and investigated the compensation criteria of Denmark. RESULTS: The association between breast cancer and night work has been reported by numerous epidemiologic studies, including cohort studies, case-control studies, and meta-analysis. However, a dose-response relationship has not clearly emerged among workers exposed to less than 20 years of night work. CONCLUSION: Although there are some limitations to the epidemiological studies so far, further consideration of breast cancer cases in patients with high exposure to night work is needed to assess breast cancer as a work-related disease.

Population attributable fractions for colorectal cancer and red and processed meats in Colombia - a macro-simulation study / Fracción Atribuible Poblacional de carnes rojas y procesadas en cáncer colorrectal en Colombia - un estudio de macro-simulación

Abstract: Aim: to estimate the population attributable risk of consumption of red and processed meat for colorectal cancer in Colombia. Methods: to model the expected incidence of colorectal cancer in the hypothetical situation of no red and processed meat consumption in Colombia, for the year 2010. A dynamic macrosimulation model, PREVENT 3.01, was used to integrate available cancer incidence, meat consumption prevalence and associated risk data and to evaluate the impact of eliminating red and processed meat from the Colombian diet on national colorectal cancer incidence. Results: Eliminating consumption of red meat altogether from the Colombian diet resulted in reductions in age-standardized colorectal cancer incidence, translating in reductions of 331 males (PAF 13%) and 297 female cases (PAF 10%). Eliminating processed meats had slightly stronger effects, with decreases of 362 males (PAF 14%) and 388 female cases (PAF 13%). Conclusions: A substantial proportion of the burden of colorectal cancer in Colombia can be attributed to the consumption of red and processed meat.

Resumen: Objetivo: estimar la fracción atribuible poblacional de consumo de carne roja y procesada para el cáncer colorrectal en Colombia. Métodos: modelación de la incidencia esperada de cáncer colorrectal en la situación hipotética de no consumo de carne roja y procesada en Colombia para el año 2010. Se utilizó un modelo dinámico de macrosimulación, PREVENT 3.01, para integrar los datos disponibles sobre incidencia de cáncer y evaluar el impacto de la eliminación de la dieta colombiana de la carne roja y procesada sobre la incidencia nacional de cáncer colorrectal. Resultados: La eliminación del consumo total de carne roja de la dieta colombiana dio lugar a reducciones en la incidencia estandarizada por edad de cáncer colorrectal, traduciéndose en la disminución de 331 casos en hombres (FAP 13%) y 297 en mujeres (FAP 10%). La eliminación de carnes procesadas tuvo efectos ligeramente más fuertes, con disminución de 362 casos en hombres (FAP 14%) y 388 en mujeres (FAP 13%). Conclusiones: Una proporción sustancial de la carga de cáncer colorrectal en Colombia puede atribuirse al consumo de carne roja y procesada.

Childhood cancer and environmental integrity: a commentary and a proposal

ABSTRACT Improvements in the health standards of developed and developing societies depend primarily on the relationships between economy and environment. Recent long-term changes in the chemical composition of man-made environments may be linked to changes in the biology of human beings. Here we argue that children are at the greatest risk of being affected by the dangerous effects of these changes, with particular reference to cancer. The concept of cancer risk must be extended to new contexts. Considering the increasing rates of chemical pollution and its spreading in the environment, we illustrate a proposal aiming to protect the human health, in an intra- and intergenerational perspective. A surveillance system of occupational and residential exposures should be implemented to prevent cancer risk in embryos and children.

Residential radon and lung cancer: a cohort study in Galicia, Spain / Radón residencial y cáncer de pulmón: un estudio de cohorte en Galicia, España / Radônio residencial e câncer de pulmão: um estudo de coorte na Galícia, Espanha

Case-control studies show an association between residential radon and lung cancer. The aim of this paper is to investigate this association through a cohort study. We designed an ambispective cohort study using the Galician radon map, Spain, with controls drawn from a previous case-control study. Subjects were recruited between 2002 and 2009. The data were cross-checked to ascertain lung cancer incidence and then analysed using a Cox regression model. A total of 2,127 subjects participated; 24 lung cancer cases were identified; 76.6% of subjects were drawn from the radon map. The adjusted hazard ratio was 1.2 (95%CI: 0.5-2.8) for the category of subjects exposed to 50Bq/m3 or more. This risk rose when subjects from the case-control study were analyzed separately. In conclusion, we did not observe any statistically significant association between residential radon exposure and lung cancer; however, it appears that with a sample of greater median age (such as participants from the case-control study), the risk of lung cancer would have been higher.

Los estudios de casos y controles muestran una asociación entre el radón residencial y el cáncer de pulmón. El objetivo del artículo fue investigar esa asociación a través de un estudio de cohorte. Proyectamos un estudio de cohorte ambispectivo, utilizando el mapa de radón de Galicia, España, con los controles obtenidos de un estudio anterior de casos y controles. Los individuos fueron reclutados entre 2002 y 2009. Los datos fueron verificados para confirmar la incidencia de cáncer de pulmón y después analizados con un modelo de regresión de Cox. Participaron un total de 2.127 individuos; se identificaron 24 casos de cáncer de pulmón; un 76,6% de los individuos fueron obtenidos a través del mapa de radón. El hazard ratio ajustado era 1,2 (IC95%: 0,5-2,8) para la categoría de individuos expuestos a 50Bq/m3 o más. El riesgo aumentó cuando los individuos del estudio de casos y controles fueron analizados separadamente. En conclusión, no se observó una asociación estadísticamente significativa entre exposición al radón residencial y cáncer de pulmón; sin embargo, parece que con una muestra con una media de edad más elevada (tales como los participantes del estudio de casos y controles), el riesgo de cáncer de pulmón habría sido más alto.

Estudos de casos e controles mostram uma associação entre radônio residencial e câncer de pulmão. O artigo teve como objetivo investigar essa associação através de um estudo de coorte. Projetamos um estudo ambispectivo coorte, utilizando o mapa de radônio da Galícia, Espanha, com os controles obtidos de um estudo anterior de casos e controles. Os indivíduos foram recrutados entre 2002 e 2009. Os dados foram verificados para confirmar a incidência de câncer de pulmão e depois analisados com um modelo de regressão de Cox. Participaram um total de 2.127 indivíduos; foram identificados 24 casos de câncer de pulmão; 76,6% dos indivíduos foram obtidos através do mapa de radônio. O hazard ratio ajustado era 1,2 (IC95%: 0,5-2,8) para a categoria de indivíduos expostos a 50Bq/m3 ou mais. O risco aumentou quando os indivíduos do estudo de casos e controles foram analisados separadamente. Em conclusão, não foi observada associação estatisticamente significativa entre exposição ao radônio residencial e câncer de pulmão; entretanto, parece que com uma amostra com mediana de idade mais elevada (tais como os participantes do estudo de casos e controles), o risco de câncer de pulmão teria sido mais alto.

Progress in the environmental risk factors, diagnosis and treatment of lung cancer in Xuanwei city, China / 肿瘤

The morbidity and mortality rates of lung cancer in Xuanwei city, Yunnan province, China are the highest in the global scope. Since 1980s, the studies conducted in this region supported by international health organizations have been focused on the epidemiology, pathogenesis and molecular biology of Xuanwei lung cancer. With the development of molecular detection techniques and the application of next-generation sequencing technique, great progress has been achieved in understanding the environmental risk factors which cause this disease and the improvement of diagnostic methods and therapeutic measures in Xuanwei city. This review surveys the recent development in research of lung cancer in this area from the perspectives of environmental risks, mutation and expression of cancer-related genes, and the diagnosis and drug treatment. Moreover, the positive role of next-generation sequencing technique in diagnosis and treatment of Xuanwei lung cancer will be discussed.

Functional mechanism of SIRT1 gene in tumor / 国际肿瘤学杂志

Sirtuin 1 (SIRT1),the Ⅲ class deacetylation enzyme,is a kind of NAD + dependent histone deacetylation enzyme.The role of SIRT1 in tumor has the duality.It can inhibit inflammation,tumor angiogenesis and interact with tumor related gene to inhibit tumor development.However,it can also regulate tumor related genes,and epithelial-mesenchymal transition,promote tumor cell proliferation and tolerance of radiotherapy and chemotherapy,and maintain the stemness of cancer stem cells to promote tumor proliferation,invasion and metastasis.