ABSTRACT
Actualmente se realiza un diagnóstico anual de 650.000 nuevos casos de carcinoma escamoso de cabeza y cuello en el mundo, siendo el carcinoma escamoso de laringe una patología neoplásica que compete al otorrinolaringólogo. La incidencia mundial del cáncer escamoso de laringe se estima en 3,9 por cada 100.000 habitantes con una mortalidad general de 2,0 por cada 100.000 habitantes. En Chile el registro de cáncer se realiza en base a los cinco registros poblacionales de cáncer que existen. No se tienen datos exactos respecto a incidencia y mortalidad por carcinoma escamoso de laringe, siendo la estimación de la incidencia de 1,2 casos por cada 100.000 habitantes y la estimación de mortalidad ajustada por edad de 0,7 casos por cada 100.000 habitantes. Se han descrito diversos factores de riesgo ambientales y estilos de vida para este cáncer, por lo tanto, las estrategias de prevención primaria en salud son claves a la hora de generar un impacto en la incidencia del carcinoma escamoso de laringe.
The annual diagnosis of head and neck squamous cell carcinoma is 650,000 new cases. The laryngeal carcinoma is a malignant disease that should include an otolaryngologist in its evaluation. The global incidence of laryngeal carcinoma is estimated at 3.9 per 100,000 inhabitants with an overall mortality rate of 2.0 per 100,000 inhabitants. In Chile the cancer registry is based on the five population cancer registries that exist. There is no accurate data on incidence and mortality from laryngeal carcinoma, being an estimated incidence of 1.2 cases per 100,000 inhabitants and an age-adjusted mortality of 0.7 cases per 100.00 inhabitants. There have been described various environmental risk factors and lifestyles for this cancer, therefore, primary prevention strategies are key to generate an impact on the incidence of larynx carcinoma.
Subject(s)
Humans , Carcinoma, Squamous Cell/mortality , Laryngeal Neoplasms/mortality , Carcinoma, Squamous Cell/epidemiology , Carcinoma, Squamous Cell/prevention & control , Chile/epidemiology , Diseases Registries , Incidence , Laryngeal Neoplasms/epidemiology , Laryngeal Neoplasms/prevention & control , Risk FactorsABSTRACT
La laringe constituye un órgano anatómicamente complejo. Glotis, supraglotis y subglotis son, en orden de importancia relativa, los sitios más frecuentes de asentamiento de tumores, los cuales se distinguen clínicamente por el modo en que afectan las principales funciones de la laringe: fonación y deglución. Describir la frecuencia, características sociodemográficas y tumorales correspondientes a los casos incidentes de cáncer de laringe en Cuba según subsitio anatómico dentro de la laringe. Se realizó un estudio descriptivo a partir de los casos nuevos de cáncer de laringe reportados al Registro Nacional de Cáncer durante el período 1988-2003. Se analizó información sociodemográfica de los casos y otras variables relacionadas con el diagnóstico y la enfermedad tumoral. Se utilizó la prueba Chi-cuadrado de independencia para determinar asociación entre las variables en estudio con un nivel de significación de 0,05. El cáncer de laringe ocupa una de las primeras causas de incidencia y mortalidad por cáncer en Cuba, fundamentalmente en hombres entre 50-74 años de edad. Mientras que el cáncer de subglotis es poco frecuente, el cáncer de glotis es hasta tres veces más frecuente que el de supraglotis. El cáncer de glotis da síntomas tempranamente pudiendo ser detectado mediante un examen relativamente sencillo. Considerando las características del sistema nacional de salud cubano, este hecho puede abrir una expectativa al diagnóstico temprano, por lo que es recomendable evaluar la factibilidad y eficacia del examen otorrinolaringológico -como parte del examen periódico anual- fundamentalmente en hombres de 50 años y más, con historia de tabaquismo o alcoholismo, con el fin de detectar y tratar tempranamente la enfermedad.
Larynx is an anatomically complex organ. Glottis, supraglottis and subglottis are, in order of relative importance, the most frequent tumor locations, which are clinically characterized by the way they affect the main functions of the larynx: phonation and deglutition. Objectives the present paper describes the frequency, socio-demographic and tumorous characteristics of laryngeal cancer cases in Cuba. A descriptive study was conducted, taking the new laryngeal cancer cases reported to the National Register of Cancer from 1988 to 2003 as a basis. Social and demographic information of cases and other variables related to diagnosis and to the tumorous disease were analyzed. Chi-square test of independence determined the association of variables under study, with significance level equal to0,05. Laryngeal cancer is one of the first causes of incidence and mortality due to cancer in Cuba, mainly in males aged 50-74 years. Although subglottis cancer is rare, glottis cancer is up to three times as frequent as that of supraglottis. Glottis cancer shows early symptoms, so it can be detected on a relatively simple examination. Considering the Cuban health system characteristics, this event could open up possibilities for early detection, therefore, it would be advisable to evaluate the feasibility and efficacy of the otorhinolaryngology test -as part of the annual systematic examination -mainly in men aged 50 years and more, with history of smoking/alcoholism, in order to detect and treat the disease early.
Subject(s)
Humans , Female , Male , Laryngoscopy/methods , Laryngeal Neoplasms/epidemiology , Laryngeal Neoplasms/prevention & control , Secondary PreventionABSTRACT
A proposta do presente estudo foi realizar um rastreamento de neoplasia laríngea, bem como pesquisar a prevalência desta doença e sua relação com fatores de risco (fumo, álcool e chimarrão), dentro de uma comunidade delimitada na cidade de Porto Alegre, Rio Grande do Sul, Brasil. Este estudo teve como objetivo avaliar a relação custo-benefício do rastreamento do câncer da laringe na população de risco para esta doença; verificar a prevalência de neoplasia da laringe na população da vila IPE 1, na cidade de Porto Alegre, possibilitando seu diagnóstico precoce nessa comunidade. Tal investigação foi realizada no período de junho a dezembro de 2001. A coleta dos dados ocorreu no Ambulatório do Departamento de Cirurgia de Cabeça e Pescoço da Universidade Luterana do Brasil ULBRA, da qual participaram 324 indivíduos inseridos em grupo de risco para câncer da laringe. Para a seleção da amostra, foram considerados indivíduos maiores de 30 anos, com hábito de fumar e/ou ingerir bebidas alcoólicas há mais de 10 anos e moradores da vila IPE 1, de Porto Alegre/RS. A coleta de dados foi realizada por meio de entrevista direta, com o preenchimento de um questionário, seguido de um exame otorrinolaringológico e fibrolaringoscópico. Os dados foram tabulados e analisados utilizando o programa EPI-INFO versão 6.01. Foram observadas altera- ções ao exame em 89 pacientes (27,5%), não sendo encontrado casos de câncer laríngeo. Dos indivíduos examinados, a maioria apresentava exame normal (72%). Em contrapartida, foram diagnosticados em 47 pacientes (14,5%) edema de Reinke, em 20 (6,2%) hiperemia das pregas vocais e em 22 indivíduos (6,8%), espessamento da parede posterior da laringe. Em relação ao diagnóstico precoce (rastreamento) do câncer da laringe, não obtivemos a efetividade esperada nesta amostra estudada, provavelmente devido à faixa etária jovem e ao pouco tempo de exposição aos fatores de risco (tabaco e álcool). Isso nos faz pensar que, além desses fatores, existem outros que são de particular importância no desenvolvimento de uma neoplasia maligna laríngea, como a imunodepressão, os fatores hereditários, além de outras doenças associadas, tipo refluxo gastroesofágico. A prevalência do câncer laríngeo, por sua vez, não pôde ser avaliada pela ausência de lesão maligna ou pré-maligna nos indivíduos investigados (AU)
The aim of this present work was to carry out an in-depth study of neoplasia of the larynx, as also to investigate the prevelance of this illness and its relation to risk factors such as smoking, consumption of alcohol and the drinking of "mate" (a herbal tea made with almost boiling water and drunk from gourd via a metal tube). This study was carried out in a delinated community in the city of Porto Alegre, Rio Grande do Sul Brazil. It also red as its objective the evaluation of the relation cost/benefit of an in-depth study of laryngeal cancer in a population at risk of this illness and for this reason a study of the prevalance of laryngeal neoplasia was carried out in the area of IPE 1, in Porto Alegre, to do early diagnosis of the illness. This investigation was carried out during the period of June to December 2001. The material for the study was collected in the Out Patients of Head and Neck Surgery Department of Lutheran University of Brasil (ULBRA). The group consisted of 324 subjects considered at risk of laryngeal cancer and, the people living in IPE 1, in Porto Alegre, over the age of 30 who had been smoking and / or drinking for over 10 year, were selected as samples. The collection of the data was carried out by means of a direct interview, the filling in of a questionaire, followed by an examination of the ear, nose and throat and a fibrolrigalscopic exam. The data was tabulated and analysed, using the 6.01 version of the EPI-INFO. In 89 subjects (27,5%) examined by the above method, some alterations were found but no cases of laryngeal cancer. The majority of the cases studied were normal (72%); in 47 subjects (14,5%) Reinke's edema was found; in 20 subjects (6,2%) hiperema of the vocal chords was found and in 22 subjects (6,8%) thickening of the posterior wall of the larynx was found. With regard to early diagnosis of laryngeal cancer, using in-depth studies we did not obtain the results we expected from the subjects studied. This may have been due to the fact that they were all young people who had not been exposed for too long to the risk factors (tabacco, alcohol and "mate"), which leads us to think that, apart from these factors, others exist which ar important in the development of malignant neoplasia of the larynx, such as auto immune depression, heriditare factors and other associated illnesses, e.g. gastroesophageal reflux disease. Therefore the conclusion reached is that cancer of the larynx cannot be evaluated by the absence of malign or pre-malign lesions in people under investigation (AU)