Disparities in cancer epidemiology and care delivery among Brazilian indigenous populations / Disparidades na epidemiologia e no tratamento de câncer nas populações indígenas brasileiras

ABSTRACT Objective: To assess aspects related to cancer in indigenous population. Methods: This is a retrospective study developed in a public university hospital. We included patients with 18 or more years of age, diagnosed with solid tumors, and followed between 2005 and 2015. Clinical features were assessed by descriptive statistics, and survival was evaluated by Kaplan-Meier curves and multivariate Cox regression. Results: Fifty patients were included. The cancer incidence was 15.73 per 100,000. The mean age at diagnosis was 54 years and most patients were female (58%). Cancer of the cervix (28%) and prostate (16%) were the most common. The mean time between the onset of symptoms and the diagnosis was 9 months and from diagnosis to the treatment was 3.4 months. Disease diagnosed at stage IV (17%) had worse overall survival (HR: 11.4; p<0.05). The 5-year survival rate ranged from 88% for prostate cancer to 0% for lung cancer. All 5-year survival rates were lower as compared to other populations. Conclusion: The most prevalent cancer sites were cervix and prostate. Disease stage and primary site were prognostic factors.

RESUMO Objetivo: Avaliar os aspectos relacionados a câncer em populações indígenas. Métodos: Estudo retrospectivo conduzido em um hospital universitário público. Foram incluídos pacientes com 18 anos ou mais, diagnosticados com tumores sólidos e acompanhados entre 2005 e 2015. Os aspectos clínicos foram avaliados por meio de estatística descritiva, e a sobrevida foi avaliada por meio de curvas de Kaplan-Meier e regressão multivariada de Cox. Resultados: Foram incluídos 50 pacientes. A incidência de câncer foi 15,73 por 100 mil. A média de idade ao diagnóstico foi 54 anos, e a maioria era do sexo feminino (58%). O câncer de colo uterino (28%) e o de próstata (16%) foram os mais frequentes. O tempo médio entre o início dos sintomas e o diagnóstico foi 9 meses, e entre o diagnóstico e o tratamento, de 3,4 meses. Doença diagnosticada no estágio IV (17%) resultou em pior sobrevida global (HR: 11,4; p<0,05). A sobrevida em 5 anos variou de 88% para o câncer de próstata a 0% para pulmão. Todas as taxas de sobrevida em 5 anos foram menores em comparação a outras populações. Conclusão: Os locais mais frequentes de neoplasia foram colo de útero e próstata. O estágio da doença e o sítio primário foram fatores prognósticos.

Translating genomics: cancer genetics, public health and the making of the (de)molecularised body in Cuba and Brazil / Convertendo a genômica: genética do câncer, saúde pública e a formação do corpo (des)molecularizado em Cuba e no Brasil

Abstract This article examines how cancer genetics has emerged as a focus for research and healthcare in Cuba and Brazil. Drawing on ethnographic research undertaken in community genetics clinics and cancer genetics services, the article examines how the knowledge and technologies associated with this novel area of healthcare are translated and put to work by researchers, health professionals, patients and their families in these two contexts. It illuminates the comparative similarities and differences in how cancer genetics is emerging in relation to transnational research priorities, the history and contemporary politics of public health and embodied vulnerability to cancer that reconfigures the scope and meaning of genomics as “personalised” medicine.

Resumo O artigo mostra como a genética do câncer, em Cuba e no Brasil, tornou-se matéria de pesquisa, despertando maior interesse da saúde pública. Foram usadas pesquisas etnográficas realizadas em clínicas de genética comunitária e serviços de genética do câncer para averiguar como o conhecimento e as tecnologias associadas à nova área da saúde são convertidos e empregados por pesquisadores, profissionais da saúde, pacientes e familiares nesses dois contextos. Destaca, comparativamente, as semelhanças e diferenças na maneira pela qual a genética do câncer se posiciona em relação às prioridades em pesquisas transnacionais, na história e na política contemporânea da saúde pública e a vulnerabilidade incorporada ao câncer que reconfigura o escopo e o significado da genômica como a medicina “personalizada”.

Cancer survival among children and adolescents at a state referral hospital in southeastern Brazil / Sobrevida do cancer em criancas e adolescentes em hospital de referencia estadual na regiao sudeste do Brasil

To analyze the patient characteristics and evaluate overall survival, survival according to demographic variables, the most common tumor groups and subgroups, the stages of disease, and risk factors after at least 5 years among children and adolescents with cancer who were admitted to a state referral hospital between 2000 and 2005. METHODS: the Kaplan-Meier method was employed to estimate survival. The survival curves were compared using the log-rank test. The Cox regression model was used to estimate the effect of independent variables. RESULTS: a total of 571 new cases were registered. The most frequent cancer groups were leukemia (34 percent), lymphoma (18 percent), and central nervous system (CNS) tumors (15 percent).The overall survival rate was 59 percent. The risk factors associated with lower survival were an age of more than 4 years or less than 1 year, the presence of CNS tumors, and non-localized disease. CONCLUSION: although this was not a populationbased study, it provides important epidemiological information about a state where population data on childhood and adolescent cancer are scarce and where hospital-based data do not exist. The survival rate found here should serve as a framework for future improvements, helping to guide policymakers focused on pediatric oncology in the state...

Analisar as características dos pacientes, avaliar sobrevida global e sobrevida de acordo com variáveis demográficas, grupos e subgrupos dos tumores mais comuns, extensão da doença e fatores de risco após pelo menos cinco anos em crianças e adolescentes com câncer, admitidos em hospital de referência estadual entre 2000 e 2005. MÉTODOS: método de Kaplan-Meier foi utilizado para estimar função de sobrevida. Curvas de sobrevida foram comparadas utilizando teste de log-rank. Modelo de Regressão de Cox foi utilizado para estimar o efeito das variáveis independentes. RESULTADOS: um total de 571 novos casos foi analisado. Os grupos mais frequentes foram leucemias (34 por cento), linfomas (18 por cento) e tumores de sistema nervoso central (SNC) (15 por cento). Taxa de sobrevida global foi 59 por cento. Fatores de risco associados à menor sobrevida: idade superior a quatro anos ou menor de um ano, presença de tumores do SNC e doença não localizada. CONCLUSÕES: embora não seja um estudo populacional, este trabalho fornece importantes informações epidemiológicas de um estado onde estudos de base populacional do câncer na infância e adolescência são escassos e hospitalares não existem. A taxa de sobrevida encontrada deve servir como um marco para melhorias futuras ajudando os formuladores de políticas com foco na área de oncologia pediátrica no Estado...

A humanização no cuidar da criança portadora de câncer: fatores limitantes e facilitadores / Humanization in the care given to children with cancer: limiting and facilitating factors

Objetivo - Identificar os meios utilizados pela enfermagem para prestar cuidados humanizados às crianças com câncer, bem como os fatores limitantes e facilitadores deste cuidar. Métodos - Estudo exploratório, descritivo e qualitativo. Foram entrevistados nove profissionais de enfermagem do setor oncológico pediátrico de um hospital filantrópico de Teresina-PI. Os dados foram coletados por meio de entrevista gravada em aparelho digital e, posteriormente, transcritos e classificados em categorias analíticas. Resultados - O estabelecimento e valorização do vinculo de confiança e amizade entre profissional, criança e família foram os meios utilizados pela enfermagem no cuidado humano à criança. Foram achados fatores que dificultam a busca da assistência humanizada como a não cooperação de alguns pais frente aos cuidados prestados e o ambiente pouco acolhedor oferecido à criança e família. Entretanto, há fatores que facilitam a assistência como a empatia do profissional de enfermagem com o setor de oncologia e a visão da criança de que este exerce um cuidado muito importante durante a hospitalização. Conclusão - Foi possível identificar os meios utilizados pela enfermagem para se prestar cuidados humanizados, bem como os fatores limitantes e facilitadores deste cuidar. É fundamental a utilização desses meios, pois contribuem para a melhoria da assistência prestada a esses sujeitos.

Objective - To identify the means used by nurses to provide humane care for children with cancer as well as the limiting and facilitating factors of such care. Methods - It is an exploratory, descriptive and qualitative study. Nine nurses in the pediatric oncology ward of a philanthropic hospital in Teresina-PI were interviewed. Data were collected through interviews recorded on digital device and later transcribed and categorized into analytical categories. Results - The establishment and enhancement of the bond of trust and friendship between professional, child and family were the means used by nurses in giving children humane care. Factors that hinder the search for humanized care were found such as the non-cooperation by some parents before the care given and unwelcoming environment offered to children and family. However, there are factors that facilitate the assistance like the nurse's empathy towards the cancer ward and the child's view that this professional gives him or her very important care during hospitalization. Conclusion - It was possible to identify the means used by nurses to provide humane care, as well as the limiting and facilitating factors of such care. It is essential to use such means, in that they contribute to improving the care given to these people.

The Relationship between the Optimistic Bias about Cancer and Cancer Preventive Behavior of the Korean, Chinese, American, and Japanese Adult Residing in Korea

PURPOSE: This study was conducted to provide basic data for developing education and health promotion programs for the prevention of cancer by identifying the relation between optimistic bias about cancer and cancer preventive behavior in Korean, Chinese, American, and Japanese residents in Korea. METHODS: Using a questionnaire administered by the researcher, data were collected from a convenience sample of 600, 19 to 64-yr-old male and female Korean, Chinese, American, and Japanese residents in Korea. Data was collected between February 6 and 28, 2009. RESULTS: Scores for optimistic bias about cancer by nationality were: Koreans, -1.03; Chinese, -0.43; Americans, -0.23; and Japanese, 0.05. The cancer preventive behavior scores were: Koreans, 43.17; Chinese, 71.84; Americans, 71.71; and Japanese, 73.97. Optimistic bias about cancer and cancer preventive behavior showed a significantly positive correlation in all participants: Koreans (r=.223, p=.006); Chinese (r=.178, p=.029); Americans (r=.225, p=.006); and Japanese (r=.402, p<.001). CONCLUSION: The greater the optimistic bias about cancer is, the lower the cancer preventive behavior. The findings suggest that nursing interventions are needed to reduce optimistic bias about cancer and to form a positive attitude towards cancer prevention because an optimistic bias about cancer adversely affects cancer preventive behavior.

Candidate gene polymorphisms for diabetes mellitus, cardiovascular disease and cancer are associated with longevity in Koreans

Long-lived people may have a unique genetic makeup that makes them more resistant than the general population to prevalent age-related diseases; however, not much is known about genes involved in the longevity. To identify susceptibility variants controlling longevity, we performed a high-throughput candidate gene study using 137 Koreans over 90 yr old and 213 young healthy Koreans. We evaluated 463 informative markers located in 176 candidate genes mostly for diabetes mellitus, cardiovascular disease and cancer under five genetic models. We estimated the odds ratios for each allele, genotype, haplotype, and gene-gene interaction using logistic regression analysis. Associations between 13 genes and longevity were detected at a P-value less than 0.01. Particularly, the rs671 (A) allele of the aldehyde dehydrogenase 2 family (mitochondrial) (ALDH2) gene was associated with longevity only in men (OR 2.11, P = 0.008). Four genes, proprotein convertase subtilisin/kexin type 1 (PCSK1, P = 0.008), epidermal growth factor receptor (EGFR, P = 0.003), paired box 4 (PAX4, P = 0.008), and V-yes-1 Yamaguchi sarcoma viral related oncogene homolog (LYN, P = 0.002) consistently yielded statistical evidence for association with longevity. The findings of the current study may provide a starting point for future studies to unravel genetic factors controlling longevity in Koreans.

Cancer incidence in the Middle Eastern population of California, 1988-2004.

International statistics suggest lower cancer incidence in the Middle East and Middle Eastern (ME) immigrants in Europe, Australia, and Canada, but little is known from the United States. This study compares cancer rates in ME population with other race/ethnic groups in California from 1988 through 2004. ME cases in California cancer registry were identified by surname and ME population was estimated from U.S. Census data. Cancer rates for ME countries was obtained from Globocan. The ME incidence rate ratios for all sites combined in male and female were 0.77 and 0.82, respectively and were statistically significant. ME rates were significantly lower for cancers of the colon, lung, skin melanoma, female breast and prostate, and were significantly higher for cancers of the stomach, liver, thyroid, leukemia, and male breast. Cancer incidence in ME population in California was 2.4 times higher than rates in home countries. Incidence trends in ME males remained fairly stable but in females shows a slight decline in recent years. Cancer incidence in ME population is lower than non-Hispanic white and non-Hispanic Black, but is higher than rates for Hispanics and Asians, and ME countries. Improved data quality, chronic infections, acculturation, and access to screening services are some of the factors responsible for the observed pattern.

Movilización social para el control de cáncer en Colombia / Social mobilization for the control of cancer in Colombia

Como se expuso en la presentación del modelo para el control del cáncer, la dimensión multicausal de este conjunto de enfermedades le da particularidades que ameritan un abordaje diferente de aquel planteado para otras entidades nosológicas, como las enfermedades infecciosas. si bien hoy no es posible hablar de visiones unicausales o deterministas en ningún problema de salud, para el cáncer, a pesar de su actual definición como enfermedad genética, no existen factores o condiciones considerados necesarios o indispensables en su génesis (excepción hecha de la infección por virus del papiloma humano en el cáncer de cuello uterino), y es mucho más difícil hablar de factores o condiciones que sean suficientes en sí mismos para producir una neoplasia maligna. Por las razones descritas, las estrategias para su control requieren un mejor entendimiento de la contribución y de las relaciones entre elementos del individuo (factores biológicos y estilos de vida), de su entorno cercano (exposiciones ambientales y condiciones de vida), de su entorno social (cultura y políticas públicas) y de los servicios de salud.

Ethnic disparities in cancer mortality among residents of Guam.

Cancer mortality data collected by the Guam Cancer Registry for the period 1998 through 2002 were analyzed by cancer site, age, and ethnicity. Ethnicity and site specific age-adjusted cancer mortality rates for Guam were calculated utilizing Guam 2000 census data, the US 2000 standard population and compared to U.S. 2002 age-adjusted cancer mortality rates. Age-adjusted cancer mortality rates for ethnic populations represented on Guam, except those of leukemia and non-Hodgkins lymphoma, were high in relation to other population groups and higher than U.S. averages. Some highlights include: 1. Chamorros had high age-adjusted mortality rates for mouth and pharynx (15.5 vs. 2.7 [corrected] U.S.), nasopharynx (9.1 vs. 0.2 U.S.), lung and bronchus (66.9 vs. 54.9 U.S.), colon-rectum-anus (28.6 vs. 19.7 U.S.), breast (32.0 vs. 28.0 U.S.) and prostate cancer (40.9 vs. 27.9 U.S.); 2. Chamorros (6.4 vs. 2.5 U.S.) and Micronesians (6.3) had high and nearly identical age-adjusted mortality rates for cancer of the mouth and pharynx when nasopharyngeal cancers were excluded; 3. Micronesians had the highest mortality rate for liver cancer over all ethnicities documented (43.5 vs. 4.9 U.S.); 4. Asians had the highest mortality rates for pancreatic (12.5 vs. 10.5 U.S.) and cervical cancer (8.5 vs. 2.6 U.S.); 5. Caucasians had the highest mortality rates for leukemia (19.9 vs. 7.5 U.S.) and Non-Hodgkin's lymphoma (17.6 vs. 7.6 U.S.). Suggestions are made for further research on both explaining and ameliorating cancer mortality disparities among ethnic groups on Guam.

Do cross-registry comparisons of Black and White Americans provide support for N-acetylation as an important determinant for urinary bladder and other tobacco-related cancers?

Tobacco smoking is an unequivocal risk factor for cancers of the larynx, lung, pancreas and urinary bladder. Whereas African-Americans demonstrate higher laryngeal, lung and pancreatic cancer rates than their Caucasian-American counterparts, they paradoxically have only approximately half of the urinary bladder incidences. One possible explanation is their N-acetyltransferase (NAT) status, since this enzyme is responsible for metabolism of arylamines in smoke and blacks are reported to have a higher rate for rapid acetylation than whites. However, other tobacco-related cancers are also linked to slow acetylation so that African-Americans might therefore also be expected to have lower incidences of other tobacco-related cancers. The present investigation was conducted with data from Cancer Incidence in Five Continents Vol VIII to assess whether there might be correlations between incidence rates for four major cancers across registries in the United States. Cluster analysis demonstrated clear separation of the white and black populations for all states, and significant correlations were observed between bladder and laryngeal cancers, and also for lung and laryngeal cancers, for both Blacks and Whites. Striking similarities in the plots for urinary bladder incidence against all three of the other cancers suggests the existence of a factor specific to the bladder. A review of black-white ratios for cancer incidences in all major body sites in both sexes and the published literature for NAT polymorphisms provided evidence that this might indeed be arylamine exposure, although other factors could also be involved.

Methodology to identify Iranian immigrants for epidemiological studies.

Determining ethnic differences in cancer patterns using administrative databases is often a methodological challenge for information on ethnicity or place of birth is commonly lacking. This paper describes the approach we used to identify Iranians residing in British Columbia (BC), Canada and who were registered within the BC Cancer Registry. A listing of common Iranian surnames and given names was generated from two sources: a residential telephone book (with a high density of Iranians) and a provincial breast cancer screening program (which allowed for the selection of women born in Iran). Surnames and given names were reviewed manually and the Iranian names were identified and coded as 'highly probable' and 'probable' Iranian. A name directory was then created and linked with the BC Cancer Registry to identify Iranian cancer cases. Using this method, 1729 surnames and 737 given names were selected from the telephone book, and 1881 surnames and 757 given names from the screening program. The majority of these names were coded as 'highly probable' Iranian (98% and 96% for surnames and given names, respectively). 12% of surnames and 10% of given names were common to both sources. A listing of the most common Iranian surnames and given names is provided. In conclusion, in the absence of other ethnicity data, surnames and given names can be very helpful to identify persons of specific ethnicities when these ethnic groups have distinctive names.

Cancer incidence among Hispanic children in the United States

OBJETIVO: Comparar de manera directa la incidencia de cáncer en niños hispanos y en niños blancos no hispanos en los estados de California y la Florida, donde viven casi las dos terceras partes de toda la población infantil hispana de Estados Unidos de América. MÉTODOS: Del Sistema de Estadísticas de Cáncer de la Florida (Florida Cancer Data System) y del Registro de Cáncer de California (California Cancer Registry) se sacaron datos transversales de 1988 a 1998 correspondientes a todos los casos nuevos de cáncer en niños (<15 años de edad), codificados según raza u origen étnico en "hispanos" o "blancos no hispanos". Los resultados se expresaron en forma de tasas de incidencia estandarizadas por edad, usando como referencia la población mundial estándar en millones de habitantes. Se comparó la frecuencia de cáncer en niños hispanos y en niños blancos no hispanos mediante razones de incidencia estandarizadas (RIE) y sus respectivos intervalos de confianza del 95% (IC95%). RESULTADOS: Al compararse la frecuencia de todos los tipos de cáncer en niños hispanos y niños blancos no hispanos, la RIE fue de 1,02 (IC95%: 0,99 a 1,05). Al examinarse ciertos tipos de tumores en particular, las RIE apuntaron a mayores tasas de incidencia de leucemia (RIE = 1,26; IC95%: 1,19 a 1,34), linfoma de Hodgkin (RIE = 1,29; IC95%: 1,08 a 1,54), y tumores de células germinativas (RIE = 1,62; IC95%: 1,34 a 1,96) en niños hispanos. Estos últimos tuvieron menores incidencias de tumores del sistema nervioso central (RIE = 0,72; IC95%: 0,66 a 0,78) y de tumores del sistema nervioso simpático (RIE = 0,76; IC95%: 0,66 a 0,87). En lo que respecta a diferencias entre estados, la incidencia de linfoma, de tumores del sistema nervioso central, de tumores del sistema nervioso simpático y de tumores óseos malignos fue mayor entre jóvenes hispanos residentes de la Florida; en cambio, la incidencia de hepatomas malignos fue mayor entre jóvenes hispanos residentes de California. CONCLUSIONES: Aunque la incidencia general de cáncer en niños hispanos fue semejante a la observada en niños blancos no hispanos, se hallaron diferencias significativas en el caso de ciertos tumores en particular. Habida cuenta de que ser hispano puede ser un factor de confusión en relación con otros factores de riesgo de cáncer (familiares, socioeconómicos o ambientales), se recomienda explorar estos últimos factores en futuras investigaciones sobre el riesgo de cáncer en niños hispanos.

Medicinas no convencionales en cáncer / Nonconventional therapies in cancer

This paper describes the therapeutic complementation carried out by cancer patients, assisted at 4 hospitals of Buenos Aires City. The authors propose to classify non conventional medicines, taking into account the sociocultural and historical context of Argentina. These categories discriminate among complementary/alternative medicines (CAM), self-treatment, traditional medicines (TM), and religious healing. The unit of analyses was a sample of 200 patients. The information was collected in semi-structured and open interviews. Results show that 90% of patients consult other medicines, at least once. CAM: 72%, self-treatment: 97%, TM: 22%, religious healing 42%. Fourty four percent of patients with progressive tumor and long duration sickness consulted two or more medicines, while only 20% of patients with primary and located cancer consulted two or more medicines. The familiarization with traditional medicines is associated to the preference for traditional healers; it increases from 22 to 55% of the immigrants and patients from inside Argentina and neighboring countries. Taking into account religious identity, it was noted that pentecostals and evangelists without exception consulted their own therapeutic rituals and rejected traditional medicine. Among catholics, 75% prefer their own religious offering and 25% other religious practices, and do not reject traditional medicines because of religious factors. There were no differences in gender or age.

Se describen las combinaciones de medicinas no convencionales utilizadas por pacientes con cánceratendidos en 4 hospitales de la ciudad de Buenos Aires. Se proponen para la clasificación de estas medicinas 4 categorías conceptuales que respetan los contextos culturales de Argentina. Se discrimina entre medicinas alternativas/complementarias, autotratamiento, medicinas tradicionales y terapias religiosas. Se tomó una muestra de 200 pacientes. La información fue recabada a través de un cuestionario semi-estructuradoy entrevistas abiertas, extensas y recurrentes. Los resultados indican que el 90% consultó otra medicinapor lo menos una vez. Medicinas alternativas/complementarias: 72%, autotratamiento: 97%, medicinas tradicionales: 22% y terapias religiosas: 42%. El 44% de los pacientes con tumores en progresión y metástasis consultó 2 o más medicinas en tanto los que presentaban cánceres primarios y localizados lo hicieron en el20%. La familiarización con las medicinas tradicionales se asocia a su preferencia, la que subió del 22% al55% considerando como subgrupo a los inmigrantes y derivados del interior y de países limítrofes. Teniendo en cuenta la identidad religiosa se advirtió que pentecostales y evangélicos, sin excepción, optan por los ritualesterapéuticos de sus propias confesiones y rechazan la medicina tradicional, los católicos en un 75% prefirieronlas terapias de su confesión y un 25% otras ofertas. No hubo diferencias por sexo y edad.

Estudio clínico comparativo de tumores del cuerpo carotideo / Comparative clinic study of tumors from carotid body

Paralelamente a la hiperplasia del cuerpo carotídeo (CC), se observa un aumento de la frecuencia de los tumores de este órgano en la altura. En el presente estudio comparativo de tumores del cuerpo carotídeo (TCC) de La Paz-Bolivia (3600 metros de altura) y de Bruselas-Bélgica (nivel del mar) esta frecuencia es 20 veces mayor en autóctonos de altura que en pacientes originarios de regiones situadas a nivel del mar. El perfil de los pacientes portadores de TCC es diferente en la altura o a nivel del mar. Los TCC de altura son generalmente unilaterales, se presentan en individuos de mediana edad (51.1 +/- 11 años) con una preponderancia femenina (89 por ciento), son excepcionalmente malignos, se asocian raramente a otros paragangliomas y la herencia no parece jugar ningún rol en su patogenia. Entre los pacientes de nivel del mar se presentan dos situaciones: existe un primer grupo parecido al de los TCC de altura que afecta a pacientes de mediana edad (media 50 años) sin antecedentes hereditarios conocidos por este tipo de lesión ni para otros paragangliomas; el segundo grupo está formado por individuos más jóvenes (media 29.4 años) donde los TCC se desarrollan en un contexto hereditario de tumor neuroendocrino. La frecuencia de TCC malignos es más alta a nivel del mar que en la altura y es independiente del caracter hereditario de las lesiones.

El cáncer en una población urbana de la altura / The carcinoma at urban poblation at high alttitude

Todos los casos de cáncer recolectados entre 1982 y 1992, de residentes de la ciudad de La Paz (3,600 msnm) y de El Alto (4,100 m) se analizan en relación al sexo y al lugar anatómico afectado. Los resultados expresados en tasa estandarizadas de incidencia ajustadas a la población y por 100,000 habitantes revelan a los cáceres cutáneo incluyendo al melanoma, prostático, gástrico, biliar y colerectal como los cinco más frecuentes en el varón mientras que los cánceres cérvicouterino, mamario, biliar, cutáneo con el melanoma de piel y el ovario tienen las tasas más altas en la mujer. Finalmente, un comparación con datos de resgistros de cáncer de otras poblaciones y una revisión de los factores de riesgo en los cánceres más importantes incluyendo el aumento de la radiación solar y ultravioleta en loa altura en el caso del cáncer de piel, se comentan a la luz de la literatura existente.

Mortalidad por cancer de los migrantes en Uruguay / Cancer mortality in migrants in Uruguay

El conjunto de extranjeros residentes en el Uruguay fallecidos por cancer en el periodo diciembre 1987-noviembre 1990 es clasificado segun sexo, edad a la muerte, pais de origen, y localizacion tumoral. Esta ultima es utilizada para la comparacion de los habitantes uruguayos en base a los datos nacionales de mortalidad por grupos de edades del bienio 1988-1989, evidenciando un paralelismo claro entre ambos grupos poblacionales en cuanto a la localizacion mas frecuente -con excepcion del esofago, de mucho menor magnitud entre los extranjeros-, en el que la mortalidad entre estos ocurre promedialmente diez años mas tarde que en la poblacion criolla. Se pone de relieve la importancia de factores externos y de la interrelacion pais hospedero-habitante huesped- en particular los habitos dieteros dentro del estilo de vida uruguayo-, como condicionantes de los procesos de cancerizacion

Proportional cancer incidence according to selected sites: comparison between residents in the city of S. Paulo, Brazil: Japanese and Brazilian/Portuguese descendent

Säo comparadas as distribuiçöes percentuais dos casos de câncer de algumas localizaçöes anatômicas segundo país de nascimento, sexo e idade. Os dados foram coletados no Registro de Câncer de Säo Paulo da Faculdade de Saúde Pública da USP, referentes aos períodos 1969-2978, para os japoneses, e 1969-1975, para os brasileiros. Razöes padronizadas de incidência proporcional e respectivos intervalos com 95%de confiança foram calculados, usando como padräo a incidência proporcional específica por idade de Säo Paulo, em 1973. Os resultados, consistentes com trabalhos anteriores relativos à mortalidade, mostraram haver possíveis padröes distintos de incidência de câncer em japoneses e brasileiros. Chamou atençäo para o fato de que alguns sub-grupos de uma populaçäo apresentam comportamentos diferentes e, no presente caso, principalmente quanto à incidência de cânceres de estômago, próstata, pele, em homens, e estômago, pele, colo uterino e útero, em mulheres