Cross-cultural adaptation of the Skin Cancer Index into Brazilian Portuguese for patients with cervicofacial nonmelanoma skin cancer.

PURPOSE: This study aimed to translate the Skin Cancer Index (SCI) into Portuguese, adapt it for Brazilian culture, and clinically validate it. METHODS: A five-stage cross-cultural adaptation model was followed, with subsequent clinical validation. Inter-rater agreement was assessed using the content validity index (CVI). The hypothesis of the non-inferiority of the CVI at 80% probability level was evaluated using an exact binomial test. We used Spearman's rank-order and Pearson's product-moment correlation analysis, internal consistency using McDonald's ω and Cronbach's α metric, and construct validity using confirmatory factor analysis. The factorial model was validated using the chi-squared test, root mean square error of approximation (RMSEA), comparative fit index (CFI), and standardized root mean square residual (SRMR). RESULTS: The first stage yielded two independent translations. After synthesis, back-translation, and review, the prefinal version was tested on 40 patients. Inter-rater agreement indices on content validity were significantly higher than 80% (p < 0.05). The SCI remained stable, and the Spearman's rank-order (rs), Pearson product-moment (r), and intraclass correlation coefficients were > 0.9, indicating excellent reliability. The reliability of McDonald's ω was considered ideal (> 0.8) in all subdimensions and scale. Cronbach's α was considered ideal in the "Emotional" and "Social" subdimensions and scale. Construct validity was observed in all subdimensions and scale through the criteria (χ2) p value > 0.05, RMSEA < 0.08, CFI ≥ 0.9, and SRMR ≤ 0.08. CONCLUSION: The cross-cultural adaptation of the SCI to Portuguese for Brazilian culture showed content validity and reliability, contributing to quality of life assessment in patients with NMSC.

Analysis of breast cancer survival in a northeastern Brazilian state based on prognostic factors: A retrospective cohort study.

Breast cancer is a major health problem worldwide. Analysis of breast cancer epidemiology in emerging countries enables assessment of prognostic factors, cancer care quality, and the equity of resource distribution. We aimed to estimate the overall (OS) and cancer-specific survival (SS) of breast cancer patients in the northeastern Brazilian state of Sergipe to identify independent prognostic factors. We analyzed a cohort for the factors age at diagnosis, place of residence, time to treatment, staging, and molecular classification, using the Kaplan-Meier method, log-rank test, Pearson's chi-squared test and Cox regression model. The outcome was the vital status at the end of the study. Our analysis showed an OS probability of 0.72 and an SS probability of 0.75. In multivariate analysis, time to treatment within 60 days, stage IV, and triple-negative classification remained independent prognostic factors for both OS [unadjusted hazard ratio (HRp) 1.50 (1.21; 1.86), HRp 16.56 (8.35; 32.85), and HRp 2.73 (1.73; 4.29), respectively] and SS [HRp 1.43 (1.13; 1.81), HRp 20.53 (9.45; 44.56), and HRp 3.14 (1.88; 5.26), respectively]. Better survival was demonstrated for the following patients: those receiving their first treatment after 60 days, with an OS of 52.5 months (51.2; 53.8) and SS of 53.5 months (52.3; 54.7); stage I patients, with an OS of 58.8 months (57.7; 60.0) and SS of 59.2 months (58.1; 60.3); patients without nodal metastasis, with an OS of 54.2 months (53.0; 55.4) and SS of 55.6 months (54.5; 56.7); and patients with luminal A classification, with an OS of 56.8 months (55.0; 58.5) and SS of 57.8 months (56.2; 59.4). This study identified independent prognostic factors and that OS and SS were lower for patients from Sergipe than for patients in high-income areas. Therefore, determining the profiles of breast cancer patients in this population will inform specific cancer care.

Temporal trend of cancer mortality in a Brazilian state with a medium Human Development Index (1980-2018).

Emerging economy countries in epidemiological transition have been especially challenged in the fight against cancer. This was an ecological study that aimed to describe the temporal trend of cancer mortality in a Brazilian northeastern state with a medium Human Development Index using official Brazilian mortality data from 1980 to 2018. We calculated the mortality crude rate (CR) and age-standardized rate (ASR) based on official population counts and estimates. The Joinpoint Regression Program, National Cancer Institute, USA, was used to calculate time trends of cancer mortality. There were 34,214 deaths from cancer, excluding nonmelanoma skin cancer, in Sergipe. The overall cancer mortality ASR was 70.1 and 57.9 per 100,000 men and women, respectively. For the last five years, the leading causes of cancer deaths were prostate (21.3), trachea, bronchus and lung (11.7), stomach (6.5), oral cavity (5.4) and liver and intrahepatic bile ducts (5.1) in males and breast (13.8), trachea, bronchus and lung (6.6), cervix (6.4), colon/rectum (5.8) and central nervous system (3.6) in females. In addition, there was a significant reduction in deaths from ill-defined causes in the series. Our results show that although there has been an increase in cancer mortality rates associated with Western lifestyles, such as prostate, breast and colon/rectum, high rates of cancer related to poverty and infections, such as stomach and cervix, still persist in Sergipe.

Trends in the incidence and mortality of colorectal cancer in a brazilian city.

OBJECTIVES: This study was conducted to analyze the trends in colorectal cancer (CRC) incidence and mortality in the city of Aracaju, Sergipe State, Brazil, between 1996 and 2015 with Joinpoint Regression Program 4.7.0.0 and to identify the geographical distribution of CRC in the municipality. RESULTS: A total of 1322 cases of CRC and 467 CRC-related deaths during the study period were included. In total, 40% of the incident cases and 43% of the deaths occurred in men, while 60% of the incident cases and 57% of the deaths occurred in women. Males who were 20 to 44 years old had the most significant trend in growth. Among women, those in the group aged 45 to 64 years had the highest observed annual percent change (APC). In both sexes, mortality was stable. Regarding the geographic distribution, there were constant hotspots in the northeast region of the municipality. This study showed a significant increase in incidence, mainly in young men between 20 and 44 years of age, but stable mortality in Aracaju.

Patient satisfaction and quality of life in breast reconstruction: assessment of outcomes of immediate, delayed, and nonreconstruction.

OBJECTIVES: This study was conducted aiming to assess the quality of life and satisfaction of women who had mastectomy treated with and without breast reconstruction. RESULTS: A total of 81 women who had mastectomy were included, of whom 53 (65.4%) underwent breast reconstruction. Quality of life was not significantly better in the reconstruction group than the nonreconstruction group. Satisfaction with the surgically operated breast, whether reconstructed or not, was positively correlated with quality of life (p = 0.004). There was no significant difference in quality of life between women with immediate and late reconstruction. This study showed that the satisfaction of patients with the operated breast, reconstructed or not, is more important in quality of life than whether the breast was reconstructed or not. When we analyzed the quality of life of women who had mastectomy who were dissatisfied with their unreconstructed breasts, we observed that nonreconstruction had a negative impact on the quality of life.

Assessing trends of breast cancer and carcinoma in situ to monitor screening policies in developing settings.

There have been arguments about the role of breast cancer screening at the population level, and some points of controversy have arisen, such the establishment of organized screening policies and the age at which to begin screening. The real benefit of screening has been questioned because the results of this practice may increase the diagnosis of indolent lesions without decreasing mortality due to breast cancer. The authors have proposed a study of incidence and mortality trends for breast cancer in a developing setting in Brazil to monitor the effectiveness of the official recommendations that prioritize the age group from 50 to 69 years. The database of the Cancer Registry and the Mortality Information System was used to calculate age-standardized and age-specific rates, which were then used to calculate incidence and mortality trends using the Joinpoint Regression Program. The results showed stability in trends across all ages and age-specific groups in both incidence and mortality. In conclusion, we found that incidence and mortality rates are compatible with those in regions with similar human development indexes, and trends have demonstrated stabilization. Thus, we do not endorse changes in the official recommendations to conduct screening for ages other than 50 to 69 years, nor should policy makers implement organized screening strategies.