Revista Brasileira de Epidemiologia

Mortality burden of malignant neoplasms of the corpus uteri in Mexico: an analysis of trends from 2000 to 2022

ABSTRACT Objective: The aim of this study was to analyze temporal trends in malignant neoplasms of corpus uteri mortality in México from 2000 through 2022. Methods: Certificates of death were analyzed. The age-standardized mortality rate (ASMR), the number of years of life lost, according to the federal state, was estimated. The changes in temporal trends were analyzed using joint point regression. Results: The ASMR from malignant neoplasms of the corpus uteri was estimated at 2.5 (95% confidence interval [CI] 2.2–2.8), and the annual percentage change from 2000 to 2018 was 4.32. The age group of 60–65 years was most affected. Conclusion: This report indicates an increase in the ASMR from malignant neoplasms of the corpus uteri. It also suggests the need for the development of public health laws focusing on the early diagnosis and prevention of uterine cancer.

Prevalence and social inequalities in the use of cancer screening tests in Campinas, Brazil (ISACamp 2014/15)

ABSTRACT Objective: To analyze the prevalence of early detection tests for cervical, breast, prostate, and colorectal cancers in the population of Campinas, São Paulo and the presence of social inequalities in access. Methods: Population-based cross-sectional study using data from ISACamp 2014/15. Dependent variables were the performance of Pap smear, mammogram, prostate-specific antigen (PSA), fecal occult blood test (FOBT) and colonoscopy/sigmoidoscopy within the age ranges recommended by national guidelines. Independent variables included sex, age, schooling, income, race/skin color, and private health insurance. Prevalence and prevalence ratio adjusted for sex and age were estimated using Poisson regression. Analyses were performed using Stata 14, considering sampling weights. Results: The prevalence of mammography (77.7%) and Pap smear (87.8%) met the targets set by the Brazilian Ministry of Health, while FOBT (22.3%) and colonoscopy/sigmoidoscopy (21.5%) showed low coverage. PSA testing in the previous three years was reported by 55.2% of eligible men. Higher prevalence of test performance was observed among individuals with higher schooling and income levels and those with private health insurance. Inequalities varied by type of test. For instance, individuals with private health insurance had 11 and 162% higher prevalence of Pap test and colonoscopy/sigmoidoscopy, respectively, compared to those without insurance. Racial inequality was observed only for mammography. Conclusion: The results indicate high coverage and lower inequalities for Pap and mammography, and low coverage with significant disparities for FOBT and colonoscopy/sigmoidoscopy. Findings highlight the need to monitor coverage and to implement public policies aimed at reducing inequities in access to cancer screening.

Pap smears in the extreme South of Brazil: low coverage and exposure of the most vulnerable pregnant women

ABSTRACT Objective: To estimate prevalence, assess trends and identify factors associated with non-performance of Pap smears among postpartum women residing in Rio Grande, Southern Brazil. Methods: Between 01/01 and 12/31 of 2007, 2010, 2013, 2016 and 2019, previously trained interviewers applied a single standardized questionnaire at the hospital to all postpartum women residing in this municipality. It was investigated from the planning of pregnancy to the immediate postpartum period. The outcome consisted of not performing a Pap smear in the last three years. The chi-square test was used to compare proportions and assess trends, and Poisson regression with robust variance adjustment in the multivariate analysis. The measure of effect was the prevalence ratio (PR). Results: Although 80% of the 12,415 study participants had performed at least six prenatal consultations, 43.0% (95%CI 42.1–43.9%) had not been screened in the period. This proportion ranged from 64.0% (62.1–65.8%) to 27.9% (26.1–29.6%). The adjusted analysis showed a higher PR for not performing Pap smears among younger puerperal women, living without a partner, with black skin color, lower schooling, and family income, who did not have paid work during pregnancy or planned pregnancy, who attended fewer prenatal consultations. smoked during pregnancy and were not being treated for any illness. Conclusion: Despite the improvement in coverage, the observed rate of non-performance of Pap smears is still high. Women most likely to have cervical cancer were those who had the highest PR for not having this test.

Incidence trend of five main causes of cancer, in greater Cuiabá, Mato Grosso, Brazil, 2000 to 2016

ABSTRACT: Objective: To analyze the incidence trend of the five main causes of cancer, according to sex and age, in Greater Cuiabá, in the state of Mato Grosso, from 2000 to 2016. Methods: Incidence information was obtained from the Population-Based Cancer Registry, referring to the municipalities Cuiabá and Várzea Grande (RCBP — Cuiabá). Crude incidence rates were calculated and the five main types of cancer were selected: for males, prostate (C61), lung (C33–34), colorectal (C18–21), stomach (C16) and oral cavity cancer (C00–10); and for females, breast (C50), cervix (C53), colorectal (C18–21), lung (C33–34) and thyroid gland cancer (C73). Age-adjusted rates were calculated by the direct method, using the world population as reference. Trends were estimated using the Joinpoint method and evaluated by Annual Percent Change (APC) and Average Annual Percent Change (AAPC). The Joinpoint Regression Program software, version 8.3.6.1, was used. Results: During the period, there was a decreasing trend of lung (AAPC=-2.2; 95%CI −4.0–-0.3) and stomach cancer (AAPC=-5.2; 95%CI −7.7–-2.6) in men, and of cervix cancer (AAPC=-7.2; 95%CI −9.0–-5.3) in women, and increasing for breast (AAPC=2.8; 95%CI 0.2–5.5) and thyroid cancer (AAPC=8.3; 95%CI 4.6–12.2). Conclusion: In Greater Cuiabá, we found a downward incidence trend among elderly men for prostate, lung and stomach cancer. Women are affected at younger age groups, with an upward trend for breast cancer and downward trend for cervix cancer.

Cervical cancer specific survival in Grande Cuiabá, Mato Grosso State, Brazil

ABSTRACT: Objective: To estimate specific five-year survival in women diagnosed with cervical cancer living in the municipalities of Cuiabá and Várzea Grande, in the state of Mato Grosso, Brazil. Methods: This is a retrospective cohort study with information from the Cuiabá Population-based Cancer Registry and the Mortality Information System. To estimate the probability of specific survival in five years, the Kaplan-Meier estimator and the log-rank test were used aiming at verifying if there were statistical differences in the lifetime per groups. To verify the proportionality of the failure rates, the Schoenfeld residual test was used according to the statistical significance level of 0.05. Results: Specific five-year survival and median time were 90.0% and 50.3 months, respectively, for cervical cancer. When analyzing by age, the highest specific survival was among women aged 20 to 49 years (91.7%) and median time was 53.3 months. For the histological type, the highest specific survival was among women with adenocarcinoma (92.3%) and the mean survival time was 53.5 months. Conclusion: This study showed that specific survival after five years of diagnosis remained about 90% in patients with cervical cancer. Patients aged 20 to 49 years had higher specific survival and there was statistically significant difference only between age groups.