Resumo Este estudo transversal investigou a prevalência e os fatores associados ao diagnóstico de câncer de mama em estágio avançado entre 18.890 mulheres assistidas em hospital especializado da capital do Rio de Janeiro, Brasil, entre os anos 1999 e 2016. Utilizou-se regressão de Poisson com variância robusta para estimar razões de prevalência e respectivos intervalos de 95% de confiança. Apresentaram maiores prevalências de diagnóstico nessa condição mulheres com idade entre 20-39 e 40-49 anos, de raça/cor da pele preta e parda, que viviam sem companheiro(a), procedentes de outros municípios do estado do Rio de Janeiro, que tiveram o Sistema Único de Saúde como origem do encaminhamento e que foram diagnosticadas nos sexênios 1999-2004 e 2005-2010. Em contrapartida, mulheres com idade entre 60-69 e 70-99 anos, que cursaram algum nível de escolaridade, com histórico familiar de câncer e que chegaram ao hospital com diagnóstico e sem tratamento apresentaram menores prevalências de diagnóstico em estágio avançado. Esses resultados podem ser considerados no planejamento de ações de prevenção secundária, a fim de antecipar o diagnóstico de câncer de mama dos grupos mais vulneráveis e assim colaborar para a redução da prevalência do diagnóstico em estágio avançado.

PurposeThe incidence of thyroid cancer (TC) has increased substantially worldwide. However, there is a lack of knowledge about age-period-cohort (APC) effects on incidence rates in South American countries. This study describes the TC incidence trends and analyzes APC effects in Cali, Colombia; Costa Rica; Goiânia, Brazil; and Quito, Ecuador.Materials and MethodsData were obtained from the Cancer Incidence in Five Continents series, and the crude and age-standardized incidence rates were calculated. Trends were assessed using the estimated annual percentage change, and APC models were estimated using Poisson regression for individuals between age 20 and 79 years.ResultsAn increasing trend in age-standardized incidence rates was observed among women from Goiânia (9.2%), Costa Rica (5.7%), Quito (4.0%), and Cali (3.4%), and in men from Goiânia (10.0%) and Costa Rica (3.4%). The APC modeling showed that there was a period effect in all regions and for both sexes. Increasing rate ratios were observed among women over the periods. The best fit model was the APC model in women from all regions and in men from Quito, whereas the age-cohort model showed a better fit in men from Cali and Costa Rica, and the age-drift model showed a better fit among men from Goiânia.ConclusionThese findings suggest that overdiagnosis is a possible explanation for the observed increasing pattern of TC incidence. However, some environmental exposures may also have contributed to the observed increase.

Objective: To describe the clinical and epidemiological profile of primary thyroid cancer hospital cases in Brazil. Methods: This is a descriptive study of cases held on hospital cancer records who had their first consultation for treatment in the period 2000-2016 and who were monitored by the hospitals providing those records. Results: Of the 52,912 cases, 83.4% were female and 96.9% were differentiated carcinoma cases. The median time to diagnosis was shorter for anaplastic cases (11 days) and for those living in Brazil's Southern region (5 days). Treatment was initiated within 60 days in 88.8% of cases that arrived at the hospitals without diagnosis and in 34.9% of those who arrived with diagnosis. Conclusion: The findings are consistent with thyroid cancer epidemiology, with a predominance of female cases and differentiated carcinomas. Analysis of time-to-treatment suggests access difficulties for those who already had diagnosis when they arrived at the hospitals.

Objective: To estimate Age-Period-Cohort effects on colorectal, colon and rectal cancer incidence rates in Latin American countries covered by high quality Population-Based Cancer Registries. Methods: A trend study was performed using data from Cancer Incidence in Five Continents. Age-Period-Cohort effects were estimated by Poisson regression for individuals aged between 20 and 79 years with colorectal, colon and rectal cancers informed by Population-Based Cancer Registries from 1983 to 2012 in Cali (Colombia); from 1983 to 2007 in Costa Rica; and from 1988 to 2012 for both Goiânia (Brazil) and Quito (Ecuador). Goodness of fit model was tested using the deviance of the models. Results: Age effect was statistically significant for both sexes in all Population-Based Cancer Registries areas and the curves slope reached peaks in the older age groups. There were cohort effects on the incidence rates for colorectal, colon and rectal cancers in all Population-Based Cancer Registries areas, except for women in Quito. Regarding the period effect, an increased ratio rate was observed in men (1.26, 95%CI 1.17 to 1.35) and women (1.23, 95%CI, 1.15 to 1.32) in Goiânia, between 2003 and 2007. Conclusions: In Latin America, age effect was observed on incidence rates for colorectal, colon and rectal cancers. Besides, birth cohort effect was identified for recent cohorts in both genders for colorectal, colon and rectal cancers in Cali and Goiânia, and cohort effect for colorectal and colon cancers in both genders in Costa Rica; while in Quito a cohort effect was only observed for rectal cancer among men. Period effect was observed in Goiânia with increased ratio rate in 2003-2007.

BACKGROUND: Although the prognosis of differentiated thyroid carcinoma (DTC) therapy is considered excellent over time, some cases have a poorer prognosis and evolve into death. OBJECTIVE: This study aimed to estimate the 5-year specific survival and to identify prognosis factors in a cohort of DTC adult subjects. METHODS: Survival probability was estimated by Kaplan-Meier’s method in a retrospective hospital-based cohort study. Comparisons were made by log-rank test. Prognosis factors were identified using Cox risk modeling and crude and adjusted Hazard Ratio measures were obtained. Two models were estimated, considering age grouping of the 7th and 8th editions of TNM. RESULTS: Specific 5-year survival in the cohort was 98.5% (95%CI: 94.2 – 97.5). Considering TNM 7th edition, the risk estimates were 9.88 (95%CI: 1.67 – 58.33) for age group ≥ 55 years, 18.87 (95%CI: 7.38 – 48.29) for individuals with distant metastasis, 6.36 (95%CI: 2.26 – 17.91) for patients who underwent lymphadenectomy and 0.16 (95%CI: 0.06 – 0.43) for those who received radioiodine therapy. For TNM 8th edition, the risk estimates were 10.12 (95%CI: 2.05 – 50.09) for age group ≥ 55 years, 12.43 (95%CI: 4.58 – 33.77) for individuals with distant metastasis, 5.06 (95%CI: 1.82 – 14.05) for patients who underwent lymphadenectomy and 0.19 (95%CI: 0.07 – 0.51) for those who received radioiodine therapy. CONCLUSIONS: This cohort had a very high survival over a 5-year period. The prognosis was negatively influenced by age, distant metastasis and lymphadenectomy, whereas radioiodine therapy was found to be protective.