A saúde do trabalhador é tema central em pesquisas de saúde pública, entretanto se deve considerar a especificidade das atividades exercidas. Objetiva-se analisar a saúde dos trabalhadores da atividade agrícola no Brasil, que possuem ocupação também agrícola ou não agrícola, por meio da autopercepção de saúde e morbidades referidas. Utilizou-se a Pesquisa Nacional por Amostra de Domicílios (PNAD 2008), incorporando as informações do plano amostral complexo. Selecionaram-se trabalhadores da atividade agrícola com 18 anos ou mais, estratificando em: os que possuíam ocupação agrícola e não agrícola. Foi realizada regressão logística para autopercepção de saúde e calculadas as razões de chances para as morbidades referidas. A ocupação agrícola diminui a chance de referir saúde como Boa e aumenta a chance de referir doença de coluna/costas, hipertensão arterial e artrite/reumatismo. Os trabalhadores com ocupação agrícola apresentam mais morbidades referidas e piores condições de vida. A autopercepção de saúde dos trabalhadores, em geral, foi melhor entre os ocupados não agrícolas.

CONTEXT: The most recent global estimate revealed the presence of about one million new cases of stomach cancer for the year 2008, setting itself as the fourth most common cause of cancer. OBJECTIVE: The present study aims to assess the trend of mortality from stomach cancer in Brazil according to regions between 1980 and 2009. METHODS: Data on deaths from stomach cancer were obtained from the Mortality Information System, and the demographic data, from the Brazilian Institute of Geography and Statistics. The rates of mortality were standardized by age according to world population. The trend curves were calculated for Brazilian regions by sex. The technique used was polynomial regression and joinpoint. RESULTS: The tendency for males and females is similar in all regions, although the magnitude is higher among men in all places. Regions Midwest, South, Southeast tended to decline, while the Northern region showed no significant trend, and the Northeast tended to increase. CONCLUSION: It is therefore a need to evaluate public health policies for gastric cancer aimed at the demographic transition (change of urbanization and lifestyle) that is occurring throughout the country.

BACKGROUND: Colorectal cancer is the third most common type of cancer in the world and the increased survival of the colorectal cancer population is very significant. Thus, it becomes relevant to study the symptoms associated with the progression of the disease and treatment, for proper clinical management. OBJECTIVE: To describe the clinical and epidemiological profile of colorectal cancer patients and to identify the most prevalent signs and symptoms patterns. METHODS: Cross-sectional study evaluating the prevalence of symptoms in 348 colorectal cancer patients admitted to a referral oncology hospital. We applied MSAS-BR scale and, through factor analysis with principal componente analysys, we performed the grouping of symptoms. RESULTS: There was a predominance of men, aged 60 years or older, married, white, with high school, moderately differentiated tumor, stage III/IV disease, colon cancer and no distant metastasis. The most prevalent symptoms were weight loss (67.53%) and the least prevalent were mouth sores (2.01%). The groupings of symptoms established were “fatigue and psychic symptoms”, “gastrointestinal symptoms”, “self-perceptive symptoms” and “general symptoms”, which described 80% of the symptoms presented. CONCLUSION: We evidenced the importance of identifying these symptoms clusters in order to improve strategies for clinical management in patients with colorectal cancer.

ContextSeveral international studies have observed a correlation between the improvement of socio-demographic indicators and rates of incidence and mortality from cancer of the colon and rectum.ObjectiveThe objective of this study is to estimate the correlation between average per capita income and the rate of colorectal cancer mortality in Brazil between 2001 and 2009.MethodsWe obtained data on income inequality (Gini index), population with low incomes (½ infer the minimum wage/month), average family income, per capita ICP and mortality from colon cancer and straight between 2001-2009 by DATASUS. A trend analysis was performed using linear regression, and correlation between variables by Pearson's correlation coefficient.ResultsThere was a declining trend in poverty and income inequality, and growth in ICP per capita and median family income and standardized mortality rate for colorectal cancer in Brazil. There was also strong positive correlation between mortality from this site of cancer and inequality (men r = -0.30, P = 0.06, women r = -0.33, P = 0.05) income low income (men r = -0.80, P<0.001, women r = -0.76, P<0.001), median family income (men r = 0.79, P = 0.06, women r = 0.76, P<0.001) and ICP per capita (men r = 0.73, P<0.001, women r = 0.68, P<0.001) throughout the study period.ConclusionThe increase of income and reducing inequality may partially explain the increased occurrence of colorectal cancer and this is possibly due to differential access to food recognized as a risk factor, such as red meat and high in fat. It is important therefore to assess the priority of public health programs addressing nutrition in countries of intermediate economy, as is the case of Brazil.

A TRANSIÇÃO DA MORTALIDADE POR CÂNCERES NO BRASIL E A TOMADA DE DECISÃO ESTRATÉGICA NAS POLÍTICAS PÚBLICAS DE SAÚDE DA MULHERResumo: Este artigo tem por objetivo descrever a evolução da transição da mortalidade por cânceres de mama e colo do útero no Brasil em relação ao desenvolvimento socioeconômico. Foram obtidos dados de mortalidade por câncer de mama e de colo do útero no Brasil para um período de 20 anos, correspondente a um intervalo bicensitário. Os óbitos foram corrigidos e as taxas padronizadas. Além disso, indicadores sociais foram mensurados para os três anos censitários incluídos na série temporal. Observa que os estados brasileiros possuem muita heterogeneidade com relação aos indicadores sociais e à mortalidade pelos dois cânceres, e parece haver um padrão entre a condição socioeconômica e a mortalidade por câncer de mama e de colo do útero. Conclui que é necessário, portanto, realizar a avaliação e o planejamento das ações, considerando cenários de desenvolvimento, para garantir o acesso universal e equitativo das mulheres às políticas públicas de saúde. Palavras-chave: Demografia, Mortalidade, Desenvolvimento, Câncer, Políticas públicas, Políticas de saúde. CANCER'S TRANSITION IN BRAZIL AND STRATEGICAL DECISION-MAKING IN WOMEN´S PUBLIC HEALTH POLICIES Abstract:This article aims to describe the evolution of the transition in mortality from breast and cervix cancers in Brazil in relation to socioeconomic development. There were data obtained of mortality from breast cancer and cervical cancer in Brazil for a period of 20 years, corresponding to a censitary range. Deaths were corrected and rates standardized. In addition, social indicators were measured for all three census years included in the time series. It was observed that the Brazilian states have a lot of heterogeneity with respect to social indicators and mortality for both cancers, and there seems to be a pattern between socioeconomic status and mortality from breast and cervix cancer. It is therefore necessary to carry out the assessment and planning of actions, considering development scenarios, to ensure universal and equal access of women to public health policies.

Objective To assess the test-retest reliability of the Memorial Symptom Assessment Scale translated and culturally adapted into Brazilian Portuguese.Methods The scale was applied in an interview format for 190 patients with various cancers type hospitalized in clinical and surgical sectors of the Instituto Nacional de Câncer José de Alencar Gomes da Silva and reapplied in 58 patients. Data from the test-retest were double typed into a Microsoft Excel spreadsheet and analyzed by the weighted Kappa.Results The reliability of the scale was satisfactory in test-retest. The weighted Kappa values obtained for each scale item had to be adequate, the largest item was 0.96 and the lowest was 0.69. The Kappa subscale was also evaluated and values were 0.84 for high frequency physic symptoms, 0.81 for low frequency physical symptoms, 0.81 for psychological symptoms, and 0.78 for Global Distress Index.Conclusion High level of reliability estimated suggests that the process of measurement of Memorial Symptom Assessment Scale aspects was adequate.

RESUMOObjetivo: Avaliar a tendência da mortalidade por câncer de tireoide no Brasil entre 1980 e 2010. Materiais e métodos: Estudo ecológico, de séries temporais. As taxas de mortalidade por câncer de tireoide ajustadas por idade segundo sexo foram calculadas entre 1980 e 2010. Os dados foram analisados por três estratégias distintas: regressão polinomial, joinpoint analysis e médias móveis. Resultados:Mais de 70% das mortes ocorrem nos idosos, independente do sexo. Entre adultos jovens, a mortalidade é baixa, sem diferença entre homens e mulheres. Entre adultos maduros e idosos a mortalidade é crescente e com aumento expressivo para mulheres. Há uma tendência de mortalidade decrescente no sexo feminino para adultos e global; e no sexo masculino para 40-59 anos e global, ambos excluindo os idosos, com significância estatística. Conclusão: O conhecimento sobre a tendência permite estabelecer prioridades e alocar recursos de forma direcionada para a modificação positiva desse cenário na população brasileira. Arq Bras Endocrinol Metab. 2013;57(7):538-44 Descritores Câncer de tireoide; mortalidade; série histórica; epidemiologia ABSTRACT Objective: To assess the trend of thyroid cancer mortality in Brazil between 1980 and 2010. Materials and methods: An ecological study of time series. Mortality rates for thyroid cancer adjusted by age according to gender were calculated between 1980 and 2010. Data were analyzed by three distinct strategies: polynomial regression, joinpoint analysis, and moving averages. Results: Over 70% of deaths occur in the elderly, regardless of sex. Among young adults, the mortality rate is low, with no difference between men and women. Among mature adults and elderly, mortality is increasing, and significantly, for women. There is a trend of decreasing mortality in all female adults and overall population, and in males and 40-59 years and overall population, both excluding the elderly, with statistical significance. Conclusion: Knowledge about trends allows setting priorities and allocating resources toward positive changes in this scenario in the Brazilian population. Arq Bras Endocrinol Metab.2013;57(7):538-44

Introdução: O câncer colorretal está entre os tipos de câncer mais comuns na população brasileira e mundial com altos índices de mortalidade. Alguns estudos mostram que há uma diferença de carga sintomatológica para esse tipo de câncer entre adultos jovens e idosos que, consequentemente, podem deteriorar a qualidade de vida nesses pacientes. Objetivo: Investigar a diferença no padrão de sintomas entre pacientes adultos e idosos com câncer de cólon e reto. Método: Estudo transversal que utilizou um conjunto de dados sobre a prevalência de sintomas entre pacientes com câncer colorretal atendidos no Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA), por meio de um inventário de sintomas recentemente adaptado para o Brasil. Resultados: Foram entrevistados 348 pacientes, destes, 101 pacientes eram adultos jovens (29,1%) e 247 idosos (70,9%). Obteve-se diferença entre os sintomas analisados para dor (p=0,033), nervosismo (p=0,013), sonolência (p=0,033), tristeza (p=0,003), problemas com desejo sexual ou atividade sexual (p=0,014), falta de apetite (p=0,028), irritação (p=0,013), mudança nos gostos dos alimentos (p=0,042), perda de cabelo (p=0,002) e “eu não pareço mais o mesmo” (p<0,001). Conclusão: A carga sintomatológica frente ao câncer colorretal pode apresentar distinção conforme a idade. Isso é relevante, pois reforça a ideia de individualizar o tratamento para melhorar a assistência e, consequentemente, a qualidade de vida desses doentes.