Many human cancers develop as a result of exposure to risk factors related to the environment and ways of life. The aim of this study was to estimate attributable fractions of 25 types of cancers resulting from exposure to modifiable risk factors in Brazil. The prevalence of exposure to selected risk factors among adults was obtained from population-based surveys conducted from 2000 to 2008. Risk estimates were based on data drawn from meta-analyses or large, high quality studies. Population-attributable fractions (PAF) for a combination of risk factors, as well as the number of preventable deaths and cancer cases, were calculated for 2020. The known preventable risk factors studied will account for 34% of cancer cases among men and 35% among women in 2020, and for 46% and 39% deaths, respectively. The highest attributable fractions were estimated for tobacco smoking, infections, low consumption of fruits and vegetables, excess weight, reproductive factors, and physical inactivity. This is the first study to systematically estimate the fraction of cancer attributable to potentially modifiable risk factors in Brazil. Strategies for primary prevention of tobacco smoking and control of infection and the promotion of a healthy diet and physical activity should be the main priorities in policies for cancer prevention in the country.
The objective of this study was to analyze the effect of age-period and cohort (APC) of birth on mortality for acute myocardial infarction in Brazil and its geographic regions, according to sex in the period from 1980 to 2009. The data was extracted from the Mortality Information System and was corrected and adjusted by means of proportional redistribution of records with sex and age ignored, ill-defined causes, and corrections were made based on the death sub-register. The APC was calculated using the Poisson regression model with estimable functions. The APC analysis on both sexes and in all regions of the country showed gradual reductions in the risk of death in birth cohorts from the decade of the 1940s, except in the Northeast. In this region, there have been progressive increases in the risk of death from the late 1940s for both sexes. This was up until the 1950s for men and the 1960s for women. It was concluded that the observed differences in the risk of death in Brazilian regions is the result of socio-economic inequalities and poor access to health services within the Brazilian territory, favoring early mortality for this cause especially in poorer areas.
The aim of this study is to estimate the effects of age-period-birth cohort (APC) on
Objective: To analyze the temporal trends of the incidence and prevalence of tuberculosis, with and without HIV co-infection, as well as of the associated mortality, in Brazil, the Americas, and worldwide. Methods: We collected data related to tuberculosis, with and without HIV co-infection, between 1990 and 2010, in Brazil, the Americas, and worldwide. Temporal trends were estimated by linear regression. Results: We identified a trend toward a decrease in tuberculosis prevalence and mortality, and that trend was more pronounced in Brazil and the Americas than worldwide. There was also a trend toward an increase in the incidence of tuberculosis/HIV co-infection, as well as in the rates of detection of new cases of active and latent tuberculosis. The incidence of tuberculosis was found to trend downward in Brazil, whereas it trended upward worldwide. Tuberculosis incidence rates correlated positively with poverty rates and with HIV incidence rates. Conclusions: Social inequality and the advent of AIDS are the major factors that aggravate the current situation of tuberculosis. In this context, methodical approaches to the assessment of surveillance activities are welcome, because they will identify situations in which the reported tuberculosis data do not reflect the true incidence of this disease.Keywords: Tuberculosis/epidemiology; HIV; Socioeconomic factors. ResumoObjetivo: Analisar a tendência temporal das taxas de prevalência, incidência e mortalidade por tuberculose, associada ou não com HIV, no Brasil, nas Américas e no mundo. Métodos: Foram coletados os dados relacionados à tuberculose, com e sem coinfecção por HIV, entre 1990 e 2010, no Brasil, nas Américas e no mundo. As tendências foram estimadas por regressão linear. Resultados: Foi identificada uma tendência de redução nas taxas de prevalência e mortalidade de tuberculose, que foi maior no Brasil e nas Américas que no mundo. Houve uma tendência crescente na incidência da coinfecção tuberculose/HIV e nas taxas de detecção de casos de tuberculose ativa e latente. Houve uma tendência de redução da incidência de tuberculose no Brasil, mas de aumento dessa no mundo. Houve uma correlação direta das taxas de incidência de tuberculose com as taxas de pobreza e as taxas de incidência de HIV. Conclusões: Desigualdades sociais e o advento da AIDS são os principais fatores que agravam a atual situação da tuberculose. Nesse contexto, abordagens metodológicas para a avaliação das ações de vigilância da tuberculose são bem-vindas, pois essas indicarão situações de dados de notificação da tuberculose que não reflitam a verdadeira incidência dessa doença.
Análise temporal da relação entre leptospirose e ocorrência de inundações por chuvas no município do Rio de Janeiro,
Regional differences were demonstrated in the mortality rates for gastric cancer in Brazil, and the least developed regions of the country will present increases in projected mortality rates.
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.
Efeitos da idade-período e coorte na mortalidade por câncer do ovário no Brasil e suas grandes regiõesEffects of age-period and cohort on mortality due to ovarian cancer in Brazil and its regions Efectos de la edad-período y cohorte en la mortalidad por cáncer de ovario en Brasil y sus macrorregiones Resumo Avaliar os efeitos da idade, período e coorte de nascimento (APC) na evolução temporal da mortalidade por câncer do ovário no Brasil e suas grandes regiões, entre o período de 1980de a 2014 ecológico de tendência temporal em que foram utilizados modelos APC com uma abordagem bayesiana e o método determinístico INLA (Integrated Nested Laplace Approximations) na inferência dos parâmetros. Os dados de mortalidade e os dados populacionais foram obtidos junto ao Departamento de Informática do Sistema Único de Saúde. As taxas de mortalidade por câncer do ovário, segundo região geográfica, foram padronizadas pelo método direito, após correção dos óbitos para causas maldefinidas e diagnóstico incompleto de câncer. No período de estudo, o Brasil apresentou 4,91 óbitos por câncer do ovário por 100 mil mulheres, as regiões Sul (5,66) e Sudeste (5,70) apresentaram as maiores taxas por 100 mil mulheres, e a Região Norte a menor (3,13/100 mil mulheres). Houve aumento progressivo da mortalidade com o avançar da idade em todas as regiões. O modelo APC multivariado de melhor ajuste evidenciou risco positivo de morte no Centro-oeste e Nordeste entre 2010-2014 e, a partir do período de 1995-1999, na Região Sul. Observou-se, ainda, risco positivo e significativo de morte para as coortes mais antigas no Sul e Sudeste, e risco reduzido para as coortes mais jovens. O inverso foi observado nas regiões Norte e Nordeste. Evidenciou-se um padrão heterogêneo na evolução temporal da mortalidade por câncer do ovário nas regiões geográficas brasileiras, o que pode estar relacionado aos distintos processos de transição demográfica e epidemiológica vivenciados por estas regiões. Neoplasias Ovarianas; Mortalidade; Estudos de Séries Temporais ARTIGO ARTICLE Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições, desde que o trabalho original seja corretamente citado. Meira KC et al. 2 Cad. Saúde Pública 2019; 35(3):e00087018Introdução O câncer do ovário representa o sétimo câncer mais incidente e a oitava causa de morte por câncer em mulheres no mundo. Em 2012, segundo o GLOBOCAN 1 , estimaram-se 239 mil casos novos (6,1 casos novos/100 mil mulheres) e 152 mil óbitos (3,8 óbitos/100 mil mulheres). Para o mesmo ano, ainda segundo o GLOBOCAN, o Brasil registrou incidência de 5,6 casos novos/100 mil mulheres e 2,7 óbitos/100 mil mulheres. O aumento da incidência esteve associado com as mudanças na estrutura etária da população, seu comportamento reprodutivo e hábitos e estilo de vida 1,2 . Ainda, podem sofrer o efeito do período das mudanças da classificação histológica da doença, assim como, da ampliação do acesso aos exame...
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