From screening-driven medicine to symptom-driven medicine

Abstract

Each year, there are celebrations of the breast cancer and prostate cancer awareness months, respectively during October and November. In addition to being fundraising movements, these very well-orchestrated worldwide movements have blurred any public health planning for prevention and treatment of other diseases and conditions, except for AIDS. Cancer and AIDS activists do not have limits on obtaining more money and funds. They are the materialization, within medical and public affairs in the 2010s, of the European trade unionist ideology of the second half of the 19 th century and the first quarter of the 20 th century, when a refrain of "more, more and more" was celebrated.1 One undisputable fact is that the propaganda has been successfully reaching lay people. For example, a survey conducted in São Paulo revealed that the population investigated considered that cancer and AIDS were the most important causes of deaths. 2 However, perusal of the files of the official health statistics for Brazil in 2014 shows that this is not true. In fact, the risk of premature mortality (< 70 years of age) due to breast cancer is almost a quarter of the risk due to stroke; and the rates of prostate cancer are a fifth of those of heart disease.* 3 If, on the one hand, the medical-industrial complex relating to cardiovascular diseases has enough power to equilibrate this dispute, on the other hand, health conditions with little or no support exist. These conditions relate to the burden of morbidity with low lethality rates.The current issue of the Journal presents original articles addressing low-back pain, 3,4 frailty, [5][6][7] ankylosis spondylitis 8 and knee osteoarthritis. 9 The constant decline in age-adjusted mortality rates for all causes including chronic diseases, combined with the increasing size of the elderly population, is bringing up a new agenda for medical and public health research. 10 This agenda relates not only to avoidance of lethal diseases, but also to reduction of discomfort and painful conditions. 11Current demographic and epidemiological profiles are demanding greater focus on research on the epidemiology of conditions such as low-back and neck pain, frailty, osteoarthritis, migraine, hearing loss, refractive and accommodation errors of vision, depression and anxiety. These conditions are not unique to Brazil, and they are among the top ten leading causes of years lived with disability, according to the Global Burden of Diseases, 2013.11 Table 1 shows the top ten conditions that cause years lived with disability (YLD) globally, in developed and developing countries and in Brazil. In decreasing order, the top ten significant illnesses associated with years lived with disability in Brazil are low-back pain, major depressive disorder, anxiety, diabetes, hearing loss, other musculoskeletal conditions, asthma, neck pain, migraine and chronic pulmonary obstructive disease. 11One condition that deserves particular comment is low-back pain. The 2013 Brazilian National Health Survey investigated people over 1...

Health Evaluation of the Barra Longa Population Affected by the Disaster in Mariana County

“…The main five reported physical symptoms were headache, cough, leg pain, anxiety and itchiness. Based on the WHO Disease Severity Group, headache and anxiety are among the first ten causes of disabilities (GLOBAL BURDEN OF DISEASES, 2015;LOTUFO, 2016). Headache is the most prevalent neurological condition among the most frequent symptoms in clinical practice.…”