The epidemiology of laryngeal cancer in Brazil

Abstract

The city of São Paulo exhibits one of the highest incidences of laryngeal cancer in world and Brazil presents remarkable occurrence, compared with other Latin American countries. Around 8,000 new cases and 3,000 deaths by laryngeal cancer occur annually in the Brazilian population. In the city of São Paulo, incidence rates for laryngeal cancer among males have been decreasing since the late 1980s while, among females, the rates have shown a stable trend. This phenomenon is probably the expression of changes in gender behavior related to tobacco smoking. Several risk factors are involved in the genesis of laryngeal cancer. The most important are tobacco smoking and alcohol intake, but occupational hazards have also been associated with the disease, such as asbestos, strong inorganic acids, cement dust and free crystalline silica. Additionally, salted meat and total fat intake have been linked to elevated risk of laryngeal cancer. Conversely, several studies have confirmed that fruits, raw leaf vegetables and legumes protect against this cancer. Some researchers have postulated a possible association between laryngeal squamous cell carcinoma and human papilloma virus (HPV), but this is not universally accepted. Gastroesophageal reflux disease is weakly, but consistently correlated with laryngeal cancer. Familial cancer clusters, particularly of head and neck tumors, seem to increase the risk of laryngeal cancer. Some genetic polymorphisms, such as of genes that code for xenobiotic-metabolizing enzymes, have shown elevated risk for laryngeal cancer according to recent studies. Public health policies regarding the control of tobacco smoking and alcohol consumption, and also surveillance of carcinogen exposure in occupational settings, could have an impact on laryngeal cancer. No proposals for screening have been recommended for laryngeal cancer, but one diagnostic goal should be to avoid treatment delay when suspected symptoms have been observed.

Fração de câncer de cabeça e pescoço atribuível ao tabaco e ao álcool em cidades de três regiões brasileiras

“…There is great variation in the occurrence of HNC in the world 30,31 . There were variations in Brazil as well 32,33 . In a systematic review about the consumption of alcohol and HNC, there were asymmetries in the occurrence of the disease by geographic regions, related to the prevalent consumption habits in the populations 8 .…”

Hábitos alimentares e de atividade física associados a risco para o desenvolvimento de câncer: prevalência em adolescentes

“…8 Vários estudos tem demonstrado associação do consumo de álcool com o desenvolvimento de cânceres de cavidade oral, esôfago e laringe, que podem ser provocados pelo resultado da ação direta do álcool na mucosa ou por sua presença na corrente sanguínea e consequente ação sobre os outros sistemas. [10][11][12][13] O consumo de carne vermelha, o qual foi elevado em toda a amostra do estudo, está associado com o aumento do risco para câncer colo-retal em 28% a 35%, enquanto a carne processada eleva este risco para 20% a 49%. 14,15 Embora a associação entre consumo de carne e câncer possa ser parcialmente explicada pelas dietas com alta taxa calórica ou alto teor de gordura, existe um possível papel direto de compostos potencialmente cancerígenos que são encontrados nas carnes, incluindo compostos N-nitrosos , aminas heterocíclicas, ou hidrocarbonetos aromáticos policíclicos.…”

Custo do tratamento de pacientes com histórico de tabagismo em hospital especializado em câncer

“…3,5,15,21,24 The database of the hospital information system of the Brazilian National Health System (Sistema Único de Saúde, SUS) was used obtain the frequencies and monetary values of hospitalizations due to these diseases in this hospital in 2003, in accordance with the three-digit categories of the International Classifi cation of Diseases, tenth revision (ICD-10).…”

“…Laryngeal cancer represents 2% of all cancers, which corresponds to around 9,000 cases per year. 24 The medical care for these three types of cancer is technology-intensive and requires a multidisciplinary approach for diagnosis, treatment and rehabilitation. Within the scenario of fi nite resources in the healthcare sector, smoking generates an important opportunity cost for Brazilian public hospitals, in relation to the provision of oncological care resources such as consultations, hospital admissions, tests, highcomplexity procedures and human resources that could be destined for treating other diseases.…”