Does life-course socioeconomic position influence racial inequalities in the occurrence of uterine leiomyoma? Evidence from the Pro-Saude Study

Boclin, Karine de Limas Irio; Faerstein, Eduardo; Szklo, Moysés

doi:10.1590/0102-311x00025413

Cited by 10 publications

(11 citation statements)

References 58 publications

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“…Up to 50% of women diagnosed with UF require treatment (1). The prevalence and incidence of UF varies according to age and ethnicity, with a higher prevalence in women of African compared with European descent (5). Many women with UF report that their symptoms negatively affect their ability to participate in social and work-related activities and cause significant psychologic distress (6)(7)(8)(9).…”

mentioning

confidence: 99%

Vilaprisan in women with uterine fibroids: the randomized phase 2b ASTEROID 1 study

Bradley

Singh

Simon

et al. 2019

Fertility and Sterility

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Objectives: To assess the safety and efficacy of four vilaprisan doses (0.5-4.0 mg) in women with uterine fibroids. Design: Randomized, double-blind, placebo-controlled, multicenter trial. Setting: Ninety-eight centers in 12 countries. Patient(s): Women aged 18-50 years with uterine fibroids and heavy menstrual bleeding were randomized equally to oral vilaprisan at 0.5, 1.0, 2.0, or 4.0 mg or placebo once daily. Intervention(s): Treatment for 12 weeks, 24-week follow-up. Main Outcome Measure(s): Primary end point was absence of scheduled or unscheduled bleeding/spotting. Key secondary efficacy end points included volume of menstrual blood loss and change in fibroid volume. Result(s): A total of 309 patients were randomized, and 300 received treatment. Complete absence of bleeding/spotting was observed in 30%, 56%, 54%, and 60% of patients in the vilaprisan 0.5, 1.0, 2.0, and 4.0 mg groups, respectively, versus 1.7% with placebo. After 12 weeks, >83% of women achieved amenorrhea (<2 mL/28 days) with R1.0 mg vilaprisan versus 9% with placebo. Heavy menstrual bleeding stopped (but returned at a lower volume after treatment cessation) with R1.0 mg vilaprisan treatment. Reductions in fibroid volume of up to 41% were observed. Most patients receiving vilaprisan reported improvements in symptom severity. No safety concerns were identified in general safety, endometrial safety (by biopsy), laboratory values, and ultrasound examinations. Conclusion(s): ASTEROID 1 supports the efficacy of vilaprisan for the treatment of heavy menstrual bleeding associated with uterine fibroids. Daily oral treatment with vilaprisan 0.5-4.0 mg was well tolerated, and vilaprisan 2.0 mg once daily has been selected for further investigation.

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mentioning

confidence: 99%

Vilaprisan in women with uterine fibroids: the randomized phase 2b ASTEROID 1 study

Bradley

Singh

Simon

et al. 2019

Fertility and Sterility

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“…O principal objetivo dos oito trabalhos 22,[25][26][27][29][30][31]33 que abordaram o câncer ginecológico foi analisar os fatores associados à não realização do exame citopatológico. Mais uma vez, as iniquidades de saúde geradas pela cor, idade, renda, nível educacional e ausência de um cônjuge foram relevantes e relacionadas a elementos locais.…”

Section: Câncer Ginecológicounclassified

“…Ainda no contexto dos tumores ginecológicos, dois estudos trouxeram dados sobre os miomas uterinos (MU), que são neoplasias benignas monoclonais de crescimento lento consideradas como os tumores mais comuns do sistema reprodutor feminino 25,26 . O MU é mais frequente em mulheres negras e entre aquelas expostas a fatores associados ao aumento de hormônios ovarianos (estrogênio e progesterona).…”

Section: Câncer Ginecológicounclassified

“…O MU é mais frequente em mulheres negras e entre aquelas expostas a fatores associados ao aumento de hormônios ovarianos (estrogênio e progesterona). É responsável pela queda na qualidade de vida de mulheres jovens em idade reprodutiva, principalmente em razão de cirurgias mutiladoras (histerectomia) 25,26 . No Brasil, mesmo com políticas governamentais que buscam ampliar, qualificar e humanizar a atenção integral à saúde da mulher, considerando especificidades étnico-raciais, ainda há escassez de dados sociodemográficos e de acesso a serviços de saúde para uma análise mais apurada.…”

Section: Câncer Ginecológicounclassified

“…Como variáveis marcadoras de acesso e utilização de serviços de saúde, nos dois estudos, foi considerada a realização do Papanicolau, além da origem do atendimento; ou seja, se os entrevistados possuíam ou não plano de saúde 25,26 . Os resultados vão ao encontro com os demais desta revisão, salientando mais uma vez a vulnerabilidade da mulher negra principalmente com baixa escolaridade e seu maior risco de apresentar MU.…”

Section: Câncer Ginecológicounclassified

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Acessibilidade da População Negra ao Cuidado Oncológico no Brasil: Revisão Integrativa

Paulista

Assunção

Lima

2020

Rev. Brasileira.De.Cancerologia

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Introdução: Tem-se apontado a persistência de desigualdades raciais na acessibilidade a bens e serviços de saúde, estando o indivíduo com câncer inserido nesse contexto. Objetivo: Analisar os fatores que impactam a acessibilidade da população negra ao cuidado oncológico no Brasil. Método: Por meio de uma revisão integrativa da literatura, buscaram-se, nas bases PubMed, LILACS e Embase, artigos originais publicados em português, inglês e espanhol sem limite temporal. Resultados: Foram incluídos 13 artigos, analisados a partir do tipo de câncer abordado: câncer de mama, câncer ginecológico, câncer de próstata e câncer de cavidade oral. Conclusão: As desigualdades raciais e socioeconômicas refletem nas ações de acessibilidade ao cuidado oncológico, maioritariamente na detecção precoce. Independentemente do tipo de câncer e das formas de diagnóstico e de tratamento, é inegável a dificuldade do paciente negro aos cuidados oncológicos por razões de natureza social e econômica. Os profissionais de saúde deveriam assegurar o atendimento à população negra ao mesmo nível prestado aos demais grupos sociais para garantir e superar as barreiras de acesso aos bens e serviços de saúde.

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Social Context and Geographic Space: An Ecological Study about Hospitalizations of Older Persons

Cavaletti

Caldas

Lima

2018

Value in Health Regional Issues

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To identify the diseases that lead older persons to hospitalizations in the public health system in the state of Rio de Janeiro and, through a study of spatial distribution among hospitalization rates of the municipal districts, discuss the social contexts involved in the hospitalization of the elderly. Methods: An ecological cross-sectional study using secondary data from the Brazilian hospital information system from the period 2009 to 2015 was performed. The hospitalization rates of people 60 years and older, residing in 92 municipalities in the state of Rio de Janeiro, were calculated. The municipal districts were grouped according to the similarity of such rates using K-means nonhierarchical clustering analysis. Results: Diseases of the circulatory and respiratory systems, endocrine disorders, illnesses of the genitourinary system or the digestive tract, and certain infectious and parasitic diseases were the most discriminatory diseases for cluster composition. The first cluster, the municipal districts with the lowest hospitalization rates, which were more urbanized and had greater access to social and health services, was named Access and Inclusion. The second group, which had the highest hospitalization rates, was named Isolation and Vulnerability. Conclusions: The primary care-sensitive conditions are the main causes of hospitalization of the elderly in the state, with greater intensity in the municipalities that are geographically rugged and remote. These outcomes reinforce the importance of valuing geographical knowledge, the guidelines of the unified health system concerning equity and regionalization, and the determinants and social determinations involved in the process of health and disease.

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Does life-course socioeconomic position influence racial inequalities in the occurrence of uterine leiomyoma? Evidence from the Pro-Saude Study

Abstract: A posição socioeconômica influencia as desigualdades raciais na ocorrência de miomas uterinos? Evidências do Estudo Pró-Saúde ¿El nivel socioeconómico influye en las desigualdades raciales en cuanto a la incidencia de miomas uterinos? Evidencia del Estudio Pró-Saúde

Cited by 10 publications

References 58 publications

Vilaprisan in women with uterine fibroids: the randomized phase 2b ASTEROID 1 study

Vilaprisan in women with uterine fibroids: the randomized phase 2b ASTEROID 1 study

Acessibilidade da População Negra ao Cuidado Oncológico no Brasil: Revisão Integrativa

Social Context and Geographic Space: An Ecological Study about Hospitalizations of Older Persons

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