Primary Health Care and Cervical Cancer Mortality Rates in Brazil

Rocha, Thiago Augusto Hernandes; Silva, Núbia Cristina da; Thomaz, Érika Bárbara Abreu Fonseca; Queiroz, Rejane Christine de Sousa; Souza, Marta Rovery de; Lein, Adriana; Rocha, Jorge Luiz da; Álvares, V. de S.; Almeida, Dante Grapiuna de; Barbosa, Allan Claudius Queiroz; Thumé, Elaine; Staton, Catherine A.; Vissoci, João Ricardo Nickenig; Facchini, Luiz Augusto

doi:10.1097/jac.0000000000000185

Cited by 27 publications

(23 citation statements)

References 29 publications

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“…Ovarian cancer is the second most common cancer and main cause of death with gynecological tumors worldwide (Qin et al, 2013;Zhu and Sun, 2017). Moreover, cervical cancer is the third most frequent neoplasm among women worldwide (Rocha et al, 2017). In 2017, a study showed that ovarian cancer (47%) followed by cervical cancer (29%) are the most common gynecological malignancy among Pakistan women (Manzoor et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Association of MTHFR 677C>T Polymorphism with Susceptibility to Ovarian and Cervical Cancers: A Systematic Review and Meta-Analysis

Karimi-Zarchi

Moghimi

Abbasi

et al. 2019

Asian Pac J Cancer Prev

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Background: Previous studies have evaluated the impact of MTHFR 677C>T polymorphism on susceptibility to ovarian and cervical cancers in women, but the conclusions are still controversial. To get a more precise evaluation of the association between MTHFR 677C>T polymorphism and risk of ovarian and cervical cancers, we performed a meta-analysis of the association of all eligible studies. Methods: A comprehensive search performed in PubMed, Google Scholar, CNKI, and Web of Science databases to identify the relevant studies up to October 15, 2018. The strength of the association was estimated by odds ratios (OR) with 95% confidence interval (CI). Results: A total of 27 case-control studies including eleven studies with 4990 cases 7730 controls on ovarian cancer and 16 studies with 4990 cases and 7730 controls on cervical cancer were selected. Pooled data revealed that the MTHFR 677C>T polymorphism not significantly associated with an increased risk of ovarian and cervical cancers under all five genetic models. However, stratified analysis by ethnicity showed that the MTHFR 677C>T polymorphism was significantly associated with risk of ovarian cancer in Asians. No publication bias was found in the current meta-analysis. Conclusions: The results of this meta-analysis proposes that the MTHFR 677C>T polymorphism may not play a role in development of ovarian and cervical cancers in overall population. Further well-designed studies are necessary to clarify the precise role of the MTHFR 677C>T polymorphism on ovarian and cervical cancers risk.

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Section: Introductionmentioning

confidence: 99%

Association of MTHFR 677C>T Polymorphism with Susceptibility to Ovarian and Cervical Cancers: A Systematic Review and Meta-Analysis

Karimi-Zarchi

Moghimi

Abbasi

et al. 2019

Asian Pac J Cancer Prev

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“…[28][29][30][31] The mortality rate stability in the post-PNAISM period detected in the present study may be regarded as an expected result, given the cancer progression time from early detection to the time of death with respect to breast 28 and cervical 29 cancers as well as an improvement in the lling out of forms and in the quality of information of the information systems concerning the causes of death. [28][29][30] Still, the stability of the cancer mortality rates may be viewed as a warning for the type of unorganized screening performed in Brazil, with breast and cervical cancers at the forefront in women's health. 31 There was no reduction in deaths from respiratory diseases, a nding also shown in the results of Schmitt et al 8 The implementation success of other public policies, such as that of smoking, 32 could have changed the outcome.…”

Section: Discussionmentioning

confidence: 61%

Brazilian National Policy of Comprehensive Women’s Health Care and Mortality during Climacteric Period: Has Anything Changed?

Sorpreso

Figueiredo

Ramos

et al. 2020

Preprint

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Background: The National Policy for Integral Attention to Women’s Health was implemented more than two decades ago, with the monitoring of potential benefits being explored. One of the life cycles of women contemplated in this health policy is the importance of health care during the climacteric. Prevention and health promotion actions carried out by the Brazil National Health System - Unified Health System and enshrined in health Brazilian policies for women. Thus, our purpose was to identify climacteric women’s main causes of death as well as the mortality trend of such causes, especially after PNAISM implementation. Methods: An ecological study was conducted by Disciplina de Ginecologia da Faculdade de Medicina da Universidade de São Paulo from 2018–2019. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the National Health Information, divided into periods 1996–2004 and 2005–2006 according to implementation of the National Police. The death records of Brazilian women aged 35 to 64 years who had a diagnosis were retrieved. Trends and differences between periods were evaluated using linear regression. The significance level was set at 5%. Results: The main causes of death in women were circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine , nutritional and metabolic diseases (6.81%, 170,881 deaths), and external causes of morbidity and mortality (5.49%, 137,674 deaths). Implementation of PNAISM led to a further reduction in mortality from circulatory system diseases (β=-0.58; 95% CI, -0.68 to -0.48; r²=0.93; p<0.001), and any significant changes in neoplasm mortality (β=0.07; 95% CI, -0.01. 0.15; r²=0.22; p=0.070). Conclusions: The leading causes of death during climacteric are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality, with no changes in neoplasms and respiratory system diseases. Thus, the analysis of women’s health indicators, such as mortality rates, is fundamental in order to enable the monitoring of benefits and results related to PNAISM as well as directing the design and implementation of other new health policies to be developed for women.

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“…Cuts in health care spending have come on top of old challenges associated with inequity in the distribution of the medical work force. The potential excess deaths projected in our research may be associated with other health problems, such as additional costs for emergency services (30,31) and an increase in disabilityadjusted life years (32).…”

Section: Discussionmentioning

confidence: 90%

Mortality associated with alternative policy options for primary care and the Mais Médicos (More Doctors) Program in Brazil: forecasting future scenarios

Francesconi

Tasca

Basu

et al. 2020

Revista Panamericana De Salud Pública

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Objective. To forecast the impact of alternative scenarios of coverage changes in Brazil’s Family Health Strategy (Estratégia Saúde da Família) (ESF)—due to fiscal austerity measures and to the end of the Mais Médicos (More Doctors) Program (PMM)—on overall under-5 mortality rates (U5MRs) and under-70 mortality rates (U70MRs) from ambulatory care sensitive conditions (ACSCs) up through 2030. Methods. A synthetic cohort of 5 507 Brazilian municipalities was created for the period 2017-2030. A municipal-level microsimulation model was developed and validated using longitudinal data. Reductions in ESF coverage, and its effects on U5MRs and U70MRs from ACSCs, were forecast based on two probable austerity scenarios, as compared to the maintenance of current ESF coverage. Fixed effects longitudinal regression models were employed to account for secular trends, demographic and socioeconomic changes, variables related to health care, and program duration effects. Results. In comparison to maintaining stable ESF coverage, with the decrease in ESF coverage due to austerity measures and PMM termination, the mean U5MR and U70MR would be 13.2% and 8.6% higher, respectively, in 2030. The end of PMM would be responsible for a mean U5MR from ACSCs that is 4.3% higher and a U70MR from ACSCs that is 2.8% higher in 2030. The reduction of PMM coverage due only to the withdrawal of Cuban doctors who have been working in PMM would alone be responsible for a U5MR that is 3.2% higher, and a U70MR that is 2.0% higher in 2030. Conclusions. Reductions in primary health care coverage due to austerity measures and the end of the PMM could be responsible for many avoidable adult and child deaths in coming years in Brazil.

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Primary Health Care and Cervical Cancer Mortality Rates in Brazil

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 27 publications

References 29 publications

Association of MTHFR 677C>T Polymorphism with Susceptibility to Ovarian and Cervical Cancers: A Systematic Review and Meta-Analysis

Association of MTHFR 677C>T Polymorphism with Susceptibility to Ovarian and Cervical Cancers: A Systematic Review and Meta-Analysis

Brazilian National Policy of Comprehensive Women’s Health Care and Mortality during Climacteric Period: Has Anything Changed?

Mortality associated with alternative policy options for primary care and the Mais Médicos (More Doctors) Program in Brazil: forecasting future scenarios

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