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Aggarwal S, Agarwal P, Gupta N. A comprehensive narrative review of challenges and facilitators in the implementation of various HPV vaccination program worldwide. Cancer Med 2024; 13:e6862. [PMID: 38213086 PMCID: PMC10911072 DOI: 10.1002/cam4.6862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/08/2023] [Accepted: 11/25/2023] [Indexed: 01/13/2024] Open
Abstract
INTRODUCTION Cervical cancer has been considered as one of the most common cancers in women (15-44 years) globally, but the advent of the human papilloma virus (HPV) vaccine has raised the anticipation that eradication of cervical carcinoma might be achieved in the near future as several prophylactic cervical carcinoma vaccines have already been currently licensed in various countries. Countries should devise strategies, practices and policies to attain and sustain higher levels of HPV immunization coverage as still 68% countries have introduced HPV vaccine in their national immunization programs even after 17 years following the licensure of the first prophylactic HPV vaccine. METHODOLOGY A comprehensive literature analysis was conducted using various databases and search engines, to include the most relevant research articles and data available and critically discussed the operational gaps that need to be answered to achieve adequate coverage of HPV vaccination. RESULTS The present review highlights the existing HPV vaccination strategies, unmet needs and challenges needed to be addressed for proper implementation framework as well as the collaborations required to achieve decent vaccination coverage. Well-coordinated vaccination strategy with focus on adolescent girls and if possible, boys can lead to dramatic impact on disease reduction around the world.
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Affiliation(s)
- Sumit Aggarwal
- Division of ECD, Indian Council of Medical ResearchNew DelhiIndia
| | - Pragati Agarwal
- Division of ECD, Indian Council of Medical ResearchNew DelhiIndia
| | - Nivedita Gupta
- Division of ECD, Indian Council of Medical ResearchNew DelhiIndia
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Rumgay H, Cabasag CJ, Offman J, de Camargo Cancela M, Barchuk A, Mathur P, Wang S, Wei W, Sasieni P, Soerjomataram I. International burden of cancer deaths and years of life lost from cancer attributable to four major risk factors: a population-based study in Brazil, Russia, India, China, South Africa, the United Kingdom, and United States. EClinicalMedicine 2023; 66:102289. [PMID: 38192589 PMCID: PMC10772154 DOI: 10.1016/j.eclinm.2023.102289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 01/10/2024] Open
Abstract
Background We provide a comprehensive view of the impact of alcohol consumption, tobacco smoking, excess body weight, and human papillomavirus (HPV) infection on cancer mortality and years of life lost (YLLs) in Brazil, Russia, India, China, South Africa, the United Kingdom (UK), and United States (US). Methods We collected population attributable fractions of the four risk factors from global population-based studies and applied these to estimates of cancer deaths in 2020 to obtain potentially preventable cancer deaths and their 95% confidence intervals (CIs). Using life tables, we calculated the number and age-standardised rates of YLLs (ASYR). Findings In Brazil, Russia, India, China, South Africa, the UK, and the US in 2020, an estimated 5.9 million (3.3 million-8.6 million) YLLs from cancer were attributable to alcohol consumption, 20.8 million (17.0 million-24.6 million) YLLs to tobacco smoking, 3.1 million (2.4 million-3.8 million) YLLs to excess body weight, and 4.0 million (3.9 million-4.2 million) YLLs to HPV infection. The ASYR from cancer due to alcohol consumption was highest in China (351.4 YLLs per 100,000 population [95% CI 194.5-519.2]) and lowest in the US (113.5 [69.6-157.1]) and India (115.4 [49.7-172.7). For tobacco smoking, China (1159.9 [950.6-1361.8]) had the highest ASYR followed by Russia (996.8 [831.0-1154.5). For excess body weight, Russia and the US had the highest ASYRs (385.1 [280.6-481.2] and 369.4 [299.6-433.6], respectively). The highest ASYR due to HPV infection was in South Africa (457.1 [453.3-462.6]). ASYRs for alcohol consumption and tobacco smoking were higher among men than women, whereas women had higher ASYRs for excess body weight and HPV infection. Interpretation Our findings demonstrate the importance of cancer control efforts to reduce the burden of cancer death and YLLs due to modifiable cancer risk factors and promote the use of YLLs to summarise disease burden. Funding Cancer Research UK.
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Affiliation(s)
- Harriet Rumgay
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Citadel J. Cabasag
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Judith Offman
- School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Marianna de Camargo Cancela
- Division of Cancer Surveillance and Data Analysis, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
| | - Anton Barchuk
- Institute for Interdisciplinary Health Research, European University at St. Petersburg, St. Petersburg, Russia
- ITMO University, St. Petersburg, Russia
| | - Prashant Mathur
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Bengaluru, India
| | - Shaoming Wang
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenqiang Wei
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Peter Sasieni
- School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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Wendt A, Machado AKF, Costa CS, Rachadel D, Crochemore‐Silva I, Brazo‐Sayavera J, Hembecker PK, Ricardo LIC. Health inequalities in Brazilian adolescents: Measuring and mapping gaps in a cross-sectional school-based survey. Health Sci Rep 2023; 6:e1761. [PMID: 38107154 PMCID: PMC10723783 DOI: 10.1002/hsr2.1761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023] Open
Abstract
Background and Aims This study aims to describe inequalities in health indicators according to gender, area of residence, and socioeconomic position among Brazilian adolescents. Methods Cross-sectional study using data from a school-based survey carried out in Brazil in 2019. Twelve health outcomes were evaluated. Dimensions of inequality assessed were gender, area of residence, wealth and subnational region. Results This study comprises a sample of 124,898 adolescents. The most prevalent outcome was physical inactivity (71.9%) followed by thinking life is worthless (52.6%) and bullying (51.8%). Gender inequalities were more marked for physical inactivity and thinking life is worthless with girls presenting a prevalence more than 20 p.p. higher than boys. In zero-dose HPV, however, the prevalence in girls was 17.7 p.p. lower than in boys. Area of residence and wealth inequalities were smaller than gender disparities. Context presented a relevant role in inequality with analysis stratified by states of the country, revealing high variability in estimates. Conclusions We highlight the need for attention to disparities between subgroups of the adolescent population, especially for gender inequalities that were the most marked for this age group.
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Affiliation(s)
- Andrea Wendt
- Graduate Program in Health TechnologyPontifícia Universidade Católica do Paraná, GraduateCuritibaBrazil
| | | | - Caroline S. Costa
- Postgraduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
| | - Daniela Rachadel
- Graduate Program in Health TechnologyPontifícia Universidade Católica do Paraná, GraduateCuritibaBrazil
| | - Inacio Crochemore‐Silva
- Postgraduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
- Postgraduate Program in Physical EducationFederal University of PelotasPelotasBrazil
| | | | - Paula K. Hembecker
- Graduate Program in Health TechnologyPontifícia Universidade Católica do Paraná, GraduateCuritibaBrazil
| | - Luiza I. C. Ricardo
- Medical Research Council Epidemiology UnitUniversity of CambridgeCambridgeUK
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Glehn MDPV, Nascimento LMD, Freire KMR, Minuzzi TTCES, Hott CE, Maranhão AGK, Moraes CD. Human papillomavirus vaccination coverage in Northeast Brazil, 2013-2021: a descriptive study. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2023; 32:e2022790. [PMID: 37222355 DOI: 10.1590/s2237-96222023000200012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/27/2023] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVE to describe human papillomavirus (HPV) vaccination coverage in the Northeast region of Brazil, in the period from 2013 to 2021. METHODS this was a descriptive study conducted with data obtained from the National Immunization Program, which sets a goal of 80% coverage of HPV vaccination in girls aged between 9 and 14 years and boys aged between 11 and 14 years. RESULTS HPV vaccination coverage in girls was 73.9%, regarding the first dose, and 54.3% regarding the second dose, and for boys, the coverage of each dose was 49.7% and 32.6%, respectively; with the exception of the states of Ceará and Paraíba, which reached coverage above 80% regarding the first dose in girls, none of the states reached the goal for both doses. CONCLUSIONS between 2013 and 2021, HPV vaccination coverage was below the target for both sexes, with the exception of the states of Ceará and Paraíba, which reached the goal for the first dose in the girls.
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Affiliation(s)
| | | | | | | | - Carlos Edson Hott
- Ministério da Saúde, Secretaria de Vigilância em Saúde e Ambiente, Brasília, DF, Brazil
| | | | - Camile de Moraes
- Ministério da Saúde, Secretaria de Vigilância em Saúde e Ambiente, Brasília, DF, Brazil
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Silva GAE, Claro IB, Tomazelli JG, Ribeiro CM, Girianelli VR, Almeida PFD, Lima LDD. [Reply to the Letter to the Editors by Rotava et al.]. CAD SAUDE PUBLICA 2023; 38:e00215622. [PMID: 36629612 DOI: 10.1590/0102-311xpt215622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 11/17/2022] [Indexed: 01/11/2023] Open
Affiliation(s)
- Gulnar Azevedo E Silva
- Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Itamar Bento Claro
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brasil
| | | | | | - Vania Reis Girianelli
- Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Luciana Dias de Lima
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Mello VMDS, Santos VCGD, Baptista AD, Fonseca SC, Faria CA, Vitral CL, Cavalcanti S. Knowledge about human papillomavirus transmission and prevention among physicians in Rio de Janeiro state, Brazil. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20220291. [PMID: 37098929 PMCID: PMC10176655 DOI: 10.1590/1806-9282.20220291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/14/2022] [Indexed: 04/27/2023]
Abstract
OBJECTIVE This study aimed to assess physicians' knowledge about human papillomavirus infection and its prevention. METHODS Descriptive web-based survey with 15 objective questions targeted to physicians affiliated with the Regional Council of Medicine from Rio de Janeiro state, Brazil. Participants were invited by e-mail and the Council social networks, between January and December 2019. RESULTS The study sample had 623 participants, with a median age of 45 years, predominantly women (63%). The most frequent specialties were Obstetrics and Gynecology (21.1%), Pediatrics (11.2%), and Internists (10.5%). Concerning human papillomavirus knowledge, 27.9% of the participants were able to identify accurately all possible forms of transmission, and none of them could recognize all the risk factors of infection. Nevertheless, 95% recognized that asymptomatic infection could occur in both sexes. Regarding knowledge about clinical manifestations, diagnosis, and screening, only 46.5% were able to identify all human papillomavirus-related cancers, 42.6% were aware of the periodicity of Pap smears, and 39.4% indicated that serological test was not adequate for diagnosis. The recommended age group for human papillomavirus vaccination was recognized by 94% of the participants, as well as the need for a Pap smear and the use of condoms, even after vaccination. CONCLUSIONS There is good knowledge about prevention and screening for human papillomavirus infections; many gaps were identified regarding transmission, risk factors, and associated diseases among physicians in Rio de Janeiro state.
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Affiliation(s)
| | | | | | - Sandra Costa Fonseca
- Universidade Federal Fluminense, Instituto de Saúde Coletiva, Departamento de Epidemiologia e Bioestatística - Niterói (RJ), Brazil
| | - Carlos Augusto Faria
- Universidade Federal Fluminense, Faculdade de Medicina, Departamento Materno Infantil - Niterói (RJ), Brazil
| | - Claudia Lamarca Vitral
- Universidade Federal Fluminense, Instituto Biomédico, Departamento de Microbiologia e Parasitologia - Niterói (RJ), Brazil
| | - Silvia Cavalcanti
- Universidade Federal Fluminense, Instituto Biomédico, Departamento de Microbiologia e Parasitologia - Niterói (RJ), Brazil
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Filho DST, Rocha CMR, Bacha E, Andrade ÁNM, Pereira DDP, Nunes LM, Passos LD, Braz PTS, Braz PAS, Bisneta AIS, Sobrinho F. Current HPV Vaccination Strategies in Brazil. Health (London) 2023. [DOI: 10.4236/health.2023.152009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Luvisaro BMO, Silva TPR, Felisbino-Mendes MS, Silva TMRD, Silva RBD, Lachtim SAF, Freitas GLD, Matozinhos FP. Eventos adversos após a vacina papilomavírus humano em adolescentes no estado de Minas Gerais. REME: REVISTA MINEIRA DE ENFERMAGEM 2022. [DOI: 10.35699/2316-9389.2022.40892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
Objetivo: investigar as notificações dos eventos adversos pós-vacinação papilomavírus humano no Estado de Minas Gerais, segundo a localidade de notificação, causalidade, gravidade, bem como a evolução dos casos. Métodos: estudo epidemiológico realizado com os dados de 2015-2019, notificados no Sistema de Informação de Vigilância de Eventos Adversos. Os dados foram analisados e apresentadas em proporções, segundo as macrorregiões de saúde e os anos do estudo. Resultados: em 2015, foram notificados 26,41% eventos adversos, sendo o ano com maior notificação. Ao se analisar as macrorregiões de saúde, Vale do Jequitinhonha apresentou a menor prevalência de registro, com 0,43%, e a Centro a maior prevalência de notificação (30,95%). Os eventos adversos locais mais prevalentes foram: dor (56,48%) e edema (38,89%). Já quanto aos eventos sistêmicos a cefaleia (29,69%) e gastroenterite (29,69%) tiveram os maiores registros de casos. Os eventos classificados como eventos adversos não graves (59,82%) foram os mais prevalentes e, quanto a causa, 35,94% deles foram atribuídos aos erros de imunização. Conclusão: este estudo reforça que os eventos adversos pós-vacina de HPV foram, em sua maioria, eventos não graves, demonstrando, portanto, a segurança da vacina HPV para o público adolescente e contribuindo para o aumento das taxas de cobertura vacinal.
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Silva IDAG, de Sá ACMGN, Prates EJS, Malta DC, Matozinhos FP, da Silva TMR. Vaccination against human papillomavirus in Brazilian schoolchildren: National Survey of School Health, 2019. Rev Lat Am Enfermagem 2022; 30:e3834. [PMID: 36449928 PMCID: PMC9699524 DOI: 10.1590/1518-8345.6296.3834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE to analyze the prevalence of schoolchildren vaccinated against human papillomavirus (HPV) and the reasons related to non-vaccination. METHOD cross-sectional study, with data from the 2019 National Survey of School Health. The sample consisted of 160,721 students aged 13 to 17 years. The prevalence and confidence intervals (95%CI) of vaccinated adolescents were estimated according to location, sex, and administrative dependence of the school. The differences between the strata were evaluated with the Chi-square test. Adjusted prevalence ratios (aPR) and 95%CI were estimated with the Poisson regression model. RESULTS most of the students were vaccinated (62.9%), and the prevalence of girls (76.1%) was higher than that of boys (49.1%). The most prevalent reason for not vaccinating was "did not know they had to take" (46.8%), with the highest aPR in public schoolchildren in Brazil (1.6; 95%CI 1.5;1.7), from the Northeast region (1.2; 95%CI 1.1;1.2), and in students from private schools in the Northeast regions (1.1; 95%CI 1.1;1.2) and North (1.3; 95%CI 1.2;1.4). CONCLUSION one out of every two Brazilian schoolchildren was vaccinated against HPV. Misinformation was a recurring reason for non-vaccination. The North and Northeast regions had the highest prevalence of non-vaccinated people, observed mainly in adolescents from public schools. HIGHLIGHTS (1) 63% of Brazilian schoolchildren reported having been vaccinated against human papillomavirus (HPV).(2) In Brazil, in 2019, the prevalence of immunized girls was higher than that of boys.(3) Misinformation and fear are reasons for hesitating vaccination.(4) Social and health inequalities may reflect upon HPV vaccination.(5) Achieving the goal of 80% in HPV vaccination coverage is a challenge in Brazil.
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Affiliation(s)
- Isabella de Alcântara Gomes Silva
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | | | - Elton Junio Sady Prates
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil,Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Fernanda Penido Matozinhos
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | - Tércia Moreira Ribeiro da Silva
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
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Luvisaro BMO, da Silva TPR, da Silva TMR, Lachtim SAF, Souza JFA, Matozinhos FP. Environmental factors associated with human papillomavirus vaccine coverage in adolescents: 2016-2020 analysis. Rev Lat Am Enfermagem 2022; 30:e3804. [PMID: 36449925 PMCID: PMC9695280 DOI: 10.1590/1518-8345.6285.3804] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/15/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE to analyze the association between the factors of the social environment and the coverage rates of the human papillomavirus (HPV) vaccine in adolescents, in the State of Minas Gerais, Brazil. METHOD this is an epidemiological, ecological study, with panel and trend analysis from 2016 to 2020. The population consisted of adolescents aged 9 to 13 years. The environmental variables were coverage rates, the municipal index of human development, income, education, and longevity; and the rate of violence. The Prais-Winsten autoregression and the panel regression model were used, in addition to the estimate of the mean annual percentage variation. RESULTS the vaccination coverage rates are below the goals recommended by the Ministry of Health for all regions analyzed. Moreover, these rates are associated with factors related to the application of the first dose and to aspects inherent to the social environment, such as the rate of violence. CONCLUSION our findings showed that, although tenuous, aspects of the environment, in addition to individual characteristics, provide relevant information to understand the occurrence of health outcomes, since this vaccination campaign presents a strong influence of the environment and age as factors associated with the low rates. HIGHLIGHTS (1) The coverage of human papillomavirus vaccination is below the target in Minas Gerais.(2) The rates are associated with aspects inherent to the social environment, such as violence.(3) The environment provides relevant information for understanding health outcomes.
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Ferreira GRON, Formigosa JADS, Lira ALBDC, Reis RK, Gir E, Freitas WLS, Carvalho JN, Gonçalves LHT, Botelho EP, Ramos AMPC. The Family Health Strategy Influence on the Human Papillomavirus Vaccine Acceptance in a Peripheral Community of the Brazilian Amazon Region. Health Equity 2022; 6:852-861. [DOI: 10.1089/heq.2022.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | | | - Renata Karina Reis
- Graduate Program in Fundamental Nursing, Ribeirão Preto, Sao Paulo, Brazil
| | - Elucir Gir
- Graduate Program in Fundamental Nursing, Ribeirão Preto, Sao Paulo, Brazil
| | | | - Jacira Nunes Carvalho
- Graduate Nursing Program at the Federal University of Pará (UFPA), Belém, Pará, Brazil
| | | | - Eliã Pinheiro Botelho
- Graduate Nursing Program at the Federal University of Pará (UFPA), Belém, Pará, Brazil
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Corrêa FM, Migowski A, de Almeida LM, Soares MA. Cervical cancer screening, treatment and prophylaxis in Brazil: Current and future perspectives for cervical cancer elimination. Front Med (Lausanne) 2022; 9:945621. [PMID: 36091685 PMCID: PMC9449345 DOI: 10.3389/fmed.2022.945621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
As a middle-income country, Brazil has one of the largest public health systems worldwide, which deals with free and universal access to health care. Regarding cervical cancer, the country possesses a large infrastructure for the screening of premalignant and malignant lesions, but yet based on old technology, having Papanicolaou as the major screening method, followed by colposcopy and treatment. Also, large disparities in access are present, which makes effectiveness of screening and treatment in different regions of the country highly unequal. In this review, we describe and evaluate the current screening, treatment and prophylactic (HPV vaccination) strategies to combat cervical cancer in Brazil, and discuss potential incorporation of more recent technologies in these areas in the country to pave its way toward cervical cancer elimination.
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Affiliation(s)
- Flávia M. Corrêa
- Cancer Early Detection Division, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
| | - Arn Migowski
- Cancer Early Detection Division, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
| | - Liz M. de Almeida
- Coordination of Prevention and Surveillance, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
| | - Marcelo A. Soares
- Oncovirology Program, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
- Department of Genetics, Universidade Federal Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Galvão SM, Atanaka M, Sousa NFDS, Galvão ND. Potential years of life lost to cancer in Mato Grosso, stratified by sex: 2000 to 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220009. [PMID: 35766766 DOI: 10.1590/1980-549720220009.supl.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 12/13/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To estimate the potential years of life lost (PYLL) to cancer in the State of Mato Grosso, from 2000 to 2019, stratified by sex, according to age groups and cancer types. METHODS It is a quantitative study with an ecological approach developed from secondary data, using the PYLL and its derivatives. RESULTS In the period analyzed, deaths from cancer in Mato Grosso resulted in 680,338 PYLL before the age of 80, with a variation of 82.5%. Of this total, 52.7% were assigned to males. The rate of the PYLL for cancer before the age of 60 was 70.9% in males, and 80.1% among women. The rates of PYLL increased in the period and showed slightly higher values in males. In the analysis according to age group, the rates of PYLL were also higher in males, except between the ages of 30 and 49. Lung cancers and lymphomas/leukemias resulted in greater losses of PYLL among men and female specific cancers (breast, cervical and uterine, and ovarian cancer) accounted for 36.26% of the PYLL among women, with variability per age groups. CONCLUSION In Mato Grosso, the PYLL indicator for cancer presented unfavorable evolution between 2000 and 2019, with greater damage for males and for the younger population. Leukemias, lymphomas, and lung and breast cancers were the main causes for the PYLL.
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Affiliation(s)
- Silvano Macedo Galvão
- Universidade Federal de Mato Grosso, Law School - Cuiabá (MT), Brazil.,Universidade Federal de Mato Grosso, Institute for Collective Health, Postgraduate Program - Cuiabá (MT), Brazil
| | - Marina Atanaka
- Universidade Federal de Mato Grosso, Institute for Collective Health - Cuiabá (MT), Brazil
| | | | - Noemi Dreyer Galvão
- Universidade Federal de Mato Grosso, Institute for Collective Health - Cuiabá (MT), Brazil
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da Silva DCB, Garnelo L, Herkrath FJ. Barriers to Access the Pap Smear Test for Cervical Cancer Screening in Rural Riverside Populations Covered by a Fluvial Primary Healthcare Team in the Amazon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4193. [PMID: 35409875 PMCID: PMC8998957 DOI: 10.3390/ijerph19074193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/21/2022] [Accepted: 03/29/2022] [Indexed: 02/01/2023]
Abstract
Cervical cancer is a major public health problem, especially in the north region of Brazil. The aim of the study was to identify the factors associated with not undergoing the cervical cancer screening test in rural riverside populations in the Amazon. A cross-sectional home-based survey was carried out in 38 locations covered by a fluvial primary healthcare team, and the administrative records of the screening tests from January 2016 to May 2019 were analyzed. After the descriptive analysis, logistic regression was performed considering the outcome of having undergone cervical cancer screening within the past three years. Of the 221 women assessed, 8.1% had never undergone the test, and 7.7% had undergone it more than three years ago. Multiparity (OR = 0.76 (95%CI = 0.64-0.90)), occupation in domestic activities (OR = 0.31 (95%CI = 0.11-0.89)), and lack of knowledge of the healthcare unit responsible for the service (OR = 0.18 (95%CI = 0.04-0.97)) were associated with not undergoing the cervical cancer screening test. The administrative records revealed that the screening test was performed outside the recommended age range (24%), performed needlessly (9.6%) with undue repetitions (3.2%), and a high percentage of the samples collected were unsatisfactory (23.5%). The findings revealed the existence of barriers for riverside women to access cervical cancer screening tests.
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Affiliation(s)
- Débora C. B. da Silva
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Rua Teresina 476, Manaus 69057-070, Brazil; (D.C.B.d.S.); (L.G.)
| | - Luiza Garnelo
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Rua Teresina 476, Manaus 69057-070, Brazil; (D.C.B.d.S.); (L.G.)
| | - Fernando J. Herkrath
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Rua Teresina 476, Manaus 69057-070, Brazil; (D.C.B.d.S.); (L.G.)
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Av. Carvalho Leal 1777, Manaus 69065-001, Brazil
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15
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Silva TMRD, Nogueira de Sá ACMG, Beinner MA, Abreu MNS, Matozinhos FP, Sato APS, Vieira EWR. Impact of the COVID-19 Pandemic on Human Papillomavirus Vaccination in Brazil. Int J Public Health 2022; 67:1604224. [PMID: 35431762 PMCID: PMC9008128 DOI: 10.3389/ijph.2022.1604224] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 03/03/2022] [Indexed: 11/25/2022] Open
Abstract
Objective: To analyze the number of applied HPV vaccine doses before (from April 2019 to March 2020) and after (from April 2020 to September 2020) social distancing measures in response to the COVID-19 pandemic in states and regions of Brazil. Methods: Ecological time-series study, using data from the Brazilian National Immunization Program (PNI). Using the Mann-Whitney test, we evaluated the difference between the median number of applied doses during the periods April 2019 to March 2020 and from April 2020 to September 2020. Spatial analysis identified clusters with a high or low percentage reduction in the median applied doses. Prais-Winsten regression models identified temporal trends in the applieddoses from both periods. Results: There was a significant reduction in the median HPV vaccine doses applied, formation of spatial clusters and, after a sharp drop in the number of applieddoses during the months following social distancing. There was a tendency to increase the applied vaccines doses. Conclusion: The COVID-19 pandemic resulted in reduction of the number of HPV vaccine doses applied as a possible effect of restrictive measures caused by the pandemic.
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Affiliation(s)
- Tércia Moreira Ribeiro Da Silva
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Mark Anthony Beinner
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Fernanda Penido Matozinhos
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Ed Wilson Rodrigues Vieira
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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16
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Galvão SM, Atanaka M, Sousa NFDS, Galvão ND. Anos potenciais de vida perdidos por câncer em Mato Grosso, estratificados por sexo: 2000 a 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220009.supl.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
RESUMO: Objetivo: Estimar os anos potenciais de vida perdidos por câncer no estado de Mato Grosso, no período de 2000 a 2019, estratificando os dados por sexo, segundo faixas etárias e tipos de câncer. Métodos: Trata-se de um estudo quantitativo, com abordagem ecológica a partir de dados secundários, utilizando-se o indicador anos potenciais de vida perdidos e seus derivados. Resultados: No período analisado, as mortes por câncer em Mato Grosso resultaram em 680.338 anos potenciais de vida perdidos antes dos 80 anos, com variação de 82,5%. Desse total, 52,7% foram atribuídos ao sexo masculino. O peso dos anos potenciais de vida perdidos por câncer antes dos 60 anos foi de 70,9% no sexo masculino e 80,1% entre as mulheres. As taxas de anos potenciais de vida perdidos aumentaram no período estudado e apresentaram valores ligeiramente mais elevados entre os homens. Na análise segundo faixas etárias, as taxas de anos potenciais de vida perdidos também foram maiores entre os homens, exceto entre 30 e 49 anos. Os cânceres de pulmão e linfomas/leucemias resultaram em maiores perdas de anos potenciais de vida entre os homens, e os cânceres de especificidade feminina (mama, colo e corpo do útero e ovário) responderam por 36,26% dos anos potenciais de vida perdidos entre as mulheres, com variabilidade por faixas etárias. Conclusão: Em Mato Grosso, o indicador anos potenciais de vida perdidos por câncer apresentou evolução desfavorável entre 2000 e 2019, com maior prejuízo para o sexo masculino e para a população mais jovem. As leucemias, linfomas e cânceres de pulmão e mama foram os principais responsáveis pelos anos potenciais de vida perdidos.
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Affiliation(s)
- Silvano Macedo Galvão
- Universidade Federal de Mato Grosso, Brazil; Universidade Federal de Mato Grosso, Brazil
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17
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Filho DST, Rocha CMR, Bacha E, Beltrão MC, Barros LMD, Andrade ÁNM, Valadares FT, Machado YN. HPV Vaccine: Integrative Review of National and International Guidelines. Health (London) 2022. [DOI: 10.4236/health.2022.1412091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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18
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Luvisaro BMO, Silva TPRD, Silva TMRD, Lachtim SAF, Souza JFA, Matozinhos FP. Factores ambientales asociados con la cobertura de la vacuna contra el virus del papiloma humano en adolescentes: análisis de 2016 a 2020. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.6285.3803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Resumen Objetivo: analizar la asociación entre los factores del entorno social y las tasas de cobertura de la vacuna contra el virus del papiloma humano (VPH) en los adolescentes del estado de Minas Gerais. Método: estudio epidemiológico, ecológico, con análisis de panel y de tendencia, en el período de 2016 a 2020. La población estaba compuesta por adolescentes de 9 a 13 años. Las variables ambientales fueron las tasas de cobertura; el índice de desarrollo humano municipal, la renta, la educación y la longevidad, y la tasa de violencia. Se utilizó el modelo autorregresivo de Prais-Winsten, el cálculo de la variación porcentual media anual y la regresión en panel. Resultados: las tasas de cobertura de la vacuna en todas las regiones analizadas están por debajo de los objetivos recomendados por el Ministerio de Salud. Además, estas tasas están asociadas a los factores relacionados con la aplicación de la primera dosis y a aspectos inherentes al entorno social, como la tasa de violencia. Conclusión: las evidencias encontradas demostraron que, aunque tenues, aspectos del entorno, además de las características individuales, proporcionan informaciones relevantes para comprensión de la ocurrencia de los resultados de salud, una vez que para esa vacuna tenemos la fuerte influencia del entorno y de la edad como factores asociados a la baja tasa de vacunación.
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Luvisaro BMO, Silva TPRD, Silva TMRD, Lachtim SAF, Souza JFA, Matozinhos FP. Fatores ambientais associados à cobertura da vacina contra o papilomavírus humano em adolescentes: análise de 2016 a 2020. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.6285.3805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Resumo Objetivo: analisar a associação entre os fatores do ambiente social e as taxas de cobertura da vacina contra o papilomavírus humano (HPV) nos adolescentes do estado de Minas Gerais. Método: estudo epidemiológico, ecológico, com análise em painel e de tendência, no período de 2016 a 2020. A população foi composta por adolescentes de 9 a 13 anos. As variáveis ambientais foram as taxas de cobertura; o índice de desenvolvimento humano municipal, de renda, de educação e de longevidade; e a taxa de violência. Utilizou-se o modelo autorregressivo de Prais-Winsten, o cálculo da variação percentual média anual e a regressão em painel. Resultados: as taxas de cobertura da vacina em todas as regiões analisadas estão abaixo das metas preconizadas pelo Ministério da Saúde. Ademais, tais taxas estão associadas aos fatores relacionados à aplicação da primeira dose e a aspectos inerentes ao ambiente social, como a taxa de violência. Conclusão: as evidências encontradas demonstraram que, embora tênues, aspectos do ambiente, além das características individuais, fornecem informações relevantes para compreensão da ocorrência dos desfechos de saúde, uma vez que para essa vacina temos a forte influência do ambiente e da idade como fatores associados à baixa taxa de vacinação.
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