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Tanaka R, Matsuzaka M, Sasaki Y. Risk Factors Contributing to Disparities in Medical Treatment and Lower Survival Rates among Patients with Non-Small Cell Lung Cancer Induced by Residential Areas. Asian Pac J Cancer Prev 2024; 25:185-190. [PMID: 38285783 PMCID: PMC10911731 DOI: 10.31557/apjcp.2024.25.1.185] [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: 08/21/2023] [Accepted: 01/19/2024] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVE Because of a lack of medical resources for cancer treatment, particularly in rural areas, there are disparities in receiving medical treatment between urban and rural area. This study examined the association between residential area or areal deprivation index (ADI) and lack of surgical treatment or chemotherapy in patients with non-small cell lung cancer (NSCLC) in rural area, Japan. METHODS We analyzed the Aomori population-based cancer registry data from 926 cancer patients with NSCLC diagnosed between January and December 2014. Multivariable logistic regression and Cox proportional hazards models were used to examine association of patients' residential area/ADI with either surgery/chemotherapy or survival time, respectively. The residential area was divided into six medical areas based on the location of specialist hospitals. The medical areas were defined by Aomori Prefecture. RESULTS The residential area (medical area) was strongly associated with access to cancer treatment for patients with NSCLC and ultimately contributed to lower survival rates. There was no significant influence in the distance from home to hospital and areal deprivation. CONCLUSION We identified the risk factors related to a lack of medical treatment and shorter survival in rural area, Japan.
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Affiliation(s)
- Rina Tanaka
- Department of Medical Informatics, Hirosaki University, Graduate School of Medicine, Japan.
| | | | - Yoshihiro Sasaki
- Department of Medical Informatics, Hirosaki University, Graduate School of Medicine, Japan.
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Bonometto JVB, Sette CVDM, Santi PX, Maselli-Schoueri JH, Giglio AD, Cubero DDIG. Critical assessment of resource waste in staging and follow-up of breast cancer. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230565. [PMID: 38055451 DOI: 10.1590/1806-9282.20230565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 08/27/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Breast cancer is a public health problem with both high incidence and cure rates. After treatment, patients are monitored for long periods of time due to the risk of recurrence. Thus, staging and follow-up strategies should consider not only the best results for the patient but also its costs for the public health system. OBJECTIVE The objective of this study was to quantify the waste of resources on breast cancer follow-up and evaluate its impact on the public health system. METHODS This is a retrospective analysis of consecutive medical records to identify the intervals between consultations and tests used for staging and during the first 2 years of follow-up of patients with breast cancer treated at a public hospital in Brazil. Data were compared with the guidelines of the main international consensus. RESULTS Medical records of 60 consecutive patients treated in 2018 were selected, of whom 52 had 2 or more years of follow-up, and 8 had only 1 year of complete follow-up. A total of 34 patients (56.67%) underwent excessive examinations for stating. During follow-up, 125 surplus consultations were performed (33.6%). In this phase, 111 surplus exams were also performed, representing an increase of 100.9%. A total of 423 laboratory tests were performed for 18 patients in the first year and 229 tests for 14 patients in the second year. CONCLUSION Excessive tests and consultations significantly burdened the Unified Health System without any benefit to patients. Better adherence to staging and follow-up recommendations could reduce costs and optimize the limited resources used in the public health system.
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Affiliation(s)
| | - Claudia Vaz de Melo Sette
- Centro Universitário Faculdade de Medicina do ABC, Department of Oncology - Santo André (SP), Brazil
| | - Patricia Xavier Santi
- Centro Universitário Faculdade de Medicina do ABC, Department of Oncology - Santo André (SP), Brazil
| | | | - Auro Del Giglio
- Centro Universitário Faculdade de Medicina do ABC, Department of Oncology - Santo André (SP), Brazil
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da Luz Costa T, Dantas DB, de Campos Gomes F, Soares CO, Castelhano JR, Fonseca LC, Neves LMT, Figueiredo ERL, de Melo Neto JS. Impacts of Sociodemographic Factors, Screening, and Organization of Health Services on Breast Cancer Mortality in Brazil: An Ecological Study of 20 Years. Int J Breast Cancer 2023; 2023:6665725. [PMID: 37936925 PMCID: PMC10627721 DOI: 10.1155/2023/6665725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/20/2023] [Accepted: 10/04/2023] [Indexed: 11/09/2023] Open
Abstract
Background Breast cancer mortality is increasing in Brazil. This study examines the impact of sociodemographic factors, screening procedures, and primary healthcare (PHC) on breast cancer mortality. Methods An ecological study analyzed secondary data of women diagnosed with breast cancer who died between 2000 and 2019. Sociodemographic factors, screening procedures, and PHC were examined in relation to breast cancer mortality. Statistical analyses included normality tests, Kruskal-Wallis and one-way ANOVA tests with post hoc comparisons, Pearson and Spearman correlation tests, age-period-cohort analysis, Kaplan-Meier analysis, and Cox regression analysis. Significance was set at p < 0.05. Results Mortality rates were higher in the southeast (15.77) and south (15.97) regions compared to the north (5.07) (p < 0.0001). Survival rates were longer in the southeast (70.3 ± 0.05) and south (70.6 ± 0.09) than in the north (63.98 ± 0.053) (p ≤ 0.001). Mortality increased with age after 32 years (p ≤ 0.001). Brown and indigenous women had lower mortality and survival rates. Increased coverage of PHC, ultrasound, and biopsy did not reduce mortality. However, improved cytopathologic analysis led to a decrease in mortality. Conclusions Sociodemographic factors, screening procedures, and PHC are specific predictors of breast cancer mortality in Brazil.
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Affiliation(s)
- Thalita da Luz Costa
- Institute of Health Sciences, Federal University of Pará (UFPA), Belém, PA, Brazil
| | - Diego Bessa Dantas
- Institute of Health Sciences, Federal University of Pará (UFPA), Belém, PA, Brazil
| | - Fabiana de Campos Gomes
- Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
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dos Santos L, Roszkowski I, Pujals C, de Oliveira RR, Fernando Castilho FC, Borghesan DHP, Romani I, Bitencourt MR, Alarcão ACJ, Marques VD, Pereira Silva MDA, Carvalho MDDB, Raíssa Bocchi RB, Pelloso SM. Comparative Analysis of Mortality due to Breast Cancer and Mammography Uptake in the Federative Units of Brazil-2015 to 2021. Asian Pac J Cancer Prev 2023; 24:4339-4348. [PMID: 38402419 PMCID: PMC10909118 DOI: 10.31557/apjcp.2023.24.12.4339] [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: 06/12/2023] [Accepted: 11/28/2023] [Indexed: 02/26/2024] Open
Abstract
Objective: Compare the breast cancer mortality rate and the rate of mammograms with socioeconomic factors, in Brazilian´s Federative Units, during the period of 2015 to 2021. Methods: This is an ecological study, of a descriptive nature, which covers the 27 Brazilian federative units, using secondary data extracted from the DATASUS System. The information analyzed was mammography data, breast cancer mortality, demographic and economic data of the resident population and women over 20 years of age. Results: There is a direct relationship between mortality rate and mammograms rates in the Federative Units. The data obtained for Brazil presents a total of 133,048 deaths from breast cancer and 17,324,526 mammography exams in the period from 2015 to 2021. In other words, Brazil presents a standardized mortality rate value, 19.25 deaths per 100,000 women. Regarding the mammography rate, the value of the exam-specific mammography rate was 2,506.55 per 100,000 women. In relation to socioeconomic data by mortality rate group, higher mortality rates from breast cancer present higher rates in the variables: income rate by State (2,594.86), people with income (63.5), average percentage of women with more over 50 years old (29.5%), women with average years of education (6.64), white population (55.1%) and mammography exam rate (2873.20). When analysing the highest rates of mammography exam rates, higher rates are observed income rate by State (2,161.47), people with income (62.5%), average percentage of women over 50 years old (28.6%), women with an average number of years of education (5.8). Conclusion: Brazil has a high mortality rate due to breast cancer, when compared to other countries. The reasons are diverse, such as the modern, industrialized and populous lifestyle. The Federative Units with the highest mortality rate also have high rates of mammograms, that is, in the Federative Units with "better" sociodemographic conditions, the South and Southeast.
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Affiliation(s)
- Lander dos Santos
- Post-Graduation Program in Health Sciencies at State University of Maringa, PR, Brazil.
| | - Igor Roszkowski
- Post-Graduation Program in Health Sciencies at State University of Maringa, PR, Brazil.
| | - Constanza Pujals
- Post-Graduation Program in Health Sciencies at State University of Maringa, PR, Brazil.
| | | | | | | | - Isaac Romani
- Post-Graduation Program in Health Sciencies at State University of Maringa, PR, Brazil.
| | | | | | | | | | | | | | - Sandra Marisa Pelloso
- Post-Graduation Program in Health Sciencies at State University of Maringa, PR, Brazil.
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Rocha AFBM, Freitas-Junior R, Ferreira GLR, Rodrigues DCN, Rahal RMS. COVID-19 and Breast Cancer in Brazil. Int J Public Health 2023; 68:1605485. [PMID: 36938303 PMCID: PMC10020228 DOI: 10.3389/ijph.2023.1605485] [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: 10/13/2022] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
Objectives: This study aimed to evaluate COVID-19 effects on breast cancer screening and clinical stage at diagnosis in patients of 50-69 years of age receiving care within the public healthcare network (SUS) in 2013-2021 in Brazil and its macro-regions. Methods: This ecological study used Poisson regression to analyze trends in screening and staging. A secondary database was formed using SUS sources: outpatient data system of the SUS network and Oncology-Brazil Panel. Results: There was a reduction in screening, with an annual percent change of -5.9 (p < 0.022). The number of notified cases fell by 31.5% in 2020-2021 compared to 2018-2019. There was a 10.7% increase in the proportion of stage III/IV cases (p < 0.001) in 2020-2021 compared to 2013-2019, now surpassing the number of cases of early stage breast cancer. Conclusion: COVID-19 led to a reduction in breast cancer screening and an expressive increase in advanced tumors in users of the public healthcare network. Urgent interventions in public policies are required as the negative effects of the pandemic on the diagnosis/treatment of breast cancer are becoming apparent even earlier than expected.
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Affiliation(s)
- Aline Ferreira Bandeira Melo Rocha
- Postgraduate Program in Health Sciences, Federal University of Goiás, Goiânia, Brazil
- *Correspondence: Aline Ferreira Bandeira Melo Rocha,
| | - Ruffo Freitas-Junior
- Advanced Center for Breast Diagnosis (CORA), Federal University of Goiás, Goiânia, Brazil
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Cuoghi IC, da Silva Soares MF, dos Santos GMC, dos-Reis FJC, Poli-Neto OB, de Andrade JM, Bosquesi PL, Orlandini LF, Tiezzi DG. 10-year opportunistic mammographic screening scenario in Brazil and its impact on breast cancer early detection: a nationwide population-based study. J Glob Health 2022; 12:04061. [PMID: 36227588 PMCID: PMC9564571 DOI: 10.7189/jogh.12.04061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- Isabela Campeti Cuoghi
- CEPAM – Centro de Pesquisa Avançada em Medicina da UNILAGO, Faculdade de Medicina UNILAGO, União das Faculdades dos Grandes Lagos, São José do Rio Preto, São Paulo, Brazil
| | - Mariana Furlani da Silva Soares
- CEPAM – Centro de Pesquisa Avançada em Medicina da UNILAGO, Faculdade de Medicina UNILAGO, União das Faculdades dos Grandes Lagos, São José do Rio Preto, São Paulo, Brazil
| | | | | | - Omero Benedicto Poli-Neto
- Faculdade de Medicina de Ribeirão Preto FMRP – USP, Ribeirão Preto, São Paulo, Brazil
- Laboratory for Translational Data Science - University of São Paulo, São Paulo, Brazil
| | | | - Priscila Longhin Bosquesi
- CEPAM – Centro de Pesquisa Avançada em Medicina da UNILAGO, Faculdade de Medicina UNILAGO, União das Faculdades dos Grandes Lagos, São José do Rio Preto, São Paulo, Brazil
- Faculdade de Ciências Farmacêuticas UNESP, Araraquara, São Paulo, Brazil
| | | | - Daniel Guimarães Tiezzi
- CEPAM – Centro de Pesquisa Avançada em Medicina da UNILAGO, Faculdade de Medicina UNILAGO, União das Faculdades dos Grandes Lagos, São José do Rio Preto, São Paulo, Brazil
- Faculdade de Medicina de Ribeirão Preto FMRP – USP, Ribeirão Preto, São Paulo, Brazil
- Laboratory for Translational Data Science - University of São Paulo, São Paulo, Brazil
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Moterani Júnior NJW, Moterani VC, Moterani LBBG, Pimentel FF, Reis FJCD. Impact of coronavirus disease 2019 pandemic on breast cancer screening and detection of high-risk mammographic findings. REVISTA DA ASSOCIAÇÃO MÉDICA BRASILEIRA 2022; 68:842-846. [DOI: 10.1590/1806-9282.20220182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 11/22/2022]
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Nascimento JHF, Vieira ATS, Souza Filho BM, Tomaz SC, Delgado Bocanegra RE, Melo Costa VS, Johnson LFP, Gusmão-Cunha A, Silva Neto MM, Andrade AB. Breast cancer in Brazil: Screening program and surgical approach. Cancer Epidemiol 2021; 73:101970. [PMID: 34216956 DOI: 10.1016/j.canep.2021.101970] [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: 12/22/2020] [Revised: 06/01/2021] [Accepted: 06/16/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Screening mammography for breast cancer (BC) is a current strategy that reduces the mortality of BC by up to 30 %. Although mastectomy has been an important component of treatment for decades, conservative surgery (lumpectomy) has become the gold-standard approach for most cases, yet it depends on early detection of the BC. METHODS This was an epidemiological study performed through DATASUS (2010-2018). We evaluated the temporal trend of screening mammograms, deaths from BC, and surgical procedures at national, regional and state levels. Statistical analysis was performed on VassarStat®-Website for Statistical Computation (Vassar College, New York, USA) and the R-software (R Foundation, v.4.0.3). RESULTS During 2010-2018 there were 67,392 oncological mastectomies and 48,567 lumpectomies in Brazil's health system. Mastectomies decreased in the Northeast (-3.67 % ± 0.43 per year) and in Bahia state (-3.58 % ± 0.24 per year). Lumpectomies increased in Brazil (median 2.19 (-9.6 to 20.96)), the Northeast (median -12.07 (-25.8 to 9.43)) and Bahia (median 0.16 (-29.1 to 1.9)). Also, screening mammograms increased in Brazil (3.29 % ± 0.43), the Northeast (6.36 % ± 0.49) and Bahia (5.51 % ± 0.31), with 35,317,728 exams during this period. Deaths from BC increased annually in Brazil (+4.13 % ± 0.86), the Northeast (+4.76 % ± 1.45) and Bahia (+5.65 % ± 0.83). CONCLUSION The number of mammograms related to the screening program increased in the years 2010-2018 in Brazil. Furthermore, we identified an increase in lumpectomies as opposed to mastectomies, and this approach is associated with a reduction in hospitalization days by almost a half, which in turn might result in a cost decrease and probably an earlier return to work.
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Affiliation(s)
| | | | | | | | | | | | | | - André Gusmão-Cunha
- Department of Life Sciences, Universidade do Estado da Bahia (UNEB), Salvador, BA, Brazil
| | | | - André Bouzas Andrade
- Department of Life Sciences, Universidade do Estado da Bahia (UNEB), Salvador, BA, Brazil; Hospital Santa Izabel (HSI), Salvador, BA, Brazil.
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Kriaucioniene V, Petkeviciene J. Predictors and Trend in Attendance for Breast Cancer Screening in Lithuania, 2006-2014. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224535. [PMID: 31744058 PMCID: PMC6887946 DOI: 10.3390/ijerph16224535] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/08/2019] [Accepted: 11/14/2019] [Indexed: 12/24/2022]
Abstract
In Lithuania, a Nationwide Breast Cancer (BC) Screening Program was launched in 2005, offering mammography for women aged 50 to 69 years, every other year. This study aimed to determine the trend in the attendance for mammography screening during 2006–2014 and to identify the factors that are predictive for participation in it. The study sample consisted of 1941 women aged 50–64 years, who participated in five cross-sectional biennial postal surveys of Lithuanian Health Behavior Monitoring, carried out in independent national random samples. The attendance for screening was identified if women reported having had a mammogram within the last two years. The proportion of women attending the screening was continuously increasing from 20.0% in 2006 up to 65.8% in 2014. The attendance for BC screening was associated with the participation in cervical cancer screening. A higher level of education, living in a city, frequent contact with a doctor, and healthy behaviors (fresh-vegetable consumption, physical activity, and absence of alcohol abuse) were associated with higher participation rates in BC screening. To increase BC screening uptake and to reduce inequalities in attendance, new strategies of organized BC screening program using systematic personal invitations are required in Lithuania.
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