Fatores Predisponentes Do Câncer De Pênis: Uma Revisão De Literatura

AVALIAÇÃO EPIDEMIOLÓGICA DO CÂNCER DE CABEÇA E PESCOÇO NO BRASIL: MORTALIDADE E FATORES DE RISCO REGIONAIS

RESUMO: O objetivo deste estudo foi analisar a real situação dos casos e óbitos por câncer de cabeça e pescoço (HNC) e avaliar práticas e estratégias para melhorar a compreensão da população frente aos principais fatores de risco no Brasil. Trata-se de um estudo retrospectivo descritivo com abordagem quantitativa, por análise de dados sobre mortalidade do HNC no Brasil entre 2014 e 2018, proveniente do Atlas de Mortalidade por Câncer. Foram analisadas as variáveis sociodemográficas, faixas etárias, sexo, verificando taxas de óbitos aplicados ao método de Variação Percentual Média Anual (AAPC) e estatística descritiva. Verificou-se que a taxa de óbito do HNC acometendo homens foi 369,40% maior que nas mulheres. As idades mais afetadas estiveram no grupo entre 60 a 69 anos para homens e mulheres (n= 14.159; 2.354), respectivamente. Houve crescimento na taxa de mortalidade para mulheres nos últimos anos. Assim, é possível confirmar que HNC no Brasil merece atenção da saúde pública e que demanda ações efetivas aplicadas à população.

Palavras-chave: Neoplasias de cabeça e pescoço; Fatores de risco; Epidemiologia descritiva; Oncologia.

EPIDEMIOLOGICAL ASSESSMENT OF HEAD AND NECK CANCER IN BRAZIL: MORTALITY AND REGIONAL RISK FACTORS

ABSTRACT: The objective of this study was to analyze the real situation of cases and deaths from head and neck cancer (HNC) and to evaluate practices and strategies to improve the population understanding of the main risk factors in Brazil. This was a retrospective descriptive quantitative study that analyzed data on mortality from the HNC in Brazil between 2014 and 2018, from the Atlas of Cancer Mortality. Analyses were carried out for sociodemographic variables, age groups, sex and death rates using the Average Annual Percent Change (AAPC) method and descriptive statistics. HNC death rate affecting men was 369.40% higher than in women. The most affected ages were in the group between 60 and 69 years for men and women (n = 14,159; 2,354), respectively. However, the mortality rate increased for women in recent years. Thus, it is possible to confirm that HNC in Brazil deserves public health attention and demands effective actions applied to the population.

Key words: Head and Neck Neoplasms; Risk factors; Descriptive Epidemiology; Oncology.

INTRODUCTION

The term Head and Neck Cancer (HNC) is defined by malignant neoplasms diagnosed in the upper aerodigestive tract. For this type of neoplasm, there is a specific area of oncology that carries out the study, diagnosis, prevention and treatment of various segments of this part of the body, such as tumors found in the regions of the oral cavity, larynx, pharynx and paranasal sinuses¹.

Squamous cell carcinoma is the most frequent histological type of cancer, present in more than 90% cases, with a record of high mortality, while the remaining 10% are presented by the various malignant tumors from odontogenic infections and variants of the squamous cell carcinoma, lymphomas, melanomas and sarcomas².

Etiological factors of neoplasms in the head and neck segments are attributed to habits and lifestyle, which influence cancer development, with individual or concomitant action; smoking and alcohol consumption can be cited as the main agents, because when together they have a synergistic effect, becoming preponderant factors, and in addition, the etiology can also be related to the place where the individual lives, exposure to radiation, chemical agents, viruses, genetic predisposition, disease-causing agents, leukoplakia and/or erythroplakia, poor oral hygiene and poor tooth conservation³.

According to the World Health Organization (WHO), in 2018, there were about 18 million new cases of cancer, close to 10 million deaths worldwide. The global forecast of this burden is to double to about 29 to 37 million new cases by 2040, with a projected global growth of approximately 60% cancer cases in the coming decades, with the largest increases identified in low- and middle-income countries, and the lack of resources for prevention is the main cause for this development4.

In the period from 2014 to 2015, 576 thousand new cases of cancer were considered in Brazil, including non-melanoma skin cases5. Currently, it is estimated that the country may have 625,000 new cases of cancer annually in the triennium from 2020 to 2022, excluding cases of non-melanoma skin cancer, there are a total of 450,000 new cases for each year of the triennium6.

Taking into account that the epidemiological spread of cancer in Brazil projects an evolution for the coming years, involving a growth in the types and numbers of cancer, including head and neck cancer, mainly associated with socioeconomic status and its various risk factors, consequently, become worrying facts, as it is necessary to monitor and control the incidence of cancer, as well as to examine the transitions in the patterns of this disease7.

In this way, this study aimed to evaluate data from the Atlas of Cancer Mortality of the National Cancer Institute (INCA) and literature on epidemiology, focusing on head and neck cancer in Brazil from 2014 to 2014, presenting an analysis of the sociodemographic distribution for the five Brazilian regions and emphasizing the main risk factors.

In view of the above, the authors aimed to contribute to epidemiological studies, as they are of great importance, and allow to analyze the real situation of society, as well as to evaluate and put into practice strategies and actions to have an impact on the understanding of foundations that determine the advance of head and neck cancer in our country.

METHODOLOGY

        This was a retrospective descriptive quantitative study, based on the analysis of digital data. The adopted records on HNC mortality were collected by the Atlas of Cancer Mortality - National Cancer Institute (INCA)8, considering the updated data from 2014 to 2018.

Data collected and used here are public domain and available at the following electronic address: www.inca.gov.br, therefore, it was not necessary to submit the project to the human research ethics committee. Data were analyzed using Microsoft Excel software.

The use of the Atlas of Cancer Mortality, in the present study, was due to the association of information, as it contains digital data, free of charge and publicly, periodically estimates of mortality rates, through the information provided by the sources of the Mortality Information System (SIM/DATASUS), gathering elements on deaths from malignant neoplasms in Brazil until the year 2018; thus, giving results in tabulated configurations, in the form of graphs and maps.