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Ribeiro K.B.,International Agency for Research on Cancer | Levi J.E.,University of Sao Paulo | Pawlita M.,German Cancer Research Center | Matos E.,University of Buenos Aires | And 21 more authors.
International Journal of Epidemiology | Year: 2011

Background: Recent studies support an important role for human papillomavirus (HPV) in a subgroup of head and neck squamous cell carcinomas (HNSCC). We have evaluated the HPV deoxyribonucleic acid (DNA) prevalence as well as the association between serological response to HPV infection and HNSCC in two distinct populations from Central Europe (CE) and Latin America (LA). Methods: Cases (n=2214) and controls (n=3319) were recruited from 1998 to 2003, using a similar protocol including questionnaire and blood sample collection. Tumour DNA from 196 fresh tissue biopsies was analysed for multiple HPV types followed by an HPV type-specific polymerase chain reaction (PCR) protocol towards the E7 gene from HPV 16. Using multiplex serology, serum samples were analysed for antibodies to 17 HPV types. Statistical analysis included the estimation of adjusted odds ratios (ORs) and the respective 95% confidence intervals (CIs). Results: HPV16 E7 DNA prevalence among cases was 3.1% (6/196), including 4.4% in the oropharynx (3/68), 3.8% in the hypopharynx/larynx (3/78) and 0% among 50 cases of oral cavity carcinomas. Positivity for both HPV16 E6 and E7 antibodies was associated with a very high risk of oropharyngeal cancer (OR=179, 95% CI 35.8-899) and hypopharyngeal/laryngeal cancer (OR=14.9, 95% CI 2.92-76.1).Conclusions: A very low prevalence of HPV DNA and serum antibodies was observed among cases in both CE and LA. The proportion of head and neck cancer caused by HPV may vary substantially between different geographical regions and studies that are designed to evaluate the impact of HPV vaccination on HNSCC need to consider this heterogeneity. Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2010; all rights reserved.


Reis A.A.S.,Pontifical Catholic University of Goiás | de Paula L.B.,University of Sao Paulo | de Paula A.A.P.,ACCG | Saddi V.A.,Pontifical Catholic University of Goiás | da Cruz A.D.,Pontifical Catholic University of Goiás
Ciencia e Saude Coletiva | Year: 2010

The general objective of this article is to review the current literature regarding the epidemiology, biological behavior and risk factors for penile cancer development, such as HPV infection. Phimosis and chronic irritation related to poor hygiene are commonly associated with penile cancer, whereas neonatal circumcision reduces the relative risk for the disease. There is strong evidence that HPV types 16 and 18 are associated with penile carcinoma in as many as 50% of cases. Patients with penile lesions should undergo physical examination, which is often sufficient to diagnose and to define tumor stagging, as well as contributes to decision-making regarding therapeutical approaches and case management.


Freitas Jr. R.,Federal University of Goais | Gonzaga C.M.R.,Federal University of Goais | Freitas N.M.A.,ACCG | Martins E.,ACCG | Dardes R.C.M.,University of Sao Paulo
Clinics | Year: 2012

Objective: To describe the temporal trends in female breast cancer mortality rates in Brazil in its macro-regions and states between 1980 and 2009. Methods: This was an ecological time-series study using data on breast cancer deaths registered in the Mortality Data System (SIM/WHO) and census data on the resident population collected by the Brazilian Institute of Geography and Statistics (IBGE/WHO). Joinpoint regression analyses were used to identify the significant changes in trends and to estimate the annual percentage change (APC) in mortality rates. Results: Female breast cancer mortality rates in Brazil tended to stabilize from 1994 onward (APC = 0.4%). Considering the Brazilian macro-regions, the annual mortality rates decreased in the Southeast, stabilized in the South and increased in the Northeast, North, and Midwest. Only the states of Sao Paulo (APC = -1.9%), Rio Grande do Sul (APC = -0.8%) and Rio de Janeiro (APC = -0.6%) presented a significant decline in mortality rates. The greatest increases were found in Maranhao (APC=12%), Paraiba (APC=11.9%), and Piaui (APC=10.9%). Conclusion: Although there has been a trend toward stabilization in female breast cancer mortality rates in Brazil, when the mortality rate of each macro-region and state is analyzed individually, considerable inequalities are found, with rate decline or stabilization in states with higher socioeconomic levels and a substantial increase in those with lower socioeconomic levels. © 2012 CLINICS.


This study assessed the reliability of cancer as the underlying cause of death using probabilistic linkage between the Mortality Information System and Population-Based Cancer Registry (PBCR) in Goiânia, Goiás State, Brazil, from 2000 to 2005. RecLink III was used for probabilistic linkage, and reliability was assessed by Cohen's kappa and prevalence-adjusted and biasadjusted kappa (PABAK). In the probabilistic linkage, 2,874 individuals were identified for the reliability analysis. Cohen's kappa ranged from 0.336 to 0.846 and PABAK from 0.810 to 0.990 for 14 neoplasm groups defined in the study. For reliability of the 35 leading cancers, 12(34.3%) presented kappa values under 0.600 and PABAK over 0.981. Among the neoplasms common to both sexes, crude agreement ranged from 0.672 to 0.790 and adjusted agreement from 0.894 to 0.961. Sixty-seven percent of cases classified by the Mortality Information System as "cancer of ill-defined sites" were reclassified according to the PBCR. This study was useful for the classification of cancer mortality estimates in areas covered by the PBCR.


Gonzaga C.M.R.,Federal University of Goais | Freitas-Junior R.,Federal University of Goais | Freitas-Junior R.,ACCG | Souza M.R.,Federal University of Goais | And 3 more authors.
Breast | Year: 2014

Objectives: To evaluate trends in breast cancer mortality in urban centers and rural areas of Brazil. Methods: Ecological time-series study using data on breast cancer deaths and census. Mortality trends were analyzed using change-point regression: 1980-2010. Results: A declining trend was found in five urban centers: São Paulo (APC=-1.7%), Porto Alegre (APC=-1.6%), Belo Horizonte (APC=-1.2%), Rio de Janeiro and Recife (APC=-0.9%). An increasing was found in: Porto Velho (APC=9.0%), Teresina (APC=4.6%), João Pessoa (APC=1.6%), Belém (APC=0.8%) and Fortaleza (APC=0.5%). In the majority of rural areas, mortality continues to rise, with the exception of some areas in the southern. Conclusion: Disparities in breast cancer mortality were found across the country, with increasing trends occurring predominantly in the north and northeastern regions. One of the reasons for this disparity may be that access to treatment is more difficult for patients living in rural areas and in the north of Brazil. © 2014 Elsevier Ltd.


Mota O.M.,ACCG | Mota O.M.,Federal University of Goais | Curado M.P.,ACCG | Oliveira J.C.,ACCG | And 4 more authors.
Sao Paulo Medical Journal | Year: 2013

Context and Objectives: Esophageal cancer is the eighth commonest type of cancer worldwide, occupying sixth place in terms of mortality. Smoking and alcohol use are known risk factors for this type of cancer. The aim here was to evaluate the risk factors for esophageal cancer in a low-incidence area. Design and Setting: Case-control study in Goiânia, with 99 cases of esophageal cancer and 223 controls. Methods: The variables were sociodemographic, dietary, occupational and lifestyle data. The sample was analyzed using the chi-square test, Mann-Whitney test and Mantel-Haenszel approach for multivariate analysis. Odds ratios (OR) were calculated with 5% significance and 95% confidence intervals. Results: The risk of esophageal cancer was higher in patients ≥ 55 years (OR = 1.95; P < 0.001). Patients from rural areas were at greater risk of esophageal cancer (OR = 4.9; P < 0.001). Smoking was a risk factor among the cases (OR = 3.8; P < 0.001), as was exposure to woodstoves (OR = 4.42; P < 0.001). The practice of oral sex was not a risk factor (OR = 0.45; P = 0.04). Consumption of apples, pears, vegetables, cruciferous vegetables and fruit juices were protective against esophageal cancer. Conclusion: In a region in which the incidence of esophageal cancer is low, the most significant risk factors were exposure to woodstoves, smoking and living in rural areas.


Torres V.M.,Pontifical Catholic University of Goiás | Saddi V.A.,Pontifical Catholic University of Goiás | Saddi V.A.,ACCG
Jornal de Pediatria | Year: 2015

Objectives This review aimed to organize and consolidate the latest knowledge about mutations and genetic polymorphisms related to hereditary thrombophilia and their potential association with pediatric stroke and cerebral palsy (CP). Sources Scientific articles published from 1993 to 2013, written in Portuguese, English, French, and Spanish, were selected and reviewed. The publications were searched in electronic databases, and also in the collections of local libraries. The terms "hereditary thrombophilia", "polymorphisms", "mutation", "pediatric strokes", and "cerebral palsy" were used for the research. Summary of the findings The search in databases and in the bibliographic references retrieved 75 articles for inclusion in this review. Studies that investigated hereditary thrombophilias and their associations to CP and arterial and venous pediatric stroke presented contradictory results. The meta-analysis and case-control studies that showed positive results for this association described only slightly increased relative risks and sometimes had questionable conclusions. The association of two or more hereditary thrombophilias, or the association between thrombophilia and other specific clinical risk factors, suggest a higher risk of CP and pediatric stroke than isolated hereditary thrombophilia. Conclusions Larger, multicenter studies should be developed in order to elucidate the role of mutations leading to hereditary thrombophilia and the development of CP and pediatric stroke. The complex and multifactorial etiology of CP and stroke makes this an arduous and difficult task; however, the benefits generated by these studies are immeasurable. © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.


Gonzaga C.M.R.,Federal University of Goais | Freitas-Junior R.,Federal University of Goais | Curado M.-P.,Federal University of Goais | Curado M.-P.,ACCG | And 4 more authors.
BMC Public Health | Year: 2015

Background: Breast cancer is the most common cause of death from cancer in women in less developed regions. Therefore, the objective of this study was to provide data on the temporal trends in female breast cancer mortality between 1990 and 2011 and to evaluate its association with the social inequalities present in Brazil. Methods: Breast cancer mortality data and estimates for the resident population were obtained from the Brazilian National Health Service database for the 1990-2011 period. Age-standardized mortality rates were calculated (20-39, 40-49, 50-69 and ≥70 years) by direct standardization using the 1960 standard world population. Trends were modeled using joinpoint regression model and linear regression. The Social Exclusion Index and the Human Development Index were used to classify the 27 Brazilian states. Pearson's correlation was used to describe the association between the Social Exclusion Index and the Human DeveIopment and the variations in mortality rates in each state. Results: Age-standardized mortality rates in Brazil were found to be stable (annual percent change [APC] = 0.3; 95% CI: -0.1 - 0.7) between 1994 and 2011. Considering the Brazilian states, significant decreases in mortality rates were found in Rio Grande do Sul, Rio de Janeiro and São Paulo. Increases in mortality rates were most notable in the states of Maranhão (APC = 11.2; 95 %CI: 5.8 - 16.9), Piauí (APC = 9.8; 95% CI: 7.6 - 12.1) and Paraíba (APC = 9.3; 95% CI: 6.0 - 12.8). There was a statistically significant correlation between Social Exclusion Index and a change in female breast cancer mortality rates in the Brazilian states between 1990 and 2011 and between Human Development Index and mortality between 2001 and 2011. Conclusions: Female breast cancer mortality rates are stable in Brazil. Reductions in these rates were found in the more developed states, possibly reflecting better healthcare. © 2015 Gonzaga et al.


PubMed | Federal University of Goais, ACCG and Pontifical Catholic University of Goiás
Type: | Journal: Brazilian journal of otorhinolaryngology | Year: 2016

Molecular studies about carcinomas of the oral cavity and oropharynx demonstrate the presence of human papilomavirus genome in these tumors, reinforcing the participation of human papilomavirus in oral carcinogenesis.This study aimed to determine the prevalence of human papilomavirus and genotype distribution of HPV16 and HPV18 in oral cavity and oropharynx carcinomas, as well as their association with clinical characteristics of the tumors.This is a retrospective study, with clinical data collected from 82 patients. Human papilomavirus detection was conducted on specimens of oral cavity and oropharynx carcinomas included in paraffin blocks. Patients were assisted in a cancer reference center, in the central region of Brazil, between 2005 and 2007. Polymerase chain reaction was used for the detection and genotyping of human papilomavirus.Among the patients evaluated, 78% were male. The average age of the group was about 58 years. Risk factors, such as smoking (78%) and alcohol consumption (70.8%) were recorded for the group. HPV DNA was detected in 21 cases (25.6%; 95% confidence interval 16.9-36.6) of which 33.3% were HPV16 and 14.3% were HPV18. The presence of lymph node metastases and registered deaths were less frequent in human papilomavirus positive tumors, suggesting a better prognosis for these cases; however, the differences between the groups were not statistically significant.The results obtained in the present study, with respect to the presence of the high-risk HPV16 and HPV18 genotypes, highlight the importance of human papilomavirus vaccination in the control of oral cavity and oropharynx carcinomas.


PubMed | Federal University of Goais and ACCG
Type: Journal Article | Journal: Breast (Edinburgh, Scotland) | Year: 2014

To evaluate trends in breast cancer mortality in urban centers and rural areas of Brazil.Ecological time-series study using data on breast cancer deaths and census. Mortality trends were analyzed using change-point regression: 1980-2010.A declining trend was found in five urban centers: So Paulo (APC = -1.7%), Porto Alegre (APC = -1.6%), Belo Horizonte (APC = -1.2%), Rio de Janeiro and Recife (APC = -0.9%). An increasing was found in: Porto Velho (APC = 9.0%), Teresina (APC = 4.6%), Joo Pessoa (APC = 1.6%), Belm (APC = 0.8%) and Fortaleza (APC = 0.5%). In the majority of rural areas, mortality continues to rise, with the exception of some areas in the southern.Disparities in breast cancer mortality were found across the country, with increasing trends occurring predominantly in the north and northeastern regions. One of the reasons for this disparity may be that access to treatment is more difficult for patients living in rural areas and in the north of Brazil.

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