Brazilian National Cancer Institute

Rio de Janeiro, Brazil

Brazilian National Cancer Institute

Rio de Janeiro, Brazil
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Costa A.F.,State University of Rio de Janeiro | Costa A.F.,Brazilian National Cancer Institute | Hoek G.,University Utrecht | Brunekreef B.,University Utrecht | Ponce de Leon A.C.M.,State University of Rio de Janeiro
Environmental Health Perspectives | Year: 2017

Background: Evaluation of short-term mortality displacement is essential to accurately estimate the impact of short-term air pollution exposure on public health. Objectives: We quantified mortality displacement by estimating single-day lag effects and cumulative effects of air pollutants on mortality using distributed lag models. Methods: We performed a daily time series of nonaccidental and cause-specific mortality among elderly residents of São Paulo, Brazil, between 2000 and 2011. Effects of particulate matter smaller than 10 μm (PM10), nitrogen dioxide (NO2) and carbon monoxide (CO) were estimated in Poisson generalized additive models. Single-day lag effects of air pollutant exposure were estimated for 0-, 1- and 2-day lags. Distributed lag models with lags of 0–10, 0–20 and 0–30 days were used to assess mortality displacement and potential cumulative exposure effects. Results: PM10, NO2 and CO were significantly associated with nonaccidental and cause-specific deaths in both single-day lag and cumulative lag models. Cumulative effect estimates for 0–10 days were larger than estimates for single-day lags. Cumulative effect estimates for 0–30 days were essentially zero for nonaccidental and circulatory deaths but remained elevated for respiratory and cancer deaths. Conclusions: We found evidence of mortality displacement within 30 days for nonaccidental and circulatory deaths in elderly residents of São Paulo. We did not find evidence of mortality displacement within 30 days for respiratory or cancer deaths. © 2017 Public Health Services, US Dept of Health and Human Services. All rights reserved.


Ferlay J.,International Agency for Research on Cancer | Soerjomataram I.,International Agency for Research on Cancer | Dikshit R.,Tata Memorial Hospital | Eser S.,Hacettepe University | And 4 more authors.
International Journal of Cancer | Year: 2015

Estimates of the worldwide incidence and mortality from 27 major cancers and for all cancers combined for 2012 are now available in the GLOBOCAN series of the International Agency for Research on Cancer. We review the sources and methods used in compiling the national cancer incidence and mortality estimates, and briefly describe the key results by cancer site and in 20 large "areas" of the world. Overall, there were 14.1 million new cases and 8.2 million deaths in 2012. The most commonly diagnosed cancers were lung (1.82 million), breast (1.67 million), and colorectal (1.36 million); the most common causes of cancer death were lung cancer (1.6 million deaths), liver cancer (745,000 deaths), and stomach cancer (723,000 deaths).


De Carvalho J.N.,Federal University of Rio Grande do Norte | Roncalli A.G.,Federal University of Rio Grande do Norte | De Camargo Cancela M.,Brazilian National Cancer Institute | De Souza D.L.B.,Federal University of Rio Grande do Norte
PLoS ONE | Year: 2017

Knowledge on the occurrence of multimorbidity is important from the viewpoint of public policies, as this condition increases the consumption of medicines as well as the utilization and expenses of health services, affecting life quality of the population. The objective of this study was to estimate prevalence of self-reported multimorbidity in Brazilian adults (>18 years old) according to socioeconomic and demographic characteristics. A descriptive study is presented herein, based on data from the National Health Survey, which was a household-based survey carried out in Brazil in 2013. Data on 60,202 adult participants over the age of 18 were included. Prevalences and its respective confidence intervals (95%) were estimated according to sex, age, education level, marital status, self-reported skin color, area of residence, occupation and federative units (states). Poisson regression models univariate and multivariate were used to evaluate the association between socioeconomic and demographic variables with multimorbidity. To observe the combinations of chronic conditions the most common groups in pairs, trios, quartets and quintets of chronic diseases were observed. The prevalence of multimorbidity was 23.6% and was higher among women, in individuals over 60 years of age, people with low educational levels, people living with partner, in urban areas and among unemployed persons. The states of the South and Southeast regions presented higher prevalence. The most common groups of chronic diseases were metabolic and musculoskeletal diseases. The results demonstrated high prevalence of multimorbidity in Brazil. The study also revealed that a considerable share of the economically active population presented two or more chronic diseases. Data of this research indicated that socioeconomic and demographic aspects must be considered during the planning of health services and development of prevention and treatment strategies for chronic diseases, and consequently, multimorbidity. © 2017 Carvalho et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Levy D.,Georgetown University | Jiang M.,Harvey L Neiman Health Policy Institute | Szklo A.,Brazilian National Cancer Institute | de Almeida L.M.,Brazilian National Cancer Institute | And 2 more authors.
Nicotine and Tobacco Research | Year: 2013

Introduction: Numerous studies from high-income countries document the causal relationship between cigarette smoking during pregnancy and adverse maternal and child health (MCH) outcomes. Less research has been conducted in low- and middleincome countries, but a burgeoning literature can be found for Brazil. Methods: We review Brazilian studies of the prevalence of maternal smoking, the relative risk of smoking-attributable adverse MCH outcomes, and present new estimates for these outcomes, using the attributable fraction method. Results: We found that Brazilian studies of the relative risks of smoking-attributable adverse MCH outcomes were broadly consistent with previous reviews. Based on a comparison of maternal smoking over time, smoking during pregnancy has declined by about 50% over the last 20 years in Brazil. For 2008, we estimate that 5,352 cases of spontaneous abortion, 10,929 cases of preterm birth, 20,717 cases of low birth weight, and 29 cases of sudden infant death syndrome are attributable to maternal smoking. Between 1989 and 2008, the percent of smoking-attributable adverse MCH outcomes in Brazil was at least halved. Conclusions: The results show that over a 20-year period, during which Brazil implemented numerous effective tobacco control measures, the country experienced a dramatic decrease in both maternal smoking prevalence and smoking-attributable adverse MCH outcomes. Countries that implement effective tobacco control measures can expect to reduce both maternal smoking and adverse MCH outcomes, thereby improving the public health. © The Author 2013. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.


Nestal de Moraes G.,Brazilian National Cancer Institute INCA | Vasconcelos F.C.,Brazilian National Cancer Institute INCA | Delbue D.,Brazilian National Cancer Institute INCA | Mognol G.P.,Brazilian National Cancer Institute | And 3 more authors.
European Journal of Cell Biology | Year: 2013

Breast cancer is the leading cause of deaths in women around the world. Resistance to therapy is the main cause of treatment failure and still little is known about predictive biomarkers for response to systemic therapy. Increasing evidence show that Survivin and XIAP overexpression is closely associated with chemoresistance and poor prognosis in breast cancer. However, their impact on resistance to doxorubicin (dox), a chemotherapeutic agent widely used to treat breast cancer, is poorly understood. Here, we demonstrated that dox inhibited cell viability and induced DNA fragmentation and activation of caspases-3, -7 and -9 in the breast cancer-derived cell lines MCF7 and MDA-MB-231, regardless of different p53 status. Dox exposure resulted in reduction of Survivin and XIAP mRNA and protein levels. However, when we transfected cells with a Survivin-encoding plasmid, we did not observe a cell death-resistant phenotype. XIAP and Survivin silencing, either alone or in combination, had no effect on breast cancer cells sensitivity towards dox. Altogether, we demonstrated that breast cancer cells are sensitive to the chemotherapeutic agent dox irrespective of Survivin and XIAP expression levels. Also, our findings suggest that dox-mediated modulation of Survivin and XIAP might sensitize cells to taxanes when used in a sequential regimen. © 2013 Elsevier GmbH.


Carmo C.C.,Brazilian National Cancer Institute | Luiz R.R.,Federal University of Rio de Janeiro
International Journal of Gynecological Cancer | Year: 2010

The objective of this article was to analyze the treatment modalities used at the Brazilian National Cancer Institute, with particular emphasis on the use of radiotherapy (RT) and its indications in invasive cervical cancer, considering the staging and clinical epidemiological characteristics of the population. All cases of primary invasive tumors of the cervix (CID C53) registered at the institute and diagnosed between 1999 and 2004 were selected. The following variables were studied: (1) age, (2) year of diagnosis, (3) level of schooling, (4) race, (5) histopathologic subtype, (6) the staging of the tumor on diagnosis, and (7) the treatment modality initially offered.We analyzed 3509 cases of invasive disease, and 79.7% of them received RT. Based on the final logistic model, it was possible to construct a probabilistic model for the indication of RT in the subgroups formed by the combinations of the 3 highlighted variables (stage, age, and histological type). The likelihood varied from 22.5% in those with epidermoid carcinoma, stage I, younger than 55 years up to 100% in those with locally advanced disease and older than 65 years. These results indicate the importance of RTas a modality of treatment of invasive cervical cancer in Brazil, where a substantial proportion of the diagnoses are made in advanced stages. This set of information regarding this important center may help the long-termstrategic planning and the allocation of funds that enable the high demand to be met in an optimized manner. Copyright © 2010 by IGCS and ESGO.


Freitas V.,Brazilian National Cancer Institute | Freitas V.,University of Toronto | Scaranelo A.,University of Toronto | Menezes R.,University of Toronto | And 3 more authors.
Cancer | Year: 2013

Background: Recommendation for breast magnetic resonance imaging (MRI) screening for women with a prior history of chest radiation is currently based on expert opinion, because existing data are very scant. The objective of this study was to evaluate added cancer yield of screening breast MRI in this population. Methods: A retrospective review identified 98 women with a prior history of chest radiation therapy who had screening mammography and screening MRI performed at the authors' institution between January 2004 and July 2010. Medical records of these patients and results of 558 screening studies (296 mammograms and 262 MRI) were reviewed. Sensitivity, specificity, positive predictive value, negative predictive value, and added cancer yield were calculated. Results: Malignancy was diagnosed in 13 patients, invasive cancer was diagnosed in 10 patients, and ductal carcinomas in situ was diagnosed in 3 patients. The median latency from completion of radiation to detection of the breast cancer was 18 years (range, 8-37 years). Of the 13 cancers, 12 (92%) were detected by MRI, and 9 (69%) by mammography. For mammography, the sensitivity, specificity, positive predictive value, and negative predictive value were 69%, 98%, 82%, and 95%, respectively; and, for MRI, these values were 92%, 94%, 71%, and 99%, respectively. In 4 of 98 patients, cancer was diagnosed on MRI only, resulting in an incremental cancer detection rate of 4.1% (95% confidence interval, 1.6%-10%). Conclusions: The current results indicated that MRI is a useful adjunct modality for screening high-risk women who have a prior history of chest radiation therapy, resulting in a 4.1% (4 of 98 women) added cancer detection rate. The authors concluded that both MRI and mammography should be used to screen women in this high-risk group. Cancer 2013. © 2012 American Cancer Society.


Floriani C.A.,Brazilian National Cancer Institute | Schramm F.R.,Oswaldo Cruz Foundation
Palliative and Supportive Care | Year: 2010

Hospitality is commonly referred as one of the meanings of hospes, the Latin word which is also the root of hospice. This article explores the semantics of the word hospice - the seal of identity of modern hospice movement - and attempts to integrate the meaning of hospitality into the modern hospice movement, understood as unconditional reception. Therefore, the article analyzes the concept of unconditional hospitality, developed by Jacques Derrida and that of ethical responsibility proposed by Emmanuel Levinas based on the phenomenological experience of the other. From this point of view, these two concepts tie in with the meaning of hospice, bringing substantial grounding elements to the hospice movement for the construction of a protective ethos. © Cambridge University Press 2010.


Floriani C.A.,Brazilian National Cancer Institute | Schramm F.R.,Brazilian National Cancer Institute | Schramm F.R.,Oswaldo Cruz Foundation
Palliative and Supportive Care | Year: 2012

This article investigates some of the criticisms that have been directed at the hospice movement in the process of interaction with the traditional Western healthcare system, such as those relative to its routinization and medicalization. It also aims to review some of the consequences of this process of institutionalisation for the field of end-of-life care: surveillance and control over the process of dying, at the expense of decisions preferably based on the patient and that patient's ability to decide how to die, with the loss of wider objectives originally established by the movement, such as unconditional reception for the patient. Based on these criticisms, some considerations are made regarding the moral implications and risks related to this specific mode of action, the hospice way of care. © 2012 Cambridge University Press.


de Souza P.S.,Brazilian National Cancer Institute | Cruz A.L.S.,Brazilian National Cancer Institute | Viola J.P.B.,Brazilian National Cancer Institute | Maia R.C.,Brazilian National Cancer Institute
Cancer Science | Year: 2015

Multidrug resistance (MDR) is considered a multifactorial event that favors cancer cells becoming resistant to several chemotherapeutic agents. Numerous mechanisms contribute to MDR, such as P-glycoprotein (Pgp/ABCB1) activity that promotes drug efflux, overexpression of inhibitors of apoptosis proteins (IAP) that contribute to evasion of apoptosis, and oncogenic pathway activation that favors cancer cell survival. MDR molecules have been identified in membrane microparticles (MP) and can be transferred to sensitive cancer cells. By co-culturing MP derived from MDR-positive cells with recipient cells, we showed that sensitive cells accumulated Pgp, IAP proteins and mRNA. In addition, MP promoted microRNA transfer and NFκB and Yb-1 activation. Therefore, our results indicate that MP can induce a multifactorial phenotype in sensitive cancer cells. Microparticles promoted microRNA transfer and NFkB and Yb-1 oncogenic pathway activation. Microparticles can induce a multifactorial phenotype in sensitive cancer cells. © 2014 The Authors. Cancer Science published by Wiley Publishing Asia Pty Ltd on behalf of Japanese Cancer Association.

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