Original Article J Clin Med Res
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Original Article J Clin Med Res. 2019;11(4):275-282 Prevalence of Solid Neoplasms Diagnosed Between the Years of 2011 to 2016 and Oncologically Treated at the University Hospital of Santa Maria Fernando Borges da Silvaa, b, Marcelo Binatob, c, Juliano Tonezer da Silvad, e, Clandio Timm Marquesf, g, h, Tiango Aguiar Ribeirob, i, j, k Abstract ity procedure authorization (APAC)/Oncology. Background: Cancer is a public health problem, especially in devel- Results: A total of 2,757 patients were selected, of which 1,493 pa- oping countries. In order to establish effective measures for the cancer tients were female (54.2%) and 1,264 male (45.8%). The mean age control, there is a need for quality information, thus enabling a bet- at the time of initiation of treatment was 59.94 years for both sexes, ter understanding of the disease and its determinants, formulation of with the 95% confidence interval (59.44 - 60.44). The majority of causal hypotheses, evaluation of the technological advances applied patients were aged 61 - 70 years, totaling 747 patients, followed by to prevention and treatment as well as the effectiveness of health care. 718 patients between 51 - 60 years. In all 31 primary sites identified The objective of the study was to investigate the prevalence of solid the most prevalent one of neoplasms are breast, prostate, colorectal neoplasms diagnosed between the years 2011 to 2016 and treated at and lung; and most cases were stage IV (1,039 cases). A percentage of the Oncology Department of the University Hospital of Santa Maria the number of cases of breast and esophageal cancer was higher than and the existing oncological context. expected, and in contrast to a low percentage of hepatocarcinoma, kidney cancer and central nervous system tumors. The patients came Methods: This is an observational cross-sectional study. The target from the entire area of the fourth Health Coordinating Area, where population was comprised of adult patients (18 years of age or older) 100% of the municipalities referred to the institution, as well as other and elderly people (60 years of age or older) diagnosed with solid nine locations belonging to other coordinators. cancer by anatomico-pathological examination between 2011 and 2016, who started oncological treatment, according to high complex- Conclusion: Most of the data obtained are consistent with the Brazil- ian reality, not identifying any peculiar characteristic of this region of the study worthy of note, except for the difference in the prevalence of Manuscript submitted January 30, 2019, accepted February 22, 2019 some types of cancer, a fact that deserves further studies. There were also no discrepancies in a regional analysis. Along with this work, it aDepartment of Oncology, University Hospital of Santa Maria, Federal Uni- was possible to demonstrate the cancer situation and the profile of versity of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil oncology patients attended at a reference center for 41 municipalities, b Post-Graduate Program of Health Science, Federal University of Santa Maria mainly in the central region of Rio Grande do Sul state, which may (UFSM), Santa Maria, Rio Grande do Sul, Brazil cDepartment of Surgery, Medicine School of Federal University of Santa Ma- be useful in the elaboration of public policies to modify the profile ria (UFSM), Santa Maria, Rio Grande do Sul, Brazil identified, and serve as the basis for further studies in this region. dInstitute of Exact Sciences and Geosciences, University of Passo Fundo (UPF), Passo Fundo, Brazil Keywords: Prevalence; Cancer; Oncological context; Attention to ePost-Graduate Program in Teaching Science and Mathematics (ppgECM), health; APAC University of Passo Fundo (UPF), Passo Fundo, Brazil fDepartment of Mathematics, Franciscan University (UFN), Santa Maria, Bra- zil gPot-Graduate Program in Mathematics and Science Teaching, Franciscan University (UFN), Santa Maria, Brazil Introduction hPost-Graduate Program of Health and Life Sciences, Franciscan University (UFN), Santa Maria, Brazil iDepartment of Surgery in Orthopaedic, Medicine School of Federal Univer- The appearance of a malignant tumor (cancer or malignant sity of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil neoplasm) is influenced not only by biological and behavioral jDepartment of Orthopaedic, University Hospital of Santa Maria (SOT- characteristics but also by social, political, environmental and HUSM), Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande economic conditions [1]. We observe that the Brazilian popula- do Sul, Brazil tion, since the middle of the 20th century has undergone intense kCorresponding Author: Tiango Aguiar Ribeiro, 1000 Roraima Avenue, Fed- eral University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, modifications. Improvements in basic sanitation and combating Brazil. Email: [email protected] communicable diseases are a fact that leads to a change in the health profile of a population [2, 3]. Thus, chronic diseases and doi: https://doi.org/10.14740/jocmr3769 their complications, with malignant neoplasms being one of Articles © The authors | Journal compilation © J Clin Med Res and Elmer Press Inc™ | www.jocmr.org This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits 275 unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited Prevalence of Solid Neoplasms J Clin Med Res. 2019;11(4):275-282 Figure 1. Number of patients per age group that started treatments in the service of Oncology at the University Hospital of Santa Maria from 2011 to 2016. them, are more important in the health scenario of a nation [2]. Data regarding gender, date of birth, primary tumor site, In developing countries, it is estimated that in the coming treatment start date, tumor stage and histopathological type decades the impact of cancer will reach 80% of tumors [4]. For were collected in the APACs. For tumor staging, the classifica- this year (2019), the World Health Organisation (WHO) esti- tion of malignant tumors (TNM) [10] was used. mates that Brazil will have approximately 560 thousand new cases of cancer [5]. A marked heterogeneity of cancer morbid- ity and mortality among the different geographic regions of Statistical analysis Brazil is observed [6]. In order to establish effective measures not only for the control of cancer but also for a more targeted The processing and analysis of the collected data were carried diagnosis of the most common types present in a given region out with the program SPSS 20.0 (Statistical Package for the as well as for its prevention, it is necessary to know the quality social Sciences). The quantitative variables were described as information about the distribution of the incidence of this pa- normal through their mean and standard deviation, and when thology [7]. The effective clinical management and an assess- not normal through their median and interquartile. Qualitative ment of the needs and demands of the society require the use of variables were described by their absolute and relative fre- health information at the local level, allowing health planners quency. An ANOVA test was used to observe the age differ- and managers to make decisions about the functioning of both ence between the sexes. To vary the homogenicity of groups services and the health system as a whole [8]. a Levene test was used. Significant statistical differences were Thus, health information and knowledge should be used as considered when the value of P was < 0.05. strategic inputs, taking into account the resolubility of health actions [9]. To do so, we performed a cross-sectional obser- vational study to determine the prevalence of solid neoplasms Results diagnosed and treated in a tertiary level and public hospital in southern Brazil. A total of 3,475 patients were initially selected, of which 2,757 patients were analyzed and were part of the study. Seven hun- dred eighteen (718) patients were excluded from the study, Materials and Methods according to the previously mentioned exclusion criteria, 98 due to age below 18 years and 620 patients due to hemato- A cross-sectional observational study was carried out after ap- logical (non-solid) neoplasia. About the studied population, proval by the Research Ethics Committee (CAAE, number 1,493 (54.2%) patients were female and 1,264 (45.8%) were 2,211,192) at the University Hospital of Santa Maria (HUSM), male. The mean age of the studied population at the time of a tertiary level and hospital located in the south of Brazil. The the initiation of the treatment was 59.94 ± 13.28 years (mean ± study was carried out at the Oncology Department of this hospi- standard deviation), with the 95% confidence interval (59.44 - tal, and respected the ethical precepts of the Declaration of Hel- 60.44). The minimum age was 19 years, and the maximum age sinki of 1975. The study was carried out based on data collection was 98. In the female sex, we observed a mean age of 57.37 in the Authorization of Procedures of High Complexity in On- ± 13.24 years, with a minimum age of 20 and a maximum of cology (APAC/Oncology), document of the Ministry of Health 98 years. In male patients, mean age observed was 62.97 ± for the release of cancer treatment (chemotherapy). The APACs 12.66 years, with a minimum age of 19 and a maximum of 91 for patients treated from June 2011 to May 2016 were analyzed. years old. A statistically significant difference of age between As an inclusion criterion for this study, the APAC patient should the sexes was observed (P < 0.001), perhaps explained why the have the diagnosis of solid cancer made by anatomo-patholog- sex group is not homogeneous (P = 0.004). ical examination and have performed the chemotherapy treat- Most of the cases of solid cancer (1,465; 53.13%) were ment in our hospital.