Temporal trends and factors associated with the cancer diagnosed at stage IV in patients included in the integrated hospital-based cancer registry system in Brazil in two decades |
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| Affiliation: | 1. Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil;2. Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil. Federal University of Rio de Janeiro State (UNIRIO), Rio de Janeiro, Brazil;1. Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA;2. Biomedical Statistics Research Core, University of Vermont, Burlington, VT, USA;3. Department of Oncology, Albert Einstein College of Medicine, Bronx, NY, USA;1. Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain;2. Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d′Oncologia, L′Hospitalet de Llobregat, Barcelona, Spain;3. Tobacco Control Research Group, Epidemiology, public health, cancer prevention and palliative care program, Institut d′Investigació Biomèdica de Bellvitge - IDIBELL, L′Hospitalet de Llobregat, Spain;4. School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain;5. Center for Biomedical Research in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain;6. Group of Integrative Pharmacology and Systems Neuroscience, Neurosciences Programme, IMIM (Hospital del Mar Medical Research Institute), Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain;7. Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain;8. Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain;1. Department of Urology, NYU Langone Health, New York, NY, United States;2. School of Medicine, University of North Carolina at Chapel Hill, NC, United States;3. Health Sciences Library, University of North Carolina at Chapel Hill, NC, United States;4. Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, United States;5. Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, NC, United States;6. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NC, United States;7. Department of Family Medicine, University of North Carolina at Chapel Hill, NC, United States;8. Program on Health and Clinical Informatics, University of North Carolina at Chapel Hill, NC, United States;9. Section on Tobacco, Alcohol and Drug Use, Department of Population Health, NYU School of Medicine, New York, NY, United States;10. Department of Urology, University of North Carolina at Chapel Hill, NC, United States;1. Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China;2. Hotan District People’s Hospital, Hotan, Xinjiang 848000, China;1. Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia;2. Douglass Hanly Moir Pathology, Macquarie Park and Department of Clinical Medicine, Faculty of Medicine, Health and Human Science, Macquarie University, Sydney, Australia;3. Cancer Epidemiology Division, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia;4. Royal Melbourne Hospital, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia;5. Epworth Healthcare and Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia;6. St. Vincent''s Hospital, Sydney and University of New South Wales, Sydney, New South Wales, Australia;7. Department of Haematology, Prince of Wales Hospital and University of New South Wales, Sydney, New South Wales, Australia;8. Concord Repatriation General Hospital and University of Sydney, Concord, New South Wales, Australia;9. Clinical Haematology, Monash Health and Monash University, Clayton, Australia;10. New South Wales Health Pathology and University of New South Wales, Sydney, New South Wales, Australia;11. St. George Hospital, Kogarah and University of New South Wales, Sydney, New South Wales, Australia;12. Liverpool Hospital, Liverpool and Western Sydney University, New South Wales, Australia;13. Gosford Hospital and The University of Newcastle, New South Wales, Australia;14. Rural Medical School and Border Medical Oncology Research Unit, Albury, New South Wales, Australia;15. School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia;p. Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia;q. The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia;1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615N. Wolfe Street, Baltimore, MD 21205, USA;2. Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21205, USA |
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| Abstract: | BackgroundIn several countries, such as Brazil, the oncological diagnosis usually occurs at an advanced stage of the disease. Thus, the aim of this study was to investigate temporal trends and factors associated with the cancer diagnosed at stage IV in Brazil in two decades.MethodsSecondary-based study, with time series analysis for trend assessment and cross-sectional of factors associated with diagnosis of female breast, prostate, cervix uteri, colorectal, lung, stomach, lip and oral cavity, thyroid, esophagus or corpus uteri at stage IV.Results1,218,322 cases were evaluated. The types of cancer with the highest proportion of stage IV at diagnosis in men and women, respectively, were: lung (53.7% and 57.4%), stomach (48.4% and 45.0%) and lip/oral cavity (53.5% and 43.4%). Most showed an increasing trend of annual percent change of cancer diagnosed at stage IV, being more pronounced in corpus uteri cancer (2013–2019: +7.4%, p < 0.001). The odds of cancer diagnosed at stage IV were associated with different factors, according to primary tumor site, but marked by the inverse association with female sex [odds ratio (OR) ranging from 0.42 to 0.91, p < 0.001] and direct association in cases with < 7 years of study (OR ranging from 1.08 to 1.81, p < 0.001), living without a partner (OR ranging from 1.06, p < 0.050 to1.27, p < 0.001), living in the South and Southeast regions (OR ranging from 1.04 to 1.13, p < 0.001), with more than one tumor (OR ranging from 1.19, p < 0.050 to 1.54, p < 0.001) and treated in Centers of High Complexity in Oncology (OR ranging from 1.03, p < 0.050 to1.24, p < 0.001).ConclusionThere was a high frequency of cancer diagnosed at stage IV and an increasing trend in different cancer types, which were associated with distinct sociodemographic, lifestyle, and clinical factors. |
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| Keywords: | Advanced cancer Neoplasm staging Time series Risk factors Brazil |
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