Mortalidade, sobrevida e fatores associados em mulheres portadoras de neoplasia maligna de mama

Detalhes bibliográficos
Autor(a) principal: Queiroz, Daiane de
Data de Publicação: 2023
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
Texto Completo: https://repositorio.ufpb.br/jspui/handle/123456789/31387
Resumo: Introduction: Breast cancer is one of the main public health problems in various regions of the world. It has the highest incidence and prevalence for both developed and underdeveloped countries, being considered a barrier to increasing global life expectancy. Objective: To assess the behavior of mortality, survival, and associated factors in women diagnosed with breast cancer. Method: To achieve the different objectives, the work was structured in various scenarios: 1) For the analysis of time series and temporal trends in breast cancer mortality in Brazil, data from 2009 to 2019 were used, considering income strata of municipalities and age groups; 2) For national comparisons on the influence of socioeconomic, demographic, and health factors on breast cancer, records from 2009, 2014, and 2019 were observed using the Sistema de Informação sobre Mortalidade (SIM, Mortality Information System) as a source of information for mortality in Brazilian states and associated socioeconomic and health factors; 3) For survival analysis, a review study was conducted, evaluating data from the Hospital Cancer Registry (RHC) of hospitals in the State of Paraíba, considering cases from 2010 onwards, with the follow-up outcome being patient death recorded in the SIM. 4) Using RHC data, factors related to advanced stage breast cancer were evaluated. The research was approved by the research ethics committees of the Universidade Federal da Paraíba (UFPB) and the University Hospital Alcides Carneiro of the Universidade Federal de Campina Grande - HUAC/UFCG. Results: The population classified in the high-income stratum in Brazil has a higher mortality rate, but the highest growth in the mortality rate was among women in the low-income stratum. When considering income stratification by states, we observe patterns of similarities within specific groups. Considering the influence of socioeconomic, demographic, and health factors on breast cancer, we observed a positive association in the variables average salary and health team/10,000 inhabitants. Considering the data from the RHC of Paraíba hospitals, 6,121 registered women from the year 2010 onward were analyzed. The variables that showed differences in Kaplan-Meier curves were age, education level, marital status, referral source, clinical staging, undergoing radiotherapy, chemotherapy, or hormone therapy treatment, and the macroregion of residence. In the multivariate analysis, age, education level, marital status, clinical staging, surgery as the first treatment received at the hospital, radiotherapy as the first treatment received at the hospital, chemotherapy as the first treatment received at the hospital, hormone therapy as the first treatment received at the hospital, other types of treatment received at the hospital, and the health macroregion of residence were identified as important independent prognostic factors. Considering the analysis of the clinical staging of women registered in the RHC, we observed a prevalence of advanced breast cancer diagnosis, noted in 43.24% (95% CI: 41.62 – 44.87). For the Poisson regression model, the predictor variables for advanced staging were age, family history of breast cancer, referral source, women referred without diagnosis and treatment, and women with invasive/infiltrating ductal carcinoma histological type. Conclusion: The changes in society over space and time influence the patterns of breast cancer mortality and survival, leading to the need for assessments of regionalized epidemiological indicators and their related factors. This is essential for evaluating screening strategies for this issue.
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spelling Mortalidade, sobrevida e fatores associados em mulheres portadoras de neoplasia maligna de mamaCâncer de mamaNeoplasia de mamaAnálise de sobrevidaMortalidade - CâncerBreast cancerBreast neoplasiaSurvival analysisMortality - CancerCNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVAIntroduction: Breast cancer is one of the main public health problems in various regions of the world. It has the highest incidence and prevalence for both developed and underdeveloped countries, being considered a barrier to increasing global life expectancy. Objective: To assess the behavior of mortality, survival, and associated factors in women diagnosed with breast cancer. Method: To achieve the different objectives, the work was structured in various scenarios: 1) For the analysis of time series and temporal trends in breast cancer mortality in Brazil, data from 2009 to 2019 were used, considering income strata of municipalities and age groups; 2) For national comparisons on the influence of socioeconomic, demographic, and health factors on breast cancer, records from 2009, 2014, and 2019 were observed using the Sistema de Informação sobre Mortalidade (SIM, Mortality Information System) as a source of information for mortality in Brazilian states and associated socioeconomic and health factors; 3) For survival analysis, a review study was conducted, evaluating data from the Hospital Cancer Registry (RHC) of hospitals in the State of Paraíba, considering cases from 2010 onwards, with the follow-up outcome being patient death recorded in the SIM. 4) Using RHC data, factors related to advanced stage breast cancer were evaluated. The research was approved by the research ethics committees of the Universidade Federal da Paraíba (UFPB) and the University Hospital Alcides Carneiro of the Universidade Federal de Campina Grande - HUAC/UFCG. Results: The population classified in the high-income stratum in Brazil has a higher mortality rate, but the highest growth in the mortality rate was among women in the low-income stratum. When considering income stratification by states, we observe patterns of similarities within specific groups. Considering the influence of socioeconomic, demographic, and health factors on breast cancer, we observed a positive association in the variables average salary and health team/10,000 inhabitants. Considering the data from the RHC of Paraíba hospitals, 6,121 registered women from the year 2010 onward were analyzed. The variables that showed differences in Kaplan-Meier curves were age, education level, marital status, referral source, clinical staging, undergoing radiotherapy, chemotherapy, or hormone therapy treatment, and the macroregion of residence. In the multivariate analysis, age, education level, marital status, clinical staging, surgery as the first treatment received at the hospital, radiotherapy as the first treatment received at the hospital, chemotherapy as the first treatment received at the hospital, hormone therapy as the first treatment received at the hospital, other types of treatment received at the hospital, and the health macroregion of residence were identified as important independent prognostic factors. Considering the analysis of the clinical staging of women registered in the RHC, we observed a prevalence of advanced breast cancer diagnosis, noted in 43.24% (95% CI: 41.62 – 44.87). For the Poisson regression model, the predictor variables for advanced staging were age, family history of breast cancer, referral source, women referred without diagnosis and treatment, and women with invasive/infiltrating ductal carcinoma histological type. Conclusion: The changes in society over space and time influence the patterns of breast cancer mortality and survival, leading to the need for assessments of regionalized epidemiological indicators and their related factors. This is essential for evaluating screening strategies for this issue.NenhumaIntrodução: O câncer de mama é um dos principais problemas de saúde pública em diversas regiões do mundo. É o de maior incidência e prevalência para os países desenvolvidos e subdesenvolvidos sendo considerado uma barreira para o aumento da expectativa de vida mundial. Objetivo: Avaliar o comportamento da mortalidade, sobrevida e fatores associados em mulheres diagnosticadas com câncer de mama. Método: Para atingir os diferentes objetivos o trabalho foi estruturado com métodos específicos: 1) Para a análise das séries temporais e da tendência temporal da mortalidade por câncer de mama no Brasil foi utilizado os dados de 2009 até 2019, considerando os estratos de renda dos municípios e faixas etárias; 2) Para avaliação dos fatores socioeconômicos e de saúde associados a mortalidade por câncer de mama na população feminina no Brasil foram observados os registros de 2009, 2014 e 2019, utilizando o Sistema de Informação de Mortalidade (SIM) como fonte para os dados da mortalidade dos estados do Brasil; 3) Para a análise sobre sobrevida foi feito um estudo de revisão e avaliado os dados do Registro Hospitalar de Câncer (RHC) de hospitais do Estado da Paraíba considerando os casos a partir de 2010 do RHC sendo o desfecho do seguimento o óbito da paciente avaliado pelo SIM. 4) A partir dos dados do RHC foi avaliado os fatores relacionados ao câncer de mama em estágio avançado. A pesquisa foi aprovada pelo comitês de ética em pesquisa da Universidade Federal da Paraíba (UFPB) e do Hospital Universitário Alcides Carneiro da Universidade Federal de Campina Grande - HUAC/UFCG. Resultados: A população classificada no estrato de alta renda no Brasil possui uma maior taxa de mortalidade, porém o maior crescimento da taxa de mortalidade foi para as mulheres no estrato de baixa renda. Quando consideramos a estratificação da renda por Estados, observamos padrões de similaridades por grupos específicos. Considerando a influência de fatores socioeconômicos demográficos e de saúde para o câncer de mama observamos associação positiva nas variáveis salário médio, equipe de saúde/ 10000 habitantes. Considerando os dados do RHC dos hospitais da Paraíba foram analisadas 6121 mulheres cadastradas no RHC a partir do ano de 2010. As variáveis que apresentaram diferenças nas curvas de Kaplan-Meier foram a idade, instrução, estado conjugal, origem do encaminhamento, estadiamanto clínico, a realização de tratamento de radioterapia, quimioterapia, hormonoterapia e a macrorregião de residência. Na análise multivariada, a idade, grau de instrução, estado conjugal, estadiamento clínico, cirurgia como primeiro tratamento recebido no hospital, radioterapia como primeiro tratamento recebido no hospital, quimioterapia como primeiro tratamento recebido no hospital, hormonioterapia como primeiro tratamento recebido no hospital, outro tipo de tratamento recebido no hospital e macrorregião de saúde onde residiam apresentaram como importantes fatores prognósticos independentes. Considerando a análise sobre o estadiamento clínico das mulheres cadastradas no RHC observamos um prevalência do diagnóstico avançado do câncer de mama observada em 43,24% (IC95%: 41,62 – 44,87). Para o modelo de regressão de Poisson as variáveis preditoras para o estadiamento avançado foram a idade, histórico familiar de câncer de mama, origem do encaminhamento, mulheres encaminhadas sem diagnóstico e sem tratamento e mulheres com tipo histológico carcinoma ductal infiltrante. Conclusão: As mudanças da sociedade ao longo do espaço e tempo influenciam nos padrões de mortalidade e sobrevida por câncer de mama ocasionando a necessidade de avaliações em indicadores epidemiológicos regionalizados e em seus fatores relacionados, sendo essencial para avaliação das estratégias de rastreamento desse problema.Universidade Federal da ParaíbaBrasilCiências Exatas e da SaúdePrograma de Pós-Graduação em Modelos de Decisão e SaúdeUFPBNascimento, João Agnaldohttp://lattes.cnpq.br/6866270928240455Vianna, Rodrigo Pinheiro de Toledohttp://lattes.cnpq.br/3915051035089861Queiroz, Daiane de2024-08-13T16:31:00Z2023-12-132024-08-13T16:31:00Z2023-08-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesishttps://repositorio.ufpb.br/jspui/handle/123456789/31387porAttribution-NoDerivs 3.0 Brazilhttp://creativecommons.org/licenses/by-nd/3.0/br/info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFPBinstname:Universidade Federal da Paraíba (UFPB)instacron:UFPB2024-08-14T06:06:43Zoai:repositorio.ufpb.br:123456789/31387Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufpb.br/PUBhttp://tede.biblioteca.ufpb.br:8080/oai/requestdiretoria@ufpb.br|| diretoria@ufpb.bropendoar:2024-08-14T06:06:43Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB)false
dc.title.none.fl_str_mv Mortalidade, sobrevida e fatores associados em mulheres portadoras de neoplasia maligna de mama
title Mortalidade, sobrevida e fatores associados em mulheres portadoras de neoplasia maligna de mama
spellingShingle Mortalidade, sobrevida e fatores associados em mulheres portadoras de neoplasia maligna de mama
Queiroz, Daiane de
Câncer de mama
Neoplasia de mama
Análise de sobrevida
Mortalidade - Câncer
Breast cancer
Breast neoplasia
Survival analysis
Mortality - Cancer
CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA
title_short Mortalidade, sobrevida e fatores associados em mulheres portadoras de neoplasia maligna de mama
title_full Mortalidade, sobrevida e fatores associados em mulheres portadoras de neoplasia maligna de mama
title_fullStr Mortalidade, sobrevida e fatores associados em mulheres portadoras de neoplasia maligna de mama
title_full_unstemmed Mortalidade, sobrevida e fatores associados em mulheres portadoras de neoplasia maligna de mama
title_sort Mortalidade, sobrevida e fatores associados em mulheres portadoras de neoplasia maligna de mama
author Queiroz, Daiane de
author_facet Queiroz, Daiane de
author_role author
dc.contributor.none.fl_str_mv Nascimento, João Agnaldo
http://lattes.cnpq.br/6866270928240455
Vianna, Rodrigo Pinheiro de Toledo
http://lattes.cnpq.br/3915051035089861
dc.contributor.author.fl_str_mv Queiroz, Daiane de
dc.subject.por.fl_str_mv Câncer de mama
Neoplasia de mama
Análise de sobrevida
Mortalidade - Câncer
Breast cancer
Breast neoplasia
Survival analysis
Mortality - Cancer
CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA
topic Câncer de mama
Neoplasia de mama
Análise de sobrevida
Mortalidade - Câncer
Breast cancer
Breast neoplasia
Survival analysis
Mortality - Cancer
CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA
description Introduction: Breast cancer is one of the main public health problems in various regions of the world. It has the highest incidence and prevalence for both developed and underdeveloped countries, being considered a barrier to increasing global life expectancy. Objective: To assess the behavior of mortality, survival, and associated factors in women diagnosed with breast cancer. Method: To achieve the different objectives, the work was structured in various scenarios: 1) For the analysis of time series and temporal trends in breast cancer mortality in Brazil, data from 2009 to 2019 were used, considering income strata of municipalities and age groups; 2) For national comparisons on the influence of socioeconomic, demographic, and health factors on breast cancer, records from 2009, 2014, and 2019 were observed using the Sistema de Informação sobre Mortalidade (SIM, Mortality Information System) as a source of information for mortality in Brazilian states and associated socioeconomic and health factors; 3) For survival analysis, a review study was conducted, evaluating data from the Hospital Cancer Registry (RHC) of hospitals in the State of Paraíba, considering cases from 2010 onwards, with the follow-up outcome being patient death recorded in the SIM. 4) Using RHC data, factors related to advanced stage breast cancer were evaluated. The research was approved by the research ethics committees of the Universidade Federal da Paraíba (UFPB) and the University Hospital Alcides Carneiro of the Universidade Federal de Campina Grande - HUAC/UFCG. Results: The population classified in the high-income stratum in Brazil has a higher mortality rate, but the highest growth in the mortality rate was among women in the low-income stratum. When considering income stratification by states, we observe patterns of similarities within specific groups. Considering the influence of socioeconomic, demographic, and health factors on breast cancer, we observed a positive association in the variables average salary and health team/10,000 inhabitants. Considering the data from the RHC of Paraíba hospitals, 6,121 registered women from the year 2010 onward were analyzed. The variables that showed differences in Kaplan-Meier curves were age, education level, marital status, referral source, clinical staging, undergoing radiotherapy, chemotherapy, or hormone therapy treatment, and the macroregion of residence. In the multivariate analysis, age, education level, marital status, clinical staging, surgery as the first treatment received at the hospital, radiotherapy as the first treatment received at the hospital, chemotherapy as the first treatment received at the hospital, hormone therapy as the first treatment received at the hospital, other types of treatment received at the hospital, and the health macroregion of residence were identified as important independent prognostic factors. Considering the analysis of the clinical staging of women registered in the RHC, we observed a prevalence of advanced breast cancer diagnosis, noted in 43.24% (95% CI: 41.62 – 44.87). For the Poisson regression model, the predictor variables for advanced staging were age, family history of breast cancer, referral source, women referred without diagnosis and treatment, and women with invasive/infiltrating ductal carcinoma histological type. Conclusion: The changes in society over space and time influence the patterns of breast cancer mortality and survival, leading to the need for assessments of regionalized epidemiological indicators and their related factors. This is essential for evaluating screening strategies for this issue.
publishDate 2023
dc.date.none.fl_str_mv 2023-12-13
2023-08-31
2024-08-13T16:31:00Z
2024-08-13T16:31:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
format doctoralThesis
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dc.identifier.uri.fl_str_mv https://repositorio.ufpb.br/jspui/handle/123456789/31387
url https://repositorio.ufpb.br/jspui/handle/123456789/31387
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language por
dc.rights.driver.fl_str_mv Attribution-NoDerivs 3.0 Brazil
http://creativecommons.org/licenses/by-nd/3.0/br/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NoDerivs 3.0 Brazil
http://creativecommons.org/licenses/by-nd/3.0/br/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Universidade Federal da Paraíba
Brasil
Ciências Exatas e da Saúde
Programa de Pós-Graduação em Modelos de Decisão e Saúde
UFPB
publisher.none.fl_str_mv Universidade Federal da Paraíba
Brasil
Ciências Exatas e da Saúde
Programa de Pós-Graduação em Modelos de Decisão e Saúde
UFPB
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repository.name.fl_str_mv Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB)
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