Breast cancer in women: characterization of cases included in the hospital cancer records of the state of São Paulo and factors associated with advanced stadiums

Introduction: Breast cancer is a worldwide public health problem, being the most common malignancy in the female population. It is a potentially curable disease if diagnosed early. The advanced stage at the time of diagnosis is associated with increased morbidity and low survival of these women. Objectives: To describe the sociodemographic, clinical, and anatomopathological characteristics of breast cancer cases in women included in the São Paulo State hospital cancer database (registros hospitalares de câncer de São Paulo – RHC-SP), established in 2000 and maintained by the Fundação Oncocentro de São Paulo (FOSP) and to investigate the factors associated with the clinical stage at the time of diagnosis. Material and methods: The study design was a series of cases. The sample consisted of women with breast cancer diagnosed between 2000-2014 and included in the RHC-FOSP. The outcome variable was the clinical stage (stage 0-II versus III-IV). The explanatory variables were: age at diagnosis and education level. This study was approved by the Human Research Ethics Committee of the Botucatu Medical School, UNESP. Results: The study included 84,987 women with in situ and invasive breast cancer diagnosed between 2000-2014. The mean age of women at diagnosis was 56.7 years (95%CI 56.6–56.8 years). Sixty-five percent of the cases have complete elementary school or less and the most frequent histological type was ductal carcinoma (77.2%). During the study period, there was a small decrease in the proportion of tumors in more advanced stages, from 39.8% in 2000 to 32.6% in 2014. There was a statistically significant association between the variables age at diagnosis and level of education with the clustered clinical stage of women. Women of older age and those with a higher level of education had reduced odds ratios for tumors in more advanced stages at the time of diagnosis. Conclusion: These findings may contribute to the development of policies for the identification of breast tumors at an earlier stage.

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Survival and prognostic factors of breast cancer in women in the state of São Paulo

Mastology ◽

10.29289/259453942020v30s1046 ◽

2020 ◽

Vol 30 (Suppl 1) ◽

Author(s):

Raissa Janine de Almeida ◽

Carolina Terra de Moraes Luizaga ◽

Cristiane Murta-Nascimento

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Clinical Stage ◽

Sao Paulo ◽

The State ◽

Rank Test ◽

São Paulo ◽

Historical Cohort ◽

Female Population

Introduction: Breast cancer is the first most common malignancy in the female population worldwide. Monitoring the survival of women with breast cancer has been a strategy often adopted at the international level as a measure to assess public policy progress for disease control. Objectives: To estimate the probability of five-year survival and to investigate the prognostic factors of women with breast cancer included in the São Paulo State Cancer Hospital Records Base (RHC-SP), established in 2000 and maintained by the Oncocentro Foundation of São Paulo (Fundação Oncocentro de São Paulo – FOSP). Material and methods: This is a historical cohort. The sample consisted of women with breast cancer diagnosed between 2002 and 2012 and included in the RHC-FOSP. The event studied was specific mortality from breast cancer. Live cases at the end of follow-up (December 31st, 2017), loss of follow-up and those who died from causes other than breast cancer were considered censures on the date of the last contact or date of death. Survival analysis was performed using the Kaplan-Meyer method and the survival curves were compared using the log-rank test. Hazard ratios (HR) and respective 95% confidence intervals (95%CI) were also estimated using the Cox's proportional hazards model. This study was approved by the Human Research Ethics Committee of the School of Medicine of Botucatu, UNESP. Results: In the period between 2002‒2012, 53,146 cases of invasive breast cancer were registered at RHC-FOSP. The median age of women at diagnosis was 55.9 years. By the end of the follow-up (December 31st, 2017), 20,683 patients died and 71.4% were due to breast cancer. The probability of specific survival for the entire cohort at 5 and 10 years was 76.1% (95%CI 75.7‒76.5%) and 64.8% (95%CI 64.2‒65.3%), respectively. In the multivariate analysis, the factors associated with the prognosis were: age at diagnosis, year of diagnosis, educational level, grouped clinical stage and histological type. Conclusion: Specific survival for breast cancer in the state of São Paulo is significantly associated with several characteristics. The knowledge of these characteristics can contribute to the development of public policies in the area.

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Male breast cancer: Epidemiological evaluation and clinical outcomes.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e13619 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e13619-e13619

Author(s):

Edla Renata Cavalcante ◽

Katia Regina Marchetti ◽

Jamile Almeida Silva ◽

Laura Testa

Keyword(s):

Breast Cancer ◽

Endocrine Therapy ◽

Male Breast Cancer ◽

Cox Regression ◽

Sao Paulo ◽

Male Breast ◽

Rank Test ◽

São Paulo ◽

Male Population ◽

Female Population

e13619 Background: Male breast cancer (BC) is a rare neoplasia, with a risk of 1:1.000 in USA. Data from Sao Paulo Cancer Registry has shown that BC adjusted incidence rates is about 1.21 per 100,000 at the period from 2001 to 2005, but there is no incidence data for the whole country. Methods: We conducted a unicentric retrospective cohort, with histologically proven male BC patients whose first appointment was between 2008 and 2018 at Instituto do Câncer do Estado de São Paulo in Brazil. The primary endpoint was OS according to metastatic status and initial staging. OS and RFS were analyzed by Kaplan–Meier method and the difference calculated by log-rank test; reported hazard ratios by univariate Cox Models and P-values by score test. Multivariate analysis was calculated through COX regression. Results: 89 male BC patients were accessed, average age at diagnosis was 63.3 yeas-old. 84.2% had carcinoma of no special type (88,7% estrogen positive receptor, 84,2% progesterone positive receptor). When Charlson Comorbidity Index (CCI) was calculated, most (23.5%) were ≥ 7 (10-year survival: 0%), being 17.9% stage IV. Mastectomy was performed at 73% patients, 38.2% received adjuvant chemotherapy; 44.9% received adjuvant radiotherapy and 64% received adjuvant endocrine therapy (94.7% tamoxifen). For metastatic disease, endocrine therapy was the first option in 52%. Median OS was 75 months (95% CI, 39.2-110.7) in M0 and 39 months (95% CI, 25,2–52,8) in M1 ( p = 0.001). CCI showed be an independent death factor (HR 0.37, 95% CI, 0.17-0.8, p = 0.011). Median RFS was 97 months [95% CI, 47.3–146.7]. When BMI was evaluated for patients with obesity (> 30) there was no difference in disease relapse ( p = 0.29). Conclusions: Our results are consistent with those from previous literature, regarding histology, biomarkers and later stage at diagnosis. A quarter of our patients had high CCI and this could had impacted on best treatment option choices. Treatment approaches use to be similar from those of female population. However, as disease biology and hormonal physiology are different between gender, there is a lack of specific protocols and trials in male population.

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Factors associated with utilisation of dental services by the elders from São Paulo, Brazil

Gerodontology ◽

10.1111/ger.12519 ◽

2020 ◽

Author(s):

Gustavo Hermes Soares ◽

Ezequiel Ortiz‐Rosa ◽

Caroline Paula Alves ◽

Dayanne Paz ◽

Ki Sung An ◽

...

Keyword(s):

Sao Paulo ◽

São Paulo ◽

Dental Services ◽

Factors Associated

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Factors associated with Diaphorina citri immigration into commercial citrus orchards in São Paulo State, Brazil

Journal of Applied Entomology ◽

10.1111/jen.12851 ◽

2020 ◽

Author(s):

Fernando P. F. Zorzenon ◽

Arthur F. Tomaseto ◽

Matthew P. Daugherty ◽

João R. S. Lopes ◽

Marcelo P. Miranda

Keyword(s):

Sao Paulo ◽

São Paulo ◽

Diaphorina Citri ◽

Factors Associated ◽

Paulo State ◽

São Paulo State ◽

Citrus Orchards

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Added sugars: consumption and associated factors among adults and the elderly. São Paulo, Brazil

Revista Brasileira de Epidemiologia ◽

10.1590/s1415-790x2012000200003 ◽

2012 ◽

Vol 15 (2) ◽

pp. 256-264 ◽

Cited By ~ 8

Author(s):

Milena Baptista Bueno ◽

Dirce Maria Lobo Marchioni ◽

Chester Luis Galvão César ◽

Regina Mara Fisberg

Keyword(s):

Soft Drink ◽

Linear Regression Analysis ◽

The Elderly ◽

Sao Paulo ◽

Socioeconomic Level ◽

São Paulo ◽

Added Sugar ◽

Added Sugars ◽

Sugar Intake ◽

Factors Associated

OBJECTIVE: To investigate added sugar intake, main dietary sources and factors associated with excessive intake of added sugar. METHODS: A population-based household survey was carried out in São Paulo, the largest city in Brazil. Cluster sampling was performed and the study sample comprised 689 adults and 622 elderly individuals. Dietary intake was estimated based on a 24-hour food recall. Usual nutrient intake was estimated by correcting for the within-person variance of intake using the Iowa State University (ISU) method. Linear regression analysis was conducted to identify factors associated with added sugar intake. RESULTS: Average of energy intake (EI) from added sugars was 9.1% (95% CI: 8.9%; 9.4%) among adults and 8.4% (95% CI: 8.2%; 8.7%) among the elderly (p < 0.05). Average added sugar intake (% EI) was higher among women than among men (p < 0.05). Soft drink was the main source of added sugar among adults, while table sugar was the main source of added sugar among the elderly. Added sugar intake increased with age among adults. Moreover, higher socioeconomic level was associated with added sugar intake in the same group. CONCLUSIONS: Added sugar intake is higher among younger adults of higher socioeconomic level. Soft drink and table sugar accounted for more than 50% of the sugar consumed.

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Factors associated with the development of renal complications of diabetes mellitus in São Paulo city

Brazilian Journal of Medical and Biological Research ◽

10.1590/s0100-879x1997000600006 ◽

1997 ◽

Vol 30 (6) ◽

pp. 735-744 ◽

Cited By ~ 4

Author(s):

S.R.G. Ferreira ◽

F.M. Pinto

Keyword(s):

Diabetes Mellitus ◽

Sao Paulo ◽

São Paulo ◽

Complications Of Diabetes ◽

Factors Associated ◽

Renal Complications

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Factors associated with the prevalence of hypertension and control practices among elderly residents of São Paulo city, Brazil

Cadernos de Saúde Pública ◽

10.1590/0102-311x00151312 ◽

2013 ◽

Vol 29 (11) ◽

pp. 2275-2286 ◽

Cited By ~ 7

Author(s):

Telma de Almeida Busch Mendes ◽

Moisés Goldbaum ◽

Neuber José Segri ◽

Marilisa Berti de Azevedo Barros ◽

Chester Luiz Galvão César ◽

...

Keyword(s):

Physical Activity ◽

The Elderly ◽

Multiple Regression Model ◽

Sao Paulo ◽

Lifestyle Changes ◽

Cluster Sampling ◽

São Paulo ◽

Factors Associated ◽

Diet And Physical Activity ◽

And Control

The aim of this study was to analyze the prevalence of hypertension and control practices among the elderly. The survey analyzed data from 872 elderly people in São Paulo, Brazil, through a cluster sampling, stratified according to education and income. A Poisson multiple regression model checked for the existence of factors associated with hypertension. The prevalence of self-reported hypertension among the elderly was 46.9%. Variables associated with hypertension were self-rated health, alcohol consumption, gender, and hospitalization in the last year, regardless of age. The three most common measures taken to control hypertension, but only rarely, are oral medication, routine salt-free diet and physical activity. Lifestyle and socioeconomic status did not affect the practice of control, but knowledge about the importance of physical activity was higher among those older people with higher education and greater income. The research suggests that health policies that focus on primary care to encourage lifestyle changes among the elderly are necessary.

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Factors Associated with Reduction in Physical Activity during the COVID-19 Pandemic in São Paulo, Brazil: An Internet-Based Survey Conducted in June 2020

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182111397 ◽

2021 ◽

Vol 18 (21) ◽

pp. 11397

Author(s):

Gabriela Togni ◽

Paulo José Puccinelli ◽

Taline Costa ◽

Aldo Seffrin ◽

Claudio Andre Barbosa de Lira ◽

...

Keyword(s):

Physical Activity ◽

Minimum Wage ◽

Physical Activity Level ◽

Family Income ◽

Sao Paulo ◽

Activity Level ◽

Activity Levels ◽

São Paulo ◽

Factors Associated ◽

The City

Background: The COVID-19 pandemic negatively affected physical activity levels. This study investigated the factors associated with the change in physical activity level in Brazilians residing in the city of São Paulo. Methods: A self-administered questionnaire, addressing personal data, restriction level, education level, family income, daily working hours, and physical activity level, was answered by 2140 volunteers, of which 1179 were excluded because the answers were either incomplete or the respondents were not from São Paulo. The total number of participants selected was 961 (581 female and 380 male). Results: The physical activity level adopted prior to the pandemic period (p < 0.001) and family income (p = 0.001) correlated significantly with physical activity level reduction during the pandemic. The proportion of people who reduced their physical activity was greater among those who were very active than those who were active (adjusted prevalence ratio [aPR]: 0.65 [confidence interval (CI): 0.52–0.80]) or insufficiently active [aPR: 0.39 (0.18–0.82)]. The proportion of people who reduced their physical activity was greater among those who received a salary less than minimum wage (MW) than those who received a salary between three to six times minimum wage [(aPR: 0.50 (CI 0.35–0.70)] or more than 6 MW [(aPR: 0.56 (CI 0.40–0.79)]. Conclusions: A higher prevalence of Brazilians residing in the city of São Paulo reduced their physical activity who had a vigorous level of physical activity prior to the pandemic and who received less than a MW.

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COVID-19-associated acute kidney injury patients treated with renal replacement therapy in the intensive care unit: A multicenter study in São Paulo, Brazil

PLoS ONE ◽

10.1371/journal.pone.0261958 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0261958

Author(s):

Farid Samaan ◽

Elisa Carneiro de Paula ◽

Fabrizzio Batista Guimarães de Lima Souza ◽

Luiz Fernando Cardoso Mendes ◽

Paula Regina Gan Rossi ◽

...

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Kidney Injury ◽

Sao Paulo ◽

São Paulo ◽

Factors Associated ◽

Organ Dysfunctions

Introduction Multicenter studies involving patients with acute kidney injury (AKI) associated with the disease caused by the new coronavirus (COVID-19) and treated with renal replacement therapy (RRT) in developing countries are scarce. The objectives of this study were to evaluate the demographic profile, clinical picture, risk factors for mortality, and outcomes of critically ill patients with AKI requiring dialysis (AKI-RRT) and with COVID-19 in the megalopolis of São Paulo, Brazil. Methods This multicenter, retrospective, observational study was conducted in the intensive care units of 13 public and private hospitals in the metropolitan region of the municipality of São Paulo. Patients hospitalized in an intensive care unit, aged ≥ 18 years, and treated with RRT due to COVID-19-associated AKI were included. Results The study group consisted of 375 patients (age 64.1 years, 68.8% male). Most (62.1%) had two or more comorbidities: 68.8%, arterial hypertension; 45.3%, diabetes; 36.3%, anemia; 30.9%, obesity; 18.7%, chronic kidney disease; 15.7%, coronary artery disease; 10.4%, heart failure; and 8.5%, chronic obstructive pulmonary disease. Death occurred in 72.5% of the study population (272 patients). Among the 103 survivors, 22.3% (23 patients) were discharged on RRT. In a multiple regression analysis, the independent factors associated with death were the number of organ dysfunctions at admission and RRT efficiency. Conclusion AKI-RRT associated with COVID-19 occurred in patients with an elevated burden of comorbidities and was associated with high mortality (72.5%). The number of organ dysfunctions during hospitalization and RRT efficiency were independent factors associated with mortality. A meaningful portion of survivors was discharged while dependent on RRT (22.3%).

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