Disparities in stage at diagnosis of head and neck tumours in Brazil: a comprehensive analysis of hospital-based cancer registriesResearch in context
Summary: Background: The advanced stage of cancer is a determining factor in poor prognosis. Head and neck squamous cell carcinomas (HNSCC) are highly incident in Brazil, but similarly to many Low and Middle-Income Countries, data is limited regarding the proportion of tumours diagnosed at advanced...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | The Lancet Regional Health. Americas |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667193X24003132 |
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| author | Flávia Nascimento de Carvalho Marianna de Camargo Cancela Luciano Mesentier da Costa Luís Felipe Leite Martins Fernando Luiz Dias Dyego Leandro Bezerra de Souza Luis Felipe Ribeiro Pinto |
| author_facet | Flávia Nascimento de Carvalho Marianna de Camargo Cancela Luciano Mesentier da Costa Luís Felipe Leite Martins Fernando Luiz Dias Dyego Leandro Bezerra de Souza Luis Felipe Ribeiro Pinto |
| author_sort | Flávia Nascimento de Carvalho |
| collection | DOAJ |
| description | Summary: Background: The advanced stage of cancer is a determining factor in poor prognosis. Head and neck squamous cell carcinomas (HNSCC) are highly incident in Brazil, but similarly to many Low and Middle-Income Countries, data is limited regarding the proportion of tumours diagnosed at advanced clinical stages and the main factors associated with it. Therefore, this study aimed to identify the factors associated with advanced stage of HNSCC in Brazil. Methods: Cross-sectional study based on secondary data collected from Hospital-based Cancer Registries (HBCR) between 2000 and 2017. Descriptive data analysis and Poisson regression with robust variance were performed to determine prevalence ratios (PRs). Findings: Among 145,365 HNSCC cases, 78.2% (90,267/115,371) were diagnosed at stages III or IV. The highest percentage of advanced-stage tumours were hypopharyngeal [91.3% (10,186/11,159)], followed by oropharyngeal [86.6% (28,578/32,991)], oral cavity [75.1% (27,121/36,120)], and laryngeal cancer [69.5% (24,382/35,101)]. We observed annual increase trends of 0.29% and 0.38% for oral cavity and oropharyngeal late-stage tumours, respectively. Patients younger than 50 years old, with a low education level, presenting a primary tumour located in the hypopharynx or oropharynx, and alcohol and tobacco consumers were positively associated with advanced stage. Furthermore, we observed a dose–response effect of a statistically significant reduction in the prevalence of cases diagnosed in advanced stages as the patients' age group or education level increased. Interpretation: Diagnosis of HNSCC at advanced clinical stages in Brazil was associated with age, primary tumour site, and socioeconomic factors that must be mitigated, allowing more universal and equitable access and diagnosis at earlier stages. Funding: No funding. |
| format | Article |
| id | doaj-art-da568dc75dad4e338a0b2c4bebd89a21 |
| institution | Kabale University |
| issn | 2667-193X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Americas |
| spelling | doaj-art-da568dc75dad4e338a0b2c4bebd89a212025-01-11T06:42:14ZengElsevierThe Lancet Regional Health. Americas2667-193X2025-02-0142100986Disparities in stage at diagnosis of head and neck tumours in Brazil: a comprehensive analysis of hospital-based cancer registriesResearch in contextFlávia Nascimento de Carvalho0Marianna de Camargo Cancela1Luciano Mesentier da Costa2Luís Felipe Leite Martins3Fernando Luiz Dias4Dyego Leandro Bezerra de Souza5Luis Felipe Ribeiro Pinto6Cancer Surveillance and Data Analysis Division, Coordination of Prevention and Surveillance, Brazilian Nacional Cancer Institute (INCA), Rio de Janeiro, BrazilCoordination of Research and Innovation, Brazilian Nacional Cancer Institute (INCA), Rio de Janeiro, BrazilCancer Surveillance and Data Analysis Division, Coordination of Prevention and Surveillance, Brazilian Nacional Cancer Institute (INCA), Rio de Janeiro, BrazilCancer Surveillance and Data Analysis Division, Coordination of Prevention and Surveillance, Brazilian Nacional Cancer Institute (INCA), Rio de Janeiro, BrazilHead and Neck Surgery Section, Brazilian National Cancer Institute (INCA), Rio de Janeiro, BrazilDepartment of Collective Health, Federal University of Rio Grande do Norte (UFRN), Natal, BrazilMolecular Carcinogenesis Program, Coordination of Research and Innovation, Brazilian Nacional Cancer Institute (INCA), Rio de Janeiro, Brazil; Biochemistry Department, State University of Rio de Janeiro, Rio de Janeiro, Brazil; Corresponding author. Molecular Carcinogenesis Program, Research and Inovation Coordination, Brazilian Nacional Cancer Institute (INCA), 37th André Cavalcanti, 20231-050, Rio de Janeiro, Brazil.Summary: Background: The advanced stage of cancer is a determining factor in poor prognosis. Head and neck squamous cell carcinomas (HNSCC) are highly incident in Brazil, but similarly to many Low and Middle-Income Countries, data is limited regarding the proportion of tumours diagnosed at advanced clinical stages and the main factors associated with it. Therefore, this study aimed to identify the factors associated with advanced stage of HNSCC in Brazil. Methods: Cross-sectional study based on secondary data collected from Hospital-based Cancer Registries (HBCR) between 2000 and 2017. Descriptive data analysis and Poisson regression with robust variance were performed to determine prevalence ratios (PRs). Findings: Among 145,365 HNSCC cases, 78.2% (90,267/115,371) were diagnosed at stages III or IV. The highest percentage of advanced-stage tumours were hypopharyngeal [91.3% (10,186/11,159)], followed by oropharyngeal [86.6% (28,578/32,991)], oral cavity [75.1% (27,121/36,120)], and laryngeal cancer [69.5% (24,382/35,101)]. We observed annual increase trends of 0.29% and 0.38% for oral cavity and oropharyngeal late-stage tumours, respectively. Patients younger than 50 years old, with a low education level, presenting a primary tumour located in the hypopharynx or oropharynx, and alcohol and tobacco consumers were positively associated with advanced stage. Furthermore, we observed a dose–response effect of a statistically significant reduction in the prevalence of cases diagnosed in advanced stages as the patients' age group or education level increased. Interpretation: Diagnosis of HNSCC at advanced clinical stages in Brazil was associated with age, primary tumour site, and socioeconomic factors that must be mitigated, allowing more universal and equitable access and diagnosis at earlier stages. Funding: No funding.http://www.sciencedirect.com/science/article/pii/S2667193X24003132Head and neck cancerSocio-economic factorsStage at diagnosisHealth care access |
| spellingShingle | Flávia Nascimento de Carvalho Marianna de Camargo Cancela Luciano Mesentier da Costa Luís Felipe Leite Martins Fernando Luiz Dias Dyego Leandro Bezerra de Souza Luis Felipe Ribeiro Pinto Disparities in stage at diagnosis of head and neck tumours in Brazil: a comprehensive analysis of hospital-based cancer registriesResearch in context The Lancet Regional Health. Americas Head and neck cancer Socio-economic factors Stage at diagnosis Health care access |
| title | Disparities in stage at diagnosis of head and neck tumours in Brazil: a comprehensive analysis of hospital-based cancer registriesResearch in context |
| title_full | Disparities in stage at diagnosis of head and neck tumours in Brazil: a comprehensive analysis of hospital-based cancer registriesResearch in context |
| title_fullStr | Disparities in stage at diagnosis of head and neck tumours in Brazil: a comprehensive analysis of hospital-based cancer registriesResearch in context |
| title_full_unstemmed | Disparities in stage at diagnosis of head and neck tumours in Brazil: a comprehensive analysis of hospital-based cancer registriesResearch in context |
| title_short | Disparities in stage at diagnosis of head and neck tumours in Brazil: a comprehensive analysis of hospital-based cancer registriesResearch in context |
| title_sort | disparities in stage at diagnosis of head and neck tumours in brazil a comprehensive analysis of hospital based cancer registriesresearch in context |
| topic | Head and neck cancer Socio-economic factors Stage at diagnosis Health care access |
| url | http://www.sciencedirect.com/science/article/pii/S2667193X24003132 |
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