Background The increasing prevalence of preterm birth, which is a global phenomenon, is attributable to the increased medical indications, artificial gestations, and some socioeconomic factors. This study was conducted to identify whether development and equality indices are associated with the incidence of preterm birth, specifically, spontaneous and elective preterm births. Methods This retrospective observational study comprised an analysis of data on live births from 2019 in Brazil and on socioeconomic indices that were derived from census information in 2017. Data were summarised using absolute and relative frequencies. Spearman’s correlation was used to determine the correlation between socioeconomic factors and the preterm birth rate. Multiple beta regression analysis was performed to determine the best model of socioeconomic covariates and preterm birth rate. The significance level was set at 5%. Results In 2019 in Brazil, the preterm birth rate was 11.03%, of which 58% and 42% were spontaneous and elective deliveries, respectively. For all preterm births, Spearman’s correlation varied from ρ = 0.4 for the Gini Index and ρ = − 0.24 for illiteracy. The best fit modelled the spontaneous preterm birth fraction as a negative function of the Human Development Index (HDI). The best-fit model considered the expected elective preterm birth fraction as a positive function of the HDI and as a negative function of the Gini Index, which was used as a precision parameter. Conclusions We observed a reduction in the fraction of spontaneous preterm births; however, the distribution was not uniform in the territory: higher rates of spontaneous preterm birth were noticed in the north, northeast, and mid-west regions. Thus, areas with lower education levels and inequal income distribution have a higher proportion of spontaneous preterm birth. The fraction of elective preterm birth was positively associated with more advantaged indices of socioeconomic status.
Introduction Breast cancer has a high incidence in the population, and it still is a major cause of mortality among women. About 2/3 of these tumors express hormone receptor which are important therapeutical targets for both adjuvant and metastatic settings. Hormone therapy (HT) is an important strategy for adjuvant treatment in breast cancer, enhancing disease-free and overall survival. But the side effects of this strategy are multiple, especially by mimicking or intensifying menopausal symptoms, which can substantially compromise quality of life of patients. Moreover, treatment of women with breast cancer is rising both in intensity and extension, maximizing hormone deprivation effects. Another major factor is patient adherence as it is known that about 50% of women don’t complete the whole treatment. Bad adherence occurs mainly because side effects are poorly controlled, either being neglected or less valued during medical check-ups. Outside clinical trials, there is not enough data of patients’ perceptions about HT. Objective To evaluate adherence, side effects and medical care perceptions of breast cancer patients in use of HT. Method A questionnaire was developed and applied online to users of Oncoguia, an NGO for cancer patient’s advocacy. The adhesion was volunteer and individual data were not identified. Primarily qualitative analysis was performed to identify patterns in no meeting needs of patients using HT for breast cancer. Results 310 answers were submitted from February to July of 2020. 84.1% of patients (261) referred having used HT. Tamoxifen was used in 47.5% of these, aromatase inhibitor in 29% and double blockage in 8.1%. Related to orientation about side effects, 43.2% consider they were properly orientated, 25% superficially and 11.2% weren’t oriented. 50% of women who previously didn’t exercise started physical activities after HT. Of those who were previously active, 73,4% kept regular exercises during HT. Considering weight gain, 63% of women who didn’t have prior problems experienced trouble with weight gain; and in those who already had issues with weight there were persistence in 71.7%. For patients with normal libido before HT, 42,9% noticed reduction and 36,4% of them considered the libido absent after onset of treatment. When vaginal dryness was addressed, 75% of women had it as a new symptom. Hot flashes onset on 86.5% of women who previously didn’t present it.Humor distress wise 67.9% of patients considered they developed irritability, prior inexistent, in use of HT. Depression or depressive episodes were related by 45.5% of patients without personal history of these disturbers and by 65.2% of patients with depressive personal history.When asked about how much the symptoms interfered in their daily lives, 45.2% consider a huge/considerable interference, 32% a little interference and only 5.8% of women considered symptoms didn’t interfere on their daily lives. Discussion Bringing patients to the center of treatment, more than aiming better therapeutic results, also includes listening to their needs and perceptions about it. Outside clinical trials, there is few information about adherence to HT and factors that leads to HT drop. Surveys applied to oncologic communities may reveal concerns and perceptions that can be differently influenced by local characteristics. This kind of survey can open a window of opportunity for actions directly focused on patients demands. Conclusion Real life data has the potential to direct educational actions for patients and health professionals, according to the specifics perceptions of patient community, aiming for adherence and consequent better treatment results. Citation Format: Marina S Montemor, Lycia TV Neumann, Anna CA Siqueira, Luciana HC Barros, Solange M Sanches. Assessing patients perceptions on hormone therapy for breast cancer: Insights from a Brazilian patient group [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-12-14.
Background: The increasing prevalence of preterm birth, which is a global phenomenon, is attributable to the increased medical indications, artificial gestations, and some socioeconomic factors. This study was conducted to identify whether development and equality indices are associated with the incidence of preterm birth, specifically, spontaneous and elective preterm births.Methods: This retrospective observational study comprised an analysis of data on live births from 2019 in Brazil and on socioeconomic indices that were derived from census information in 2017. Data were summarised using absolute and relative frequencies. Spearman’s correlation was used to determine the correlation between socioeconomic factors and the preterm birth rate. Multiple beta regression analysis was performed to determine the best model of socioeconomic covariates and preterm birth rate. The significance level was set at 5%.Results: In 2019 in Brazil, the preterm birth rate was 11.03%, of which 58% and 42% were spontaneous and elective deliveries, respectively. For all preterm births, Spearman’s correlation varied from ρ = 0.4 for the Gini Index and ρ = −0.24 for illiteracy. The best fit modelled the spontaneous preterm birth fraction as a negative function of the Human Development Index (HDI). The best-fit model considered the expected elective preterm birth fraction as a positive function of the HDI and as a negative function of the Gini Index, which was used as a precision parameter.Conclusions: We observed a reduction in the fraction of spontaneous preterm births; however, the distribution was not uniform in the territory: higher rates of spontaneous preterm birth were noticed in the north, northeast, and mid-west regions. Thus, areas with lower education levels and inequal income distribution have a higher proportion of spontaneous preterm birth. The fraction of elective preterm birth was positively associated with more advantaged indices of socioeconomic status.
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