Population-Based Trends in Cervical Cancer Incidence and Mortality in Brazil: Focusing on Black and Indigenous Population Disparities

Melo, Andréia Cristina de; Silva, Jessé Lopes da; Santos, Alexssandra Lima Siqueira Dos; Thuler, Luiz Cláudio Santos

doi:10.1007/s40615-023-01516-6

Cited by 6 publications

(3 citation statements)

References 46 publications

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“…However, none of these six countries publicly provide cancer rates for Indigenous people in their registry reports. Two recent studies have estimated cervical cancer mortality among Indigenous women in Brazil, reporting a mean age-standardized mortality rate of 6.7 per 100,000 between 2000 and 2020, the highest among all ethnic groups in the country and corresponding to a significant 80% increase in cervical cancer death risk compared to white women ( 73 , 74 ). Regarding cervical cancer incidence, a study conducted on the Indigenous population in the State of Acre, located in the Brazilian Western Amazon, reported that, between 2000 and 2012, cervical cancer was the most frequent neoplasm among indigenous women, and cervical cancer incidence was significantly higher compared to the reference population (Standardized Incidence Ratio: 4.49) ( 75 ).…”

Section: The Burden Of Cervical Cancer Among Indigenous Women In Lati...mentioning

confidence: 99%

Addressing the burden of cervical cancer for Indigenous women in Latin America and the Caribbean: a call for action

Muslin

2024

Front. Public Health

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Cervical cancer, primarily caused by human papillomavirus (HPV) infection, poses a significant global health challenge. Due to higher levels of poverty and health inequities, Indigenous women worldwide are more vulnerable to cervical cancer than their non-Indigenous counterparts. However, despite constituting nearly 10% of the population in Latin America and the Caribbean (LAC), the true extent of the burden of cervical cancer among Indigenous people in this region remains largely unknown. This article reviews the available information on cervical cancer incidence and mortality, as well as HPV infection prevalence, among Indigenous women in LAC. The limited existing data suggest that Indigenous women in this region face a heightened risk of cervical cancer incidence and mortality compared to non-Indigenous women. Nevertheless, a substantial knowledge gap persists that must be addressed to comprehensively assess the burden of cervical cancer among Indigenous populations, especially through enhancing cancer surveillance across LAC countries. Numerous structural, social and cultural barriers hindering Indigenous women’s access to HPV vaccination and cervical cancer screening worldwide have been identified and are reviewed in this article. The discussion highlights the critical role of culturally sensitive education, community engagement, and empowerment strategies in overcoming those barriers. Drawing insights from the success of targeted strategies in certain high-income countries, the present article advocates for research, policies and healthcare interventions tailored to the unique context of LAC countries.

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Section: The Burden Of Cervical Cancer Among Indigenous Women In Lati...mentioning

confidence: 99%

Addressing the burden of cervical cancer for Indigenous women in Latin America and the Caribbean: a call for action

Muslin

2024

Front. Public Health

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“…Cervical cancer ranks as the fourth most prevalent malignancy among women globally and is primarily attributed to infection with high-risk human papillomavirus (HR-HPV), notably types 16 and 18 [1][2][3][4][5][6][7][8]. Persistent HR-HPV infection can progress from reversible precancerous lesions to invasive cervical cancer, driven by the actions of HPV genes, particularly E6 and E7, which lead to cell cycle dysregulation.…”

Section: Introductionmentioning

confidence: 99%

Enhancing Cervical Cancer Screening: Review of p16/Ki-67 Dual Staining as a Promising Triage Strategy

Ouh,

Kim,

et al. 2024

Diagnostics

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Cervical cancer, primarily caused by high-risk human papillomavirus (HR-HPV) types 16 and 18, is a major global health concern. Persistent HR-HPV infection can progress from reversible precancerous lesions to invasive cervical cancer, which is driven by the oncogenic activity of human papillomavirus (HPV) genes, particularly E6 and E7. Traditional screening methods, including cytology and HPV testing, have limited sensitivity and specificity. This review explores the application of p16/Ki-67 dual-staining cytology for cervical cancer screening. This advanced immunocytochemical method allows for simultaneously detecting p16 and Ki-67 proteins within cervical epithelial cells, offering a more specific approach for triaging HPV-positive women. Dual staining and traditional methods are compared, demonstrating their high sensitivity and negative predictive value but low specificity. The increased sensitivity of dual staining results in higher detection rates of CIN2+ lesions, which is crucial for preventing cervical cancer progression. However, its low specificity may lead to increased false-positive results and unnecessary biopsies. The implications of integrating dual staining into contemporary screening strategies, particularly considering the evolving landscape of HPV vaccination and changes in HPV genotype prevalence, are also discussed. New guidelines and further research are necessary to elucidate the long-term effects of integrating dual staining into screening protocols.

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“…The mean age-adjusted mortality rates according to race/skin color were 3.7/100,000 for white, 4.2/100,000 for black, 2.8/100,000 for yellow, and 6.7/100,000 for indigenous women. Taking the mortality rates in white women as a reference, there was a 27% increase in death risk in black women (RR=1.27) and 82% in indigenous women (RR=1.82) 8 .…”

Section: Introductionmentioning

confidence: 99%

Breast and gynecologic cancers as a Brazilian health priority

Nogueira-Rodrigues

Rosa

Suzuki

et al. 2023

Rev. Assoc. Med. Bras.

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SUMMARY OBJECTIVE: Cancer imposes a profound burden on low- and middle-income countries where 65% of the global cancer deaths occurred in 2020. The objective of the present review was to describe female cancer epidemiology in Brazil, barriers to prevention, screening, and treatment, and to propose strategies to a better control. METHODS: For the process of literature search and scientific acquisition, we have utilized the terms “female cancer” AND “breast cancer,” AND “cervical cancer” AND “endometrial cancer” AND “ovarian cancer” AND “Brazil” in PubMed. References of the articles included in this review were manually searched in order to identify relevant studies on the topic. The official Brazilian epidemiology data were extensively analyzed at the governmental site www.inca.gov.br . RESULTS: Considering cases of breast and gynecologic cancers together, 105,770 new cases are expected to be diagnosed yearly, positioning female cancer as the highest cancer incidence in Brazil. Female breast cancer is the most common and the leading cause of death from cancer in the female population in all regions of Brazil, except in the North, where cervical cancer ranks first. Cervical cancer, a preventable disease, corresponds to the third-most common neoplasia in women, with higher incidences in the North and Northeast regions of Brazil. An upward trend has been observed in endometrial cancer incidence, a tendency that follows the increase of its two most common risk factors: population aging and obesity. Ovarian cancer currently occupies the eighth position among female cancers in Brazil, but it is the most lethal gynecologic cancer. The main strategies to reduce female cancer mortality rates are the reduction of inequalities in healthcare services and the early diagnosis of cases. The lack of a specific national cancer program results in a reactive and unplanned approach to healthcare provision, ultimately leading to suboptimal resource utilization and higher expenditure. CONCLUSION: Analyzed together, breast and gynecologic cancers correspond to the leading cause of cancer in Brazil. A heterogeneous group, female cancer includes diseases with a high primary and secondary prevention potential. The organization of a female cancer program in Brazil prioritizing primary and secondary prevention strategies, such as adequate mammography screening and human papillomavirus vaccination coverage, could significantly improve female cancer control in the country.

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Population-Based Trends in Cervical Cancer Incidence and Mortality in Brazil: Focusing on Black and Indigenous Population Disparities

Cited by 6 publications

References 46 publications

Addressing the burden of cervical cancer for Indigenous women in Latin America and the Caribbean: a call for action

Addressing the burden of cervical cancer for Indigenous women in Latin America and the Caribbean: a call for action

Enhancing Cervical Cancer Screening: Review of p16/Ki-67 Dual Staining as a Promising Triage Strategy

Breast and gynecologic cancers as a Brazilian health priority

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