Trend of mortality rates for gastric cancer in Brazil and regions in the period of 30 years (1980-2009)

Guimarães, Raphael Mendonça; Muzi, Camila Drumond

doi:10.1590/s0004-28032012000300003

Cited by 22 publications

(26 citation statements)

References 27 publications

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“…Mortality decline has been observed with different speeds of transition in the population among all age groups (17, 32, 34, 53, 55, 61, 65, 67, 75, 86, 91, 98, 106, 114, 116, 123, 124, 145) and across specific age groups, including neonates and infants (50, 99, 117), children (35, 56), adolescents (142), and adults (73, 85, 127). In some countries – such as Spain, Japan, Mexico, and Sri Lanka – good quality vital registration allows researchers to study mortality transition over long time periods.…”

Section: Discussionmentioning

confidence: 99%

“…Demographic and socio-economic determinants, including sex, income level, education level, marital status, ethnicity, regional differences, as well as wider structural and environmental factors, can influence the transition process and lead to unequal health outcomes. In this review, we observed sex differentials in mortality over time (46, 49, 51, 73, 80, 81, 86, 94, 106, 118, 123, 132, 157); regional disparities in mortality (57, 60, 62, 72, 74, 76, 77, 85, 102, 146, 148, 172); social, economic, and mortality disparities across different ethnic groups (48, 49, 90, 98, 121, 125, 156); and climatic factors as determinants of mortality transition (115, 124, 153). …”

Section: Discussionmentioning

confidence: 99%

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The development and experience of epidemiological transition theory over four decades: a systematic review

Santosa

Wall

Fottrell

et al. 2014

Global Health Action

145

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BackgroundEpidemiological transition (ET) theory, first postulated in 1971, has developed alongside changes in population structures over time. However, understandings of mortality transitions and associated epidemiological changes remain poorly defined for public health practitioners. Here, we review the concept and development of ET theory, contextualising this in empirical evidence, which variously supports and contradicts the original theoretical propositions.DesignA Medline literature search covering publications over four decades, from 1971 to 2013, was conducted. Studies were included if they assessed human populations, were original articles, focused on mortality and health or demographic or ET and were in English. The reference lists of the selected articles were checked for additional sources.ResultsWe found that there were changes in emphasis in the research field over the four decades. There was an increasing tendency to study wide-ranging aspects of the determinants of mortality, including risk factors, lifestyle changes, socio-economics, and macro factors such as climate change. Research on ET has focused increasingly on low- and middle-income countries rather than industrialised countries, despite its origins in industrialised countries. Countries have experienced different levels of progress in ET in terms of time, pace, and underlying mechanisms. Elements of ET are described for many countries, but observed transitions have not always followed pathways described in the original theory.ConclusionsThe classic ET theory largely neglected the critical role of social determinants, being largely a theoretical generalisation of mortality experience in some countries. This review shows increasing interest in ET all over the world but only partial concordance between established theory and empirical evidence. Empirical evidence suggests that some unconsidered aspects of social determinants contributed to deviations from classic theoretical pathways. A better-constructed, revised ET theory, with a stronger basis in evidence, is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The development and experience of epidemiological transition theory over four decades: a systematic review

Santosa

Wall

Fottrell

et al. 2014

Global Health Action

145

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“…Gastric cancer patients are usually faced with a poor prognosis due to diagnosis at later stages (8,24) . In these settings, combination therapy has become an established treatment for patients with locally advanced gastric cancer, whereas the high risk of locoregional relapses has favored the inclusion of radiotherapy as a perioperative component of its comprehensive therapeutic strategy.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of N-Ratio in Selecting Patients for Adjuvant Chemoradiotherapy After D2-Gastrectomy

Costa

Coimbra

Batista

et al. 2013

Arq. Gastroenterol.

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-Context -Whether adjuvant chemoradiotherapy may contribute to improve survival outcomes after D2-gastrectomy remains controvertial. Objective -To explore the clinical utility of N-Ratio in selecting gastric cancer patients for adjuvant chemoradiotherapy after D2-gastrectomy. Methods -A retrospective cohort study was carried out on gastric cancer patients who underwent D2-gastrectomy alone or D2-gastrectomy plus adjuvant chemoradiotherapy (INT-0116 protocol) at the Hospital A. C. Camargo from September 1998 to December 2008. Statistical analysis were performed using multiple conventional methods, such as c-statistic, adjusted Cox's regression and stratified survival analysis. Results -Our analysis involved 128 patients. According to c-statistic, the N-Ratio (i.e., as a continuous variable) presented "area under ROC curve" (AUC) of 0.713, while the number of metastatic nodes presented AUC of 0.705. After categorization, the cut-offs provide by Marchet et al. displayed the highest discriminating power -AUC value of 0.702. This N-Ratio categorization was confirmed as an independent predictor of survival using multivariate analyses.There also was a trend of better survival by adding of adjuvant chemoradiotherapy only for patients with milder degrees of lymphatic spread -5-year survival of 23.1% vs 66.9%, respectively (HR = 0.426, 95% CI 0.150-1.202; P = 0.092). Conclusions -This study confirms the N-Ratio as a tool to improve the lymph node metastasis staging in gastric cancer and suggests the cut-offs provided by Marchet et al. as the best way for its categorization after a D2-gastrectomy. In these settings, the N-Ratio appears a useful tool to select patients for adjuvant chemoradiotherapy, and the benefit of adding this type of adjuvancy to D2-gastrectomy is suggested to be limited to patients with milder degrees of lymphatic spread (i.e., NR2, 10%-25%).

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“…The studies published in this issue of ARQUIVOS de GASTROENTEROLOGIA (3,7) reflects these tendency and therefore all the efforts should be developed in better sanitary health efforts to improve health conditions and educational measures must be taken to teach, show and change alimentary habits.…”

Section: Headings -Stomach Neoplasms Epidemiologymentioning

confidence: 99%

Gastric cancer trends in epidemiology

Zilberstein

Jacob

Cecconello

2012

Arq. Gastroenterol.

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Trend of mortality rates for gastric cancer in Brazil and regions in the period of 30 years (1980-2009)

Cited by 22 publications

References 27 publications

The development and experience of epidemiological transition theory over four decades: a systematic review

The development and experience of epidemiological transition theory over four decades: a systematic review

Evaluation of N-Ratio in Selecting Patients for Adjuvant Chemoradiotherapy After D2-Gastrectomy

Gastric cancer trends in epidemiology

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