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To evaluate the possible association between risk factors (smoking, sedentarism, alcohol comsumption, excessive sun exposion, overweight and obesity) for cancer and the occurrence of the disease in beneficiaries of a health plan followed by 10 years after the epidemiological profile. Reis Neto, J P; Busch, J M; Stefani, S D CASE-CONTROL STUDY ON RISK FACTORS FOR CANCER FROM THE EPIDEMIOLOGICAL SURVEY CARRIED OUT ON BENEFICIARIES OF A PRIVATE HEALTH CARE PLAN IN BRAZIL: 10 YEARS OF FOLLOW-UP Who What Where Why 4,685 individuals aged>18 years, from a private health care plan diagnosed with cancer who answered an epidemiological survey (self-referenced morbidity) To evaluate the possible association between risk factors (smoking, sedentarism, alcohol comsumption, excessive sun exposion, overweight and obesity) for cancer and the occurrence of the disease in beneficiaries of a health plan followed by 10 years after the epidemiological profile. Brazil To evaluate modifiable risk factors to neoplasms Observational case-control study involving 4,685 individuals diagnosed with cancer. For each case, three controls (same age and sex), who used medical and hospital services for non-oncological reasons (14,055 individuals) were selected When From January 2006 to December 2015 How 1. Guerra MR, Moura Gallo CV, Mendonça GAS-The risk of cancer in Brazil: tendencies and recent epidemiologic studies; Brazilian Journal Oncology 2005; 51(3): 227-234 2. Dugno et Breast cancer profile and association between risk factors and clinical staging in a hospital in the South of Brazil Brazilian Journalof clinical Oncology Vol. 10, no 36 april / may / june 2014 3. Wünsch Filho, F. et al., Tobacco smoking and cancer in Brazil: evidence and prospects, Rev Bras Epidemiol 2010; 13(2): 175-87 4. Gomes, Romeu, Rebello, Lúcia Emilia Figueiredo de Sousa, Araújo, Fábio Carvalho de, & Nascimento, Elaine Ferreira do. (2008) Prostate cancer prevention: a review of the literature. Ciência & Saúde Coletiva, 13(1), 235-246 5. Menezes, Ana MB, Horta, Bernardo L, Oliveira, André Luiz B, Kaufmann, Ricardo AC, Duquia, Rodrigo, Diniz, Alessandro, Motta, Luiz Henrique, Centeno, Marco S, Estanislau, Gustavo, & Gomes, Laura. (2002). Attributed risk to smoking for lung cancer, laryngeal cancer and esophageal cancer Revista de Saúde Pública, 36(2), 129-134 6. Bonequi, Patricia et al. “Risk Factors for Gastric Cancer in Latin-America: A Meta-Analysis.” Cancer causes & control : CCC 24.2 (2013): 217–231. PMC. Web. 16 Oct. 2017 7. Doll R, Hill AB. Mortality in relation to smoking: 10 year's observations of British doctors. Br Med J 1964; 5395: 1399-410; 1460-7. 8. Bessaoud, F. et al. Patterns of Alcohol (Especially Wine) Consumption and Breast Cancer Risk: A Case-Control Study among a Population in Southern France;Annals of Epidemiology , Volume 18 , Issue 6 , 467 - 475 The epidemiological profile of the beneficiaries from a healthcare plan can provide informations that contributes to Oncologic management, as well as to the elaboration of campaigns for decrease risk factors exposure and neoplasm prevention and screening’s programs in this group. In this study we observed possible variables that could be risk factors related to some types of cancer with higher prevalence and diagnostic in the population. CONCLUSION OBJECTIVES REFERENCES Observational case-control study involving 4,685 individuals diagnosed with cancer (Table 1). For each case, we selected three controls (same age and sex), who used medical and hospital services for non-oncological reasons (14,055 individu- als). Statistical analysis used OpenEpi version 3.01 software, by calculating the relative and absolute frequencies, means and standard deviation. For analytical statistics, Chi-square tests (Mantel-Haenszel and Fisher's Exact), when p <0.001. METHODS www.capesesp.com.br Av. Marechal Câmara, 160 - 6º e 7º andares Centro - Rio de Janeiro/RJ - Brasil [email protected] Mean age was (Graphic 1): cases, 57.6 ± 0.4 years (male, 60.5 ± 0.5 years, female, 54.7 ± 0.6 years); Controls, 57.3 ± 0.2 years (male, 60.4 ± 0.3 years, female, 54.7 ± 0.3 years). Tumor frequencies by primary localization in men (Table 2): prostate (36.37%), bronchus and lung (6.52%), colorectal (6.84%), kidney (4.08%) and bladder (3.85%); in women (Table 3): breast (28.26%), thyroid (7.31%), colorectal (7.03%), bronchus and lung (2.54%) and ovary (2.3%). RESULTS 2.4% 2.3% 6.2% 10.9% 13.4% 11.3% 11.5% 13.0% 9.5% 7.5% 5.5% 3.9% 1.7% 1.0% 2.7% 2.5% 6.6% 11.5% 13.6% 11.5% 11.4% 12.0% 9.5% 7.0% 5.5% 3.3% 2.0% 0.8% 18 - 24 years 20 - 24 years 25 - 29 years 30- 34 years 35- 39 years 40 - 44 years 45 - 49 years 50 - 54 years 55 - 59 years 60 - 64 years 65 - 69 years 70 - 74 years 75- 79 years 80 or more PROPORTION BY AGE GROUP Cases Controls GRAPHIC 1 Risk Factor Obesity Obesity + Overweight Obesity + Overweight Obesity + Overweight (pós) Obesity+ Overweight Obesity Obesity Obesity Cancer General General Female Breast Female Breast Colon-Rectus Prostate Stomach Ovaries p-Value 0.076 0.188 0.086 0.982 0.190 0.011 0.663 0.042 OR 0.917 1.045 1.162 1.004 0.842 0.739 1.127 2.170 ( 0.83 ; 1.01 ) ( 0.98 ; 1.12 ) ( 0.98 ; 1.38 ) ( 0.72 ; 1.4 ) ( 0.65 ; 1.09 ) ( 0.58 ; 0.93 ) ( 0.66 ; 1.93 ) ( 1.02 ; 4.64 ) IC-95% OVERWEIGHT AND OBESITY Cancer General Lung Female Breast Larynx Mouth Esophagus Stomach Colon-Rectus Ovaries p-Value 0.322 < 0.001 0.383 <0.001 0.188 <0.001 0.500 0.156 0.355 OR 1.035 2.248 1.093 3.929 2.048 4.876 0.864 1.213 1.351 ( 0.97 ; 1.11 ) ( 1.63 ; 3.11 ) ( 0.89 ; 1.34 ) ( 2.35 ; 6.58 ) ( 0.69 ; 6.1 ) ( 2.27 ; 10.45 ) ( 0.57 ; 1.32 ) ( 0.93 ; 1.58 ) ( 0.71 ; 2.56 ) IC-95% SMOKING WOMEN C50 C73 C18 C34 C56 C43 C54 C16 C53 C20 C67 MALIGNANT NEOPLASM OF BREAST MALIGNANT NEOPLASM OF THYROID GLAND MALIGNANT NEOPLASM OF COLON MALIGNANT NEOPLASM OF BRONCHUS AND LUNG MALIGNANT NEOPLASM OF OVARY MALIGNANT MELANOMA OF SKIN MALIGNANT NEOPLASM OF CORPUS UTERI MALIGNANT NEOPLASM OF STOMACH MALIGNANT NEOPLASM OF CERVIX UTERI MALIGNANT NEOPLASM OF RECTUM MALIGNANT NEOPLASM OF BLADDER ICD Code Description 700 181 131 63 57 52 49 46 45 43 38 Beneficiaries 28.26% 7.31% 5.29% 2.54% 2.30% 2.10% 1.98% 1.86% 1.82% 1.74% 1.53% % TABLE 3 MEN C61 C34 C18 C64 C67 C32 C16 C43 C20 C25 C73 MALIGNANT NEOPLASM OF PROSTATE MALIGNANT NEOPLASM OF BRONCHUS AND LUNG MALIGNANT NEOPLASM OF COLON MALIGNANT NEOPLASM OF KIDNEY, EXCEPT RENAL PELVIS MALIGNANT NEOPLASM OF BLADDER MALIGNANT NEOPLASM OF LARYNX MALIGNANT NEOPLASM OF STOMACH MALIGNANT MELANOMA OF SKIN MALIGNANT NEOPLASM OF RECTUM MALIGNANT NEOPLASM OF PANCREAS MALIGNANT NEOPLASM OF THYROID GLAND ICD Code Description 803 144 114 90 85 53 51 38 37 35 30 Beneficiaries % 36.37% 6.52% 5.16% 4.08% 3.85% 2.40% 2.31% 1.72% 1.68% 1.59% 1.36% TABLE 2 TABLE 4 TABLE 5 Statistically significant tobacco smoking (Table 4) association with lung cancer (p <0.001, OR 2.248), larynx (p <0.001, OR 3.929) and esophagus (p <0.001, OR 4.876) were found. Regarding obesity (Table 5), the only statistically significant association observed was with ovarian cancer (p = 0.042; OR 2.170). Alcohol consumption (Table 6) was associated with female breast cancer (p = 0.016, OR 1.859). No association between sedentary behavior and evaluated types of cancer were found. Cancer General Female Breast Larynx Mouth Esophagus Stomach Colon-Rectus p-Value 0.060 0.016 0.128 0.851 0.205 0.321 0.072 OR 0.931 1.859 1.464 1.119 1.559 1.240 1.481 ( 0.86 ; 1 ) ( 1.11 ; 3.1 ) ( 0.89 ; 2.4 ) ( 0.34 ; 3.64 ) ( 0.78 ; 3.12 ) ( 0.81 ; 1.9 ) ( 0.96 ; 2.27 ) IC-95% ALCOHOL CONSUMPTION TABLE 6 Observational Study 18 - 19 years 20 - 24 years 25 - 29 years 30 - 34 years 35 - 39 years 39 - 44 years 45 - 49 years 50 - 54 years 55 - 59 years 60 - 64 years 65 - 69 years 70 - 74 years 75 - 79 years 80 or more TOTAL: Men Women Total Men and Women 92 55 241 531 781 780 834 980 813 574 431 271 180 61 6.624 Age Group Cases Control 291 296 686 1.088 1.124 841 772 708 524 408 338 192 105 58 7.431 383 351 927 1.619 1.905 1.621 1.606 1.688 1.337 982 769 463 285 119 14.055 Cases Control Cases Control 27 15 70 173 253 241 289 389 244 204 148 92 41 22 2.208 84 91 219 338 376 287 249 221 200 148 110 90 40 24 2.477 111 106 289 511 629 528 538 610 444 352 258 182 81 46 4.685 TABLE 1 CAPESESP The development of cancer is a worldwide health problem and involves known risk factors. In Brazil, Cancer is the second leading cause of death. INTRODUCTION
