Levantamento populacional de indivíduos com predisposição ao câncer gastrointestinal hereditário
Data
2021-10-28
Autores
Silva, Marília Pereira da 
Orientadores
Forones, Nora Manoukian
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Identificar e caracterizar indivíduos em risco para síndromes de câncer gastrointestinal hereditária, em uma amostra de base populacional. Método: Trata-se de um levantamento populacional, utilizando-se de dados obtidos através de questionário epidemiológico, contendo perguntas, baseadas em critérios já estabelecidos pela literatura para análise de predisposição para o câncer do TGI hereditário, realizado no período entre 2019 a 2021. Os dados coletados foram tabulados e analisados através de estatística analítico-descritiva com auxílio da planilha Microsoft Office Excel 2010 e posteriormente, importados para o software IBM-SPSS Statistics versão 27 (IBM Corporation, NY, USA) para análise exploratória dos dados e análise comparativa entre grupos. Neste momento, variáveis binárias foram geradas, a partir daquelas já existentes no banco, quais sejam: predisposição ao câncer (fator 1) e predisposição ao câncer (fator 2), para viabilizar a comparação entre grupos. Resultados: O estudo foi composto pela análise de 1023 participantes. Verificamos a predominância do sexo feminino (74,9%), a idade variou entre 18 a 87 anos, com mediana de 33 ± 13,77 anos (mediana ± desvio padrão), nível de escolaridade acadêmico superior (71,1%), renda mensal de até 2 salários-mínimos, (37,7%), nacionalidade brasileira (99,5%) e natural do estado de São Paulo (77%). A maioria dos indivíduos não eram tabagistas (91,5%). Verificou-se que 47,8% dos participantes não ingeriram nenhum tipo de bebida alcóolica. Os demais consumiam aproximadamente 21g de etanol/semana. Entre a amostra total do estudo, 62,2% apresentaram histórico familiar de câncer, sendo 11,9% com o fator 1 de predisposição ao câncer (idade do diagnóstico até 50 anos do paciente ou familiar), 17,2% com o fator 2 de predisposição ao câncer (câncer em mais de um parente) e 8,7% com dois fatores de predisposição simultaneamente, sendo o parentesco predominante os avós (34,5%), com câncer do TGI (29,1%). Observou-se que, 3,8% dos participantes tiveram histórico de câncer pessoal e destes, 30 (76,9%) com diagnóstico antes dos 50 anos de idade e 8 com tumor gastrointestinal (21,1%). Na análise do histórico de câncer destes 8 participantes, 50% foi diagnosticado até os 50 anos de idade, e 75% afirmaram histórico familiar de câncer, sendo o irmão (50%) o grau de parentesco predominante. Conclusões: Verificamos que a maioria dos indivíduos que responderam ao questionário pertenciam ao sexo feminino e apresentavam idade inferior a 50 anos. Mais da metade relatou algum histórico familiar de câncer e menos de 1% apresentou diagnóstico de câncer do TGI, sendo que mais da metade tinham indícios para predisposição ao câncer gastrointestinal hereditário. Fatores de risco como hábito tabágico, etílico e consumo de carne vermelha não tiveram associação ao câncer gastrointestinal, neste estudo. A identificação de indivíduos e familiares com risco ao câncer do TGI hereditário é importante para a vigilância e prevenção, já que favorece o rastreamento ou diagnóstico precoce, possibilitando a intervenção em fases iniciais, quando o tratamento, geralmente, é mais efetivo.
Objective: To identify and characterize individuals at risk for hereditary gastrointestinal cancer syndromes in a population-based sample. Method: This is a population survey, which has used data obtained through an epidemiological questionnaire with questions based on criteria already established in the literature for the analysis of predisposition to hereditary GI tract cancer and has been conducted in the period between 2019 and 2021. The collected data were tabulated and analyzed using analytical-descriptive statistics in Microsoft Office Excel 2010 spreadsheet and later imported into the IBM- SPSS Statistics version 27 software (IBM Corporation, NY, USA) for exploratory data analysis and comparative analysis between groups. At this time, binary variables were generated from those already existing in the database, namely: predisposition to cancer (factor 1) and predisposition to cancer (factor 2), to enable comparison between groups. Results: The study consisted of the analysis of 1023 participants. We found a predominance of females (74.9%), age ranged from 18 to 87, with a median age of 33 ± 13.77 (median ± standard deviation), higher academic education level (71.1%), monthly income of up to 2 minimum wages (37.7%), Brazilian nationalily (99.5%) and born in the state of São Paulo (77%). Most individuals were not smokers (91.5%). It was observed that 47.8% of the participants did not drink any type of alcoholic beverage. The others consumed approximately 21g of ethanol/week. In the total study sample, 62.2% had a family history of cancer - 11.9% with factor 1 of predisposition to cancer (age at diagnosis up to 50 years of patient or family member), 17.2% with the factor 2 of predisposition to cancer (cancer in more than one relative), and 8.7% with two simultaneously predisposing factors (34.5% with the predominant kinship being grandparents, 29.1% with cancer of the GIT). It was observed that 3.8% of the participants had a history of personal cancer. Among them, 30 (76.9%) were diagnosed before the age of 50, and 8 had a gastrointestinal tumor (21.1%). In the analysis of the cancer history of these 8 participants, 50% were diagnosed up to the age of 50, and 75% stated a family history of cancer, being the sibling (50%) the predominant degree of kinship. Conclusions: We found that most individuals who responded to the questionnaire were female and were under 50 years old. More than half had a family history of cancer, and fewer than 1% reported a diagnosis of GI tract cancer, as more than half having evidence of a predisposition to hereditary gastrointestinal cancer. Risk factors such as smoking, alcohol and red meat consumption were not associated with gastrointestinal cancer in this study. The identification of individuals and family members at risk for hereditary GI tract cancer is important for surveillance and prevention, as it enhances screening or early diagnosis, enabling intervention at early stages, when treatment is generally more effective.
Objective: To identify and characterize individuals at risk for hereditary gastrointestinal cancer syndromes in a population-based sample. Method: This is a population survey, which has used data obtained through an epidemiological questionnaire with questions based on criteria already established in the literature for the analysis of predisposition to hereditary GI tract cancer and has been conducted in the period between 2019 and 2021. The collected data were tabulated and analyzed using analytical-descriptive statistics in Microsoft Office Excel 2010 spreadsheet and later imported into the IBM- SPSS Statistics version 27 software (IBM Corporation, NY, USA) for exploratory data analysis and comparative analysis between groups. At this time, binary variables were generated from those already existing in the database, namely: predisposition to cancer (factor 1) and predisposition to cancer (factor 2), to enable comparison between groups. Results: The study consisted of the analysis of 1023 participants. We found a predominance of females (74.9%), age ranged from 18 to 87, with a median age of 33 ± 13.77 (median ± standard deviation), higher academic education level (71.1%), monthly income of up to 2 minimum wages (37.7%), Brazilian nationalily (99.5%) and born in the state of São Paulo (77%). Most individuals were not smokers (91.5%). It was observed that 47.8% of the participants did not drink any type of alcoholic beverage. The others consumed approximately 21g of ethanol/week. In the total study sample, 62.2% had a family history of cancer - 11.9% with factor 1 of predisposition to cancer (age at diagnosis up to 50 years of patient or family member), 17.2% with the factor 2 of predisposition to cancer (cancer in more than one relative), and 8.7% with two simultaneously predisposing factors (34.5% with the predominant kinship being grandparents, 29.1% with cancer of the GIT). It was observed that 3.8% of the participants had a history of personal cancer. Among them, 30 (76.9%) were diagnosed before the age of 50, and 8 had a gastrointestinal tumor (21.1%). In the analysis of the cancer history of these 8 participants, 50% were diagnosed up to the age of 50, and 75% stated a family history of cancer, being the sibling (50%) the predominant degree of kinship. Conclusions: We found that most individuals who responded to the questionnaire were female and were under 50 years old. More than half had a family history of cancer, and fewer than 1% reported a diagnosis of GI tract cancer, as more than half having evidence of a predisposition to hereditary gastrointestinal cancer. Risk factors such as smoking, alcohol and red meat consumption were not associated with gastrointestinal cancer in this study. The identification of individuals and family members at risk for hereditary GI tract cancer is important for surveillance and prevention, as it enhances screening or early diagnosis, enabling intervention at early stages, when treatment is generally more effective.
Descrição
Citação
SILVA, M. P. Levantamento populacional de indivíduos com predisposição ao câncer gastrointestinal hereditário. São Paulo, 2021. 59 f. Dissertação (Mestrado em Medicina Translacional) – Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2021.