ABSTRACT

Objectives

This study aims to estimate a population-based cancer incidence among indigenous populations in the State of Acre, Brazilian Western Amazon, to provide knowledge about cancer epidemiological profiles contributing to healthcare policies and service planning. Although cancer epidemiology in Brazil is well described through incidence and mortality estimate in the general population, cancer estimates among indigenous peoples are still unknown.

Design

This is a descriptive study of cancer incidence among the indigenous population (2000–2012) in the State of Acre, Brazil. The sources used were population-based cancer registries of Goiânia, hospital-based cancer registry of Acre, São Paulo, and Porto Velho; Special Indigenous Health Districts databases of Acre, Goiânia, and São Paulo; Mortality Information System, and Rio Branco’s public and private laboratories’ reports. Standardized Incidence Ratio (SIR) was calculated using cancer incidence rates of Goiânia as reference.

Results

From 137 cancer cases, 51.8% occurred in women and 32.1% in people aged 70 + . Among men, the most frequent cancer sites were stomach (25.8%), liver (15.1%), colorectal (7.6%), leukemia (7.6%), and prostate (6.1%). Among women, the most frequent were cervical (50.7%), stomach (8.5%), leukemia (5.6%), liver (4.3%), and breast (4.3%). Among men, there was an excess of cancer cases for stomach (SIR=1.75; 95%CI:1.67–1.83), liver (SIR=1.77; 95%CI:1.66–1.88), and leukemia (SIR=1.64; 95%CI:1.49–1.78). In women, an excess of cancer cases was observed for cervical (SIR=4.49; 95%CI:4.34–4.64) and liver (SIR=2.11; 95%CI:1.88–2.34). A lower cancer incidence for prostate (SIR=0.06; 95%CI:0.05–0.07) and female breast (SIR=0.12; 95%CI:0.11–0.14) was observed.

Conclusions

Cervical, stomach, and liver cancers corresponded to 52% of the cases and were highly incident among the Brazilian indigenous population of Western Amazon compared to non-indigenous counterparts. Despite the low frequency of breast and prostate cancer, the fact they were present among indigenous peoples suggests a complex epidemiological transition framework in these populations.

中文翻译：

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巴西亚马逊西部土著居民的癌症发病率

摘要

目标

本研究旨在估计巴西西部亚马逊阿克里州土著人口中基于人群的癌症发病率，以提供有关有助于医疗保健政策和服务规划的癌症流行病学概况的知识。尽管通过对一般人群的发病率和死亡率的估计很好地描述了巴西的癌症流行病学，但土著人民的癌症估计仍然未知。

设计

这是一项关于巴西阿克里州土著人口（2000-2012 年）癌症发病率的描述性研究。使用的来源是戈亚尼亚基于人群的癌症登记处，阿克里、圣保罗和波多韦柳的医院癌症登记处；Acre、Goiânia 和 São Paulo 的特殊土著卫生区数据库；死亡率信息系统，以及 Rio Branco 的公共和私人实验室的报告。使用戈亚尼亚的癌症发病率作为参考计算标准化发病率 (SIR)。

结果

在 137 例癌症病例中，51.8% 发生在女性身上，32.1% 发生在 70 岁以上的人群中。在男性中，最常见的癌症部位是胃癌（25.8%）、肝癌（15.1%）、结直肠癌（7.6%）、白血病（7.6%）和前列腺癌（6.1%）。在女性中，最常见的是宫颈癌（50.7%）、胃癌（8.5%）、白血病（5.6%）、肝癌（4.3%）和乳腺癌（4.3%）。在男性中，胃癌（SIR=1.75；95%CI：1.67-1.83）、肝癌（SIR=1.77；95%CI：1.66-1.88）和白血病（SIR=1.64；95% CI：1.49-1.78）。在女性中，宫颈癌（SIR=4.49；95%CI：4.34-4.64）和肝癌（SIR=2.11；95%CI：1.88-2.34）的癌症病例过多。观察到前列腺癌（SIR=0.06；95%CI：0.05-0.07）和女性乳腺癌（SIR=0.12；95%CI：0.11-0.14）的癌症发病率较低。

结论

宫颈癌、胃癌和肝癌占病例的 52%，与非土著同行相比，西亚马逊巴西土著人口的发病率较高。尽管乳腺癌和前列腺癌的发病率很低，但它们存在于土著人民中的事实表明，这些人群中存在复杂的流行病学过渡框架。