Navegando por Autor "Cancela, Marianna de Camargo"
Agora exibindo 1 - 20 de 20
- Resultados por página
- Opções de Ordenação
Artigo Association of cervical and breast cancer mortality with socioeconomic indicators and availability of health services(Elsevier, 2020) Souza, Dyego Leandro Bezerra de; Oliveira, Nayara Priscila Dantas de; Siqueira, Camila Alves dos Santos; Lima, Kálya Yasmine Nunes de; Cancela, Marianna de Camargo; https://orcid.org/0000-0001-8426-3120Objective: Analyze cervical and breast cancer mortality in Brazil and its relationship with socioeconomic population indicators and availability of health services in the period 2011–2015. Methods: An ecological study is presented herein. Mortality data were extracted from the Mortality Information System, based on ICD-10, per area of residence and age group, for the period 2011–2015. Socioeconomic variables were extracted from the Brazilian Human Development Atlas, and the National Register of Health Facilities (CNES) provided data on the density of physicians and health services. Statistical analysis was carried out using the Chi-squared test and Poisson regression, with robust variance and 95 % confidence level. Results: The median age-standardized mortality rates for cervical and breast cancers were, respectively, 5.95 (± 3.97) and 10.65 (± 3.12) per 100,000 women. High cervical cancer mortality rates presented a statistically significant association with GINI Index (p=0.000) and Human Development Index - HDI (p=0.030). High breast cancer mortality rates were positively associated with the variables “number of general physicians per 100,000 inhabitants” (p = 0.005) and “Number of licensed oncology centers per 1,000,000 inhabitants” (p = 0.002). Conclusion: The importance of organization and equity in the access to health services is highlighted herein, enabling the reorientation of public policies aimed at the minimization of health disparitiesArtigo Body image of women submitted to breast cancer treatment(Asian Pacific Journal Of Cancer Prevention, 2018) Souza, Dyego Leandro Bezerra de; Guedes, Thais Sousa Rodrigues; Oliveira, Nayara Priscila Dantas de; Holanda, Ayrton Martins; Reis, Mariane Albuquerque; Silva, Clécia Patrocínio da; Silva, Bárbara Layse Rocha e; Cancela, Marianna de Camargo; https://orcid.org/0000-0001-8426-3120The study of body image includes the perception of women regarding the physical appearance of their own body. The objective of the present study was to verify the prevalence of body image dissatisfaction and its associated factors in women submitted to breast cancer treatment. Methods: A cross-sectional study carried out with 103 female residents of the municipality of Natal (Northeast Brazil), diagnosed with breast cancer who had undergone cancer treatment for at least 12 months prior to the study, and remained under clinical monitoring. The variable body image was measured through the validated Body Image Scale (BIS). Socioeconomic variables and clinical history were also collected through an individual interview with each participant. The Pearson’s chi-squared test (Fisher’s Exact) was utilized for bivariate analysis, calculating the prevalence ratio with 95% confidence interval. Poisson regression with robust variance was utilized for multivariate analysis. The statistical significance considered was 0.05. Results: The prevalence of body image dissatisfaction was 74.8% CI (65%-82%). Statistically significant associations were observed between body image and multi-professional follow-up (p=0.009) and return to employment after treatment (p=0.022). Conclusion: It was concluded that women who reported employment after cancer treatment presented more alterations in self-perception concerning their appearance. Patients who did not receive multi-professional follow-up reported negative body image, evidencing the need for strategies that increase and improve healthcare, aiming to meet the demands of this population.Artigo Completeness of cervical cancer staging information in Brazil: A national hospital-based study(Elsevier, 2022) Souza, Dyego Leandro Bezerra de; Oliveira, Nayara Priscila Dantas de; Cancela, Marianna de Camargo; Martins, Luís Felipe Leite; Meira, Karina Cardoso; Castro, Janete Lima de; https://orcid.org/0000-0001-8426-3120Background: Cancer staging information in Hospital Cancer Registries (HCR) is essential for cancer care quality evaluations. This study aimed to analyze the completeness of cervical cancer staging in Brazilian HCR and identify individual and contextual factors associated with unknown staging. Methods: The outcome analyzed was missing or unknown staging (Malignant Tumor Classification System and/or International Federation of Gynecology and Obstetrics) in 2006–2015. Individual data on cancer cases were collected from the HCR Integrator. Contextual variables were collected from the Atlas of Human Development in Brazil, the National Registry of Health Facilities, and the Outpatient Information System. The random intercept multilevel Poisson regression model was performed to identify the factors associated with the outcome. Results: The prevalence of unknown staging data was 32.4% (95% confidence interval [CI], 32.1–32.7). Women aged 18–29 years (prevalence ratio [PR], 1.48; 95% CI, 1.42–1.54), referred by the public health system (PR, 1.16; 95% CI, 1.11–1.21), living in states with a low density of oncologists (PR, 1.70; 95% CI, 1.62–1.79), and with a low cytopathological testing rate (PR, 1.69; 95% CI, 1.57–1.82) showed a higher prevalence of unknown tumor staging data. A lower level of education (PR, 0.91; 95% CI, 0.84–0.98) was associated with complete staging data. Conclusions: Individual and contextual factors were associated with missing staging data. It is necessary to improve information on cancer in the HCRs by improving the awareness and training of Brazilian cancer care professionalsArtigo COVID-19 no Brasil: tendências, desafios e perspectivas após 18 meses de pandemia(Revista Panamericana de Salud Pública, 2022) Souza, Dyego Leandro Bezerra de; Siqueira, Camila Alves dos Santos; Freitas, Yan Nogueira Leite de; Cancela, Marianna de Camargo; Carvalho, Monica; Silva, Leorik Pereira da; Dantas, Nielsen Castelo Damasceno; https://orcid.org/0000-0001-8426-3120Objetivo. Analisar as tendências de incidência e mortalidade por COVID-19 no Brasil, nas unidades da federação e nas capitais. Método. Realizou-se um estudo ecológico com dados de incidência e de mortalidade por COVID-19 referentes ao período de 25 de fevereiro de 2020 (primeiro caso notificado no Brasil) a 31 de julho de 2021. Os dados foram agrupados por mês para cálculo das taxas brutas (por 100 000 habitantes) e avaliação das tendências temporais das unidades da federação e de suas capitais. As modificações significativas nas tendências temporais foram analisadas pelo método de regressão por joinpoint. Resultados. Foram identificadas duas ondas de novos casos e óbitos. As unidades da federação com as maiores taxas de incidência foram Amapá, Rio Grande do Norte, Rondônia e Roraima; Amazonas e Rondônia tiveram as maiores taxas de mortalidade. Em geral, as taxas de incidência e mortalidade foram piores na segunda onda. Na primeira onda, a média de meses até o início de uma redução de casos novos foi maior nas capitais, enquanto na segunda onda, o início da redução demorou mais nos estados. Quanto aos óbitos, as capitais necessitaram de menos tempo para apresentar redução tanto na primeira quanto na segunda onda. Conclusão. A heterogeneidade regional detectada reforça a ideia de que a incidência e a mortalidade por COVID-19 estão associadas a fatores políticos, geográficos, culturais, sociais e econômicosTese Desigualdades no diagnóstico e mortalidade por câncer de mama e colo do útero no Brasil(Universidade Federal do Rio Grande do Norte, 2020-09-25) Oliveira, Nayara Priscila Dantas de; Souza, Dyego Leandro Bezerra de; Cancela, Marianna de Camargo; ; ; Santos, Arn Migowski Rocha dos; ; Lyra, Clelia de Oliveira; ; Godoy, Gustavo Pina; ; Rosendo, Tatyana Maria Silva de Souza;Os cânceres de mama e colo do útero destacam-se entre os tipos oncológicos femininos com elevadas taxas de incidência e mortalidade, que apresentam consideráveis diferenças regionais. A discussão sobre as desigualdades no diagnóstico e morte por câncer de mama e colo do útero possibilita a compreensão destas doenças a nível individual e populacional. A presente tese teve o objetivo de analisar o estadiamento e a mortalidade por câncer de mama e colo do útero e sua relação com o contexto socioeconômico e de oferta de serviços de saúde no Brasil. Foram desenvolvidos cinco estudos observacionais, sendo um do tipo ecológico clássico, dois estudos transversais e dois do tipo ecológico de análise espacial. Os dados sobre mortalidade foram coletados do Sistema de Informações sobre Mortalidade (SIM). Os dados individuais relacionados ao diagnóstico do câncer foram obtidos do Integrador dos Registros Hospitalares de Câncer (RHC). As variáveis socioeconômicas contextuais foram coletadas no Atlas do Desenvolvimento Humano no Brasil, e os dados sobre a oferta de serviços de saúde no Cadastro Nacional de Estabelecimentos de Saúde (CNES), no Sistema de Informações Ambulatoriais de Saúde (SIA-SUS) e na Agência Nacional de Saúde Suplementar (ANS). A análise da mortalidade foi realizada por meio da Regressão de Poisson com variância robusta. Para análise do estadiamento avançado foi realizado o modelo de Regressão de Poisson Multinível, com intercepto aleatório. Na análise espacial foi utilizado o índice de Moran Global e Indicador Local de Associação Espacial (LISA) e os modelos com efeitos espaciais globais. Os principais resultados foram: (1) A taxa média de mortalidade por câncer do colo do útero foi de 5,95 (±3,97) e a taxa média de mortalidade por câncer de mama foi de 10,65 (± 3,12) por 100.000 mulheres. A alta taxa de mortalidade por câncer de mama apresentou associação com maior densidade de médicos generalistas e maior oferta de serviços de saúde em oncologia. A alta taxa de mortalidade por câncer do colo uterino apresentou associação com maiores índices de desigualdade social local e menores níveis de desenvolvimento humano das regiões avaliadas. (2) A proporção de estadiamento avançado do câncer de mama foi de 40,0%. O estadiamento avançado apresentou associação com fatores individuais e contextuais relacionados ao acesso público aos serviços de saúde e à baixa densidade de mamógrafos. (3) Em 32,4% dos casos de câncer de colo uterino, o estadiamento estava ausente, associado significativamente a fatores individuais e contextuais de oferta de serviços de saúde. A proporção de estadiamento avançado foi de 48,4%, com associação a fatores individuais e contextuais de acesso público aos serviços de saúde e à baixa proporção de exames citopatológicos. (4) O estadiamento avançado do câncer de mama apresentou correlação espacial positiva com o Índice de Gini e negativa com a densidade de ginecologistas. As taxas de mortalidade apresentaram correlação espacial positiva com o IDH e com a densidade de médicos ginecologistas. (5) O estadiamento avançado do câncer de colo uterino apresentou correlação espacial positiva com o Índice de Gini e negativa com a proporção de beneficiários de planos privados de saúde. As taxas de mortalidade apresentaram correlação espacial positiva com o Índice de Gini e negativa com a densidade de médicos ginecologistas. O estudo sinaliza as desigualdades sociais envolvidas no diagnóstico e na mortalidade por câncer de mama e colo do útero no Brasil. Destaca-se a importância da estruturação e da equidade no acesso aos serviços e tecnologias de saúde no território brasileiro. A reorientação de políticas públicas de saúde possibilitaria otimizar o controle, prevenção e tratamento oportuno do câncer de mama e colo do útero no país.Artigo Digital rectal examination and its associated factors in the early detection of prostate cancer: a cross-sectional population-based study(Springer, 2019) Souza, Dyego Leandro Bezerra de; Soares, Samara Carollyne Mafra; Cancela, Marianna de Camargo; Migowski, Arn; https://orcid.org/0000-0001-8426-3120Background: Digital rectal examination (DRE) is one of the most common strategies for prostate cancer early detection. However, the use for screening purposes has a controversial benefit and potential harms can occur due to false-positive results, overdiagnosis and overtreatment. The objective of this study is to calculate the prevalence and identify factors associated with the receipt of DRE in Brazilian men. Methods: We selected men older than 40 from a nationwide population-based survey (13,625 individuals) excluding those with prostate cancer diagnosis. Information was extracted from the most recent database of the Brazilian National Health Survey (PNS 2013). Statistical analysis was carried out to calculate incidence rate ratios, with 95% confidence intervals and p values, through multivariate analysis with Poisson regression and robust variance. Results: Men having private health insurance (63.3%; CI = 60.5–66.0) presented higher prevalence of DRE than those in the public health system (41.6%; CI = 39.8–43.4). The results show a positive association between DRE and men having private health insurance, aged 60–69, living with a spouse, never smokers, and living in urban areas. Among public health services users, this positive association was observed among men aged 70– 79, living with a spouse, having bad/very bad health self-perception, abstainers, ex-smokers, with undergraduate studies, presenting four or more comorbidities, and residing in urban areas. Conclusions: Prostate cancer screening with DRE is quite frequent in Brazil, specially among men with private health plans and better access to health services, healthier lifestyle and at more advanced ages, characteristics which increase the risk of overdiagnosis and overtreatmentTese Disfunção sexual em mulheres com câncer: revisão sistemática e estudo de coorte retrospectivo(Universidade Federal do Rio Grande do Norte, 2023-04-12) Guedes, Thais Sousa Rodrigues; Souza, Dyego Leandro Bezerra de; Roig, Javier Jerez; https://orcid.org/0000-0001-8426-3120; http://lattes.cnpq.br/9953301230987878; http://lattes.cnpq.br/7382776477577498; Sunemi, Mariana Maia de Oliveira; Mirabal, Isabelle Ribeiro Barbosa; Micussi, Maria Thereza Albuquerque Barbosa Cabral; http://lattes.cnpq.br/2360845979410206; Cancela, Marianna de CamargoO processo de adoecimento pelo câncer, associado às alterações decorrentes dos tratamentos resultam em grandes alterações na resposta sexual feminina. O presente estudo teve como objetivos: A) Revisar sistematicamente a literatura científica acerca do risco para o desenvolvimento de disfunção sexual em mulheres adultas que passaram por tratamento para o câncer em geral. B) Analisar o risco de disfunção sexual em mulheres sobreviventes do câncer de mama em comparação com o grupo de mulheres sem um histórico de câncer. Tratam-se de dois estudos- A) Revisão sistemática da literatura de acordo com Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Foram consultadas as seguintes bases de dados: Pubmed, Lilacs, Scielo, Cinahl, Scopus e Web of Science. Os descritores foram: Cancer, neoplasmas, “Sexual Dysfunction”, “sexual function” e women. Para avaliação da qualidade de evidências foi usado a ferramenta Assessing the Quality of Observational Cohort and Cross-Sectional Studies. B) Estudo do tipo coorte retrospectivo, a amostra foi composta por mulheres com diagnóstico de neoplasia mamária há no mínimo um ano e que se submeteram ao tratamento (grupo exposto), e por mulheres da comunidade que não possuem histórico de câncer de mama (grupo não exposto). A coleta de dados foi realizada por meio dos prontuários das pacientes diagnosticadas com câncer de mama e de entrevista individual através do questionário validadado Female Sexual Function Index (FSFI) das pacientes com e sem câncer de mama. Foram incluídos 16 artigos no estudo (A), através dos quais foi possível identificar que a disfunção sexual em pacientes com câncer esteve presente em todos os estudos, exceto 2, sua incidência variou entre 30% e 80%, e o risco para o desenvolvimento da disfunção sexual aumenta entre 2,7 e 3,5 vezes em mulheres que tiveram câncer de mama e cervical. Participaram do segundo estudo (B), 90 mulheres do grupo exposto e 93 mulheres no grupo não exposto. Mulheres do grupo exposto ao câncer apresenta 3,9 vezes mais chances de apresentar disfunção sexual quando comparadas a mulheres não expostas ( OR: 3,9; IC: 1,8-8,2; p <0,001), sendo a incidência de disfunção sexual igual a 74,0% nesse grupo, a presença de comorbidades eleva as chances em 2.5 vezes para a ocorrência de disfunção sexual ( OR: 2,5; IC: 1,2-4,9; p =0,009). Conclui-se que mulheres com câncer possuem um risco 2.7 a 3.5 vezes maior de apresentar disfunção sexual, e especificamente em mulheres com câncer de mama investigadas retrospectivamente, as chances para esse público foi 3.9 vezes maior em comparação com mulheres sem histórico de câncer, assim o câncer de mama se constitui como um fator de risco para disfunção sexual em mulheres com essa neoplasia.Artigo Effects of the COVID-19 pandemic on the Brazilian electricity consumption patterns(Wiley, 2020) Souza, Dyego Leandro Bezerra de; Carvalho, Monica; Delgado, Danielle Bandeira de Mello; Lima, Karollyne Marques de; Cancela, Marianna de Camargo; Siqueira, Camila Alves dos; https://orcid.org/0000-0001-8426-3120The implementation of mobility restrictions and home office schemes due tothe COVID-19 pandemic have influenced electricity consumption patterns andlevels. This study analyzes the effect of physical distancing measures regardingmobility on the energy consumption trends for the Brazilian energy systemand its subsystems (Northeast, North, South, and Southeast-Midwest). Trendswere evaluated by the Joinpoint software, and the analysis comprehended theperiod between January 1 and May 27, 2020. Daily load data was grouped intoweeks, with the calculation of weekly percentage changes considering a 95%confidence interval andp< 0.05. The weekly electricity loads were comparedin the periods before and after the isolation decrees were enforced in Brazil(March 15, 2020). Statistically significant decreases were observed in the levelsof electricity consumption, with trends represented by two joinpoints. Due tothe different profiles of consumption across the geographic regions, theresulting electricity dynamics were also different. This is the first study toemploy joinpoint analysis for the calculation of energy consumption trendsfocusing on the COVID-29 pandemic. Data presented herein is unique, in itsfocus on Brazil, which enables more accurate implications to be drawn for Bra-zilian policy makersArtigo Lifestyle factors and high body mass index are associated with different multimorbidity clusters in the Brazilian population(Plos One, 2018) Souza, Dyego Leandro Bezerra de; Carvalho, Januse Nogueira de; Cancela, Marianna de Camargo; https://orcid.org/0000-0001-8426-3120Multimorbidity patterns of a population can be influenced by socioeconomic and lifestylerelated factors. Some of these factors are preventable when healthy habits are promoted to the population. This study analyzed the main grouping patterns of chronic diseases and the relationship with socioeconomic and lifestyle-related factors of the Brazilian population (over the age of 18), based on a population-based survey (2013 National Health Survey). A total of 60,202 participants were included. Cluster analysis was carried out to identify the combinations of chronic diseases. Bivariate and multivariate analyses were carried out to verify the relationship between disease clusters and independent variables, utilizing Poisson’s regression with robust variance, considering a 95% confidence interval. Cluster analysis revealed four disease clusters:cardiometabolic diseases/cancer, mental/occupational diseases, musculoskeletal diseases and respiratory diseases, all significantly associated with the female gender, current/past smoking habits and overweight/obesity in multivariate analyses. These aspects must be considered when planning health services and developing strategies and guidelines for the prevention and treatment of multiple chronic conditionsArtigo A multilevel assessment of the social determinants associated with the late stage diagnosis of breast cancer(Springer, 2021) Souza, Dyego Leandro Bezerra de; Oliveira, Nayara Priscila Dantas de; Cancela, Marianna de Camargo; Martins, Luís Felipe Leite; https://orcid.org/0000-0001-8426-3120The advanced-stage diagnosis of breast cancer reveals the inequalities associated with socioeconomic conditions and the offer of health services. This study analyzes the prevalence of advanced breast cancer and its relationship with individual and contextual socioeconomic indicators and offer of health service. A cross-sectional study is presented herein, on the assessment of malignant breast neoplasms in women diagnosed between 2006 and 2015 (n = 195,201). Data were collected from the Hospital Cancer Registry (HCR), Atlas of Human Development in Brazil, and from the National Registry of Health Institutions (NRHI). A multilevel Poisson Regression was carried out with random intercept. The prevalence of advanced breast cancer diagnosis was 40.0%. Advanced staging was associated with younger age groups (PR 1.41), race/nonwhite (PR 1.13), lower education levels (PR 1.38), and public access to health services (PR 1.25). There was also an association with a low density of mammographic equipment (PR 1.08), and with low indices of local social inequality (PR 1.33) and human development (PR 0.80). This study maps and highlights the causes related to inequalities in the diagnosis of advanced breast cancer in Brazil, and presents essential data to reorient public policies and health-related actions to strengthen the control of breast cancer in BrazilArtigo Multimorbidity and its associated factors among adults aged 50 and over: a crosssectional study in 17 European countries(Plos One, 2021) Souza, Dyego Leandro Bezerra de; Fabregas, Albert Oliveras; Espelt, Albert; Prous, Marina Bosque; Cancela, Marianna de Camargo; Compaño, Ester Teixido; Roig, Javier Jerez; https://orcid.org/0000-0001-8426-3120To estimate the prevalence of multimorbidity among European community-dwelling adults, as well as to analyse the association with gender, age, education, self-rated health, loneliness, quality of life, size of social network, Body Mass Index (BMI) and disability. Methods A cross-sectional study based on wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE) was conducted, and community-dwelling participants aged 50+ (n = 63,844) from 17 European countries were selected. Multimorbidity was defined as presenting two or more health conditions. The independent variables were gender, age group, educational level, self-rated health, loneliness, size of network, quality of life, BMI and disability (1+ limitations of basic activities of daily living). Poisson regression models with robust variance were fit for bivariate and multivariate analysis. Results: The prevalence of multimorbidity was 28.2% (confidence interval–CI 95%: 27.5.8–29.0) among men and 34.5% (CI95%: 34.1–35.4) among women. The most common health conditions were cardiometabolic and osteoarticular diseases in both genders, and emotional disorders in younger women. A large variability in the prevalence of multimorbidity in European countries was verified, even between countries of the same region. Conclusions: Multimorbidity was associated with sociodemographic and physical characteristics, self-rated health, quality of life and lonelinessArtigo Prevalence of multimorbidity in the Brazilian adult population according to socioeconomic and demographic characteristics(Plos One, 2017) Souza, Dyego Leandro Bezerra de; Carvalho, Januse Nogueira de; Roncalli, Angelo Giuseppe; Cancela, Marianna de Camargo; https://orcid.org/0000-0001-8426-3120Knowledge on the occurrence of multimorbidity is important from the viewpoint of public policies, as this condition increases the consumption of medicines as well as the utilization and expenses of health services, affecting life quality of the population. The objective of this study was to estimate prevalence of self-reported multimorbidity in Brazilian adults ( 18 years old) according to socioeconomic and demographic characteristics. A descriptive study is presented herein, based on data from the National Health Survey, which was a household-based survey carried out in Brazil in 2013. Data on 60,202 adult participants over the age of 18 were included. Prevalences and its respective confidence intervals (95%) were estimated according to sex, age, education level, marital status, self-reported skin color, area of residence, occupation and federative units (states). Poisson regression models univariate and multivariate were used to evaluate the association between socioeconomic and demographic variables with multimorbidity. To observe the combinations of chronic conditions the most common groups in pairs, trios, quartets and quintets of chronic diseases were observed. The prevalence of multimorbidity was 23.6% and was higher among women, in individuals over 60 years of age, people with low educational levels, people living with partner, in urban areas and among unemployed persons. The states of the South and Southeast regions presented higher prevalence. The most common groups of chronic diseases were metabolic and musculoskeletal diseases. The results demonstrated high prevalence of multimorbidity in Brazil. The study also revealed that a considerable share of the economically active population presented two or more chronic diseases. Data of this research indicated that socioeconomic and demographic aspects must be considered during the planning of health services and development of prevention and treatment strategies for chronic diseases, and consequently, multimorbiditDissertação Projeções e tendências da mortalidade por câncer de pulmão, traqueia e brônquios no Brasil(2016-08-29) Barbosa, Maria Helena Pires Araújo; Souza, Dyego Leandro Bezerra de; ; http://lattes.cnpq.br/9953301230987878; ; http://lattes.cnpq.br/2970690234992260; Barbosa, Isabelle Ribeiro; ; http://lattes.cnpq.br/0211762022010569; Cancela, Marianna de Camargo; ; http://lattes.cnpq.br/7515982754589252As neoplasias representam a segunda causa de morte no mundo. Entre elas, o câncer de pulmão destaca-se como o mais comum de todos os tumores malignos e uma das principais causas de mortalidade entre homens e mulheres nos países desenvolvidos. O objetivo deste trabalho é analisar a tendência de mortalidade por câncer de pulmão no período de 1998 a 2012 e realizar projeção da taxa de mortalidade até o ano de 2032. Trata-se de um estudo ecológico do tipo misto que avaliou a taxa de mortalidade por câncer de pulmão observando a faixa etária da população, assim como o local de residência desses óbitos considerando uma série histórica de 15 anos. As projeções de cada período foram calculadas utilizando o modelo idade – período – coorte do programa Nordpred, no software R. A análise de tendência de mortalidade foi realizada por meio do software Joinpoint Regression Program. Foi utilizado o Annual Percentage Change (APC) para avaliar a tendência de cada seguimento analisado e estimando os valores estatisticamente significativos considerando um nível de confiança de 95%. Ademais, avaliou se alterações no número de mortes estão relacionadas à população ou ao risco de desenvolver o câncer de pulmão. No Brasil 2.237.346 óbitos foram decorrentes de neoplasia no período de 1° de janeiro de 1998 a 31 de dezembro de 2012 e 273.357 (12,21%) foram por câncer de pulmão. A faixa etária com maior número de óbitos, tanto em homens quanto em mulheres, foi a compreendida pelos indivíduos com idade maior ou igual a 60 anos. A análise por meio de Joinpoint apontou redução significativa na taxa de mortalidade padronizada para todo o território brasileiro, assim como em todas as regiões para os homens. Para as mulheres, a região Norte apresentou tendência à estabilidade com posterior joinpoint em 2015 e tendência à redução significativa. Mas, a análise revelou que tanto para o Brasil quanto para as demais regiões, com exceção da região Norte, houve tendência de aumento significativo e presença de joinpoint com posterior período de estabilidade. Contudo, essas mudanças em homens e mulheres estarão relacionadas ao tamanho ou às mudanças estrutura etária da população. Conclui-se que no período investigado, considerando homens e mulheres, haverá diferenças na mortalidade por câncer de pulmão no Brasil e nas regiões brasileiras. E, entre outros fatores, essa mudança terá relação com o tamanho e a faixa etária da população investigada.Artigo Regional and gender differences in laryngeal cancer mortality: trends and predictions until 2030 in Brazil(Elsevier, 2016) Souza, Dyego Leandro Bezerra de; Oliveira, Nayara Priscila Dantas de; Barbosa, Isabelle Ribeiro; Paulino, Jéssica Nayara Vieria; Cancela, Marianna de Camargo; https://orcid.org/0000-0001-8426-3120Objective. Analysis of laryngeal cancer mortality trends in Brazil and its geographic regions for the period 1996-2010 and calculation of mortality predictions for the period 2011-2030. Study Design. An epidemiologic, ecologic, demographic-based study, which utilized information from the Mortality Information System on all cancer-related deaths in Brazil, is presented here. Mortality trends were analyzed by Joinpoint regression, and Nordpred was utilized for the calculation of predictions. Results. When comparing the last observed period and the last predicted period for men, an increase of 10,588 deaths is expected, representing an increase of 69%. For women, the expected increase in the number of deaths will be 2217, representing an increase of 104%. Laryngeal cancer mortality rates will increase in the North and Northeast regions for men and in the Northeast and Southeast regions for women. Conclusions. Despite the current high mortality for laryngeal cancer, rates will continue to increase until 2030 in BrazilArtigo Spatial assessment of advanced-stage diagnosis and lung cancer mortality in Brazil(Plos One, 2022) Souza, Dyego Leandro Bezerra de; Lima, Kalya Yasmine Nunes de; Cancela, Marianna de Camargo; https://orcid.org/0000-0001-8426-3120The high incidence and mortality rates make lung cancer a global public health issue. Socioeconomic conditions and the provision of health services may be associated with this reality. This study investigates the spatial distribution of advanced-stage diagnosis and mortality due to lung cancer and its association with the healthcare services supply and demographic and socioeconomic indicators in Brazil. This is an ecological study with 161 Intermediate Regions of Urban Articulation. Mortality data were extracted from the Mortality Information System, and the cases of lung cancer were obtained from the Integrator of Hospital-Based Cancer Registries from 2011 to 2015. Analyses employed Moran’s I, local indicators of spatial association, and the multivariable model. The proportion of advanced-stage diagnosis was 85.28% (95% CI 83.31–87.10) and was positively associated with the aging rate (Moran’s I 0.11; p = 0.02), per capita income (Moran’s I 0.05; p = 0.01) and negatively associated with Gini Index (Moran’s I -0.16; p = 0.01). The mean age-adjusted mortality rates was 12.82 deaths/100,000 inhabitants (SD 5.12). The age-adjusted mortality rates for lung cancer presented a positive and statistically significant spatial association with all demographic, socioeconomic and healthcare services supply indicators, except for the "density of family health teams" (Moran’s I -0.02 p = 0.28). The multivariable model for the mortality rates was constituted by the variables “Density of facilities licensed in oncology”, “Per capita income”, and “Health plan coverage”. The per capita income presented positive association and health plan coverage negative association with age-adjusted mortality rates. Both associations were statistically significant. The variable density of facilities licensed in oncology showed no significant association with age-adjusted mortality rates. There is a high proportion of advanced-stage diagnosis across the Brazilian territory and inequalities in lung cancer mortality, which are correlated with the most developed areas of the countryArtigo Spatial distribution of advanced stage diagnosis and mortality of breast cancer: socioeconomic and health service offer inequalities in Brazil(Plos One, 2021) Souza, Dyego Leandro Bezerra de; Oliveira, Nayara Priscila Dantas de; Cancela, Marianna de Camargo; Martins, Luís Felipe Leite; https://orcid.org/0000-0001-8426-3120Breast cancer presents high incidence and mortality rates, being considered an important public health issue. Analyze the spatial distribution pattern of late stage diagnosis and mortality for breast cancer and its correlation with socioeconomic and health service offer-related population indicators. Ecological study, developed with 161 Intermediate Region of Urban Articulation (IRUA). Mortality data were collected from the Mortality Information System (MIS). Tumor staging data were extracted from the Hospital Cancer Registry (HCR). Socioeconomic variables were obtained from the Atlas of Human Development in Brazil; data on medical density and health services were collected from the National Registry of Health Institutions (NRHI) and Supplementary National Health Agency. Global Moran's Index and Local Indicator of Spatial Association (LISA) were utilized to verify the existence of territorial clusters. Multivariate analysis used models with global spatial effects. The proportion of late stage diagnosis of breast cancer was 39.7% (IC 39.4–40.0). The mean mortality rate for breast cancer, adjusted by the standard world population was 10.65 per 100,000 women (± 3.12). The proportion of late stage diagnosis presented positive spatial correlation with Gini’s Index (p = 0.001) and negative with the density of gynecologist doctors (p = 0.009). The adjusted mortality rates presented a positive spatial correlation with the Human Development Index (p<0.001) and density of gynecologist doctors (p<0.001). Socioeconomic and health service offer-related inequalities of the Brazilian territory are determinants of the spatial pattern of breast cancer morbimortality in BrazilTese Tendências e projeções da mortalidade pelos cânceres específicos ao gênero no Brasil(Universidade Federal do Rio Grande do Norte, 2015-03-30) Barbosa, Isabelle Ribeiro; Costa, Íris do Céu Clara; Souza, Dyego Leandro Bezerra de; ; http://lattes.cnpq.br/9953301230987878; ; http://lattes.cnpq.br/9903762680376103; ; http://lattes.cnpq.br/0211762022010569; Ferreira, Maria Angela Fernandes; ; http://lattes.cnpq.br/4036539286429296; Curado, Maria Paula; ; http://lattes.cnpq.br/3397823736381748; Cancela, Marianna de Camargo; ; http://lattes.cnpq.br/7515982754589252; Rosendo, Tatyana Maria Silva de Souza; ; http://lattes.cnpq.br/4946747115155324Os cânceres que acometem os órgãos genitais masculinos e femininos, em conjunto com o câncer de mama, são responsáveis por cerca de 20% dos óbitos por câncer no mundo. Conhecer os padrões de mortalidade por esses cânceres no Brasil, as mudanças que se produziram ao longo do tempo, os grupos mais vulneráveis e a carga de mortalidade que se apresentará no futuro são elementos básicos para a estruturação das ações assistenciais e de vigilância do câncer. O objetivo desse estudo foi analisar as tendências de mortalidade pelos cânceres que acometem órgãos que são específicos a cada gênero e projetar a mortalidade por esses cânceres até o ano de 2030, para o Brasil, regiões e estados da federação. Trata-se de um estudo ecológico de base populacional que analisou os óbitos, ocorridos no período 1996 a 2010, decorrentes dos cânceres de colo do útero, corpo do útero, mama feminina, ovários, vulva, vagina, próstata, pênis e testículos, registrados no Sistema de Informação sobre Mortalidade; as informações sobre população foram obtidas do Instituto Brasileiro de Geografia e Estatística. Foi aplicada a Regressão loglineal (Joinpoint regression) com taxas padronizadas (população mundial: ASR-W) para estimar o Annual Percentage Change (APC), o Average Annual Percentage Change (AAPC), o intervalo de confiança 95% e os pontos de inflexão da curva; as projeções foram calculadas através do programa Nordpred, inscrito no programa R, utilizando o modelo idade-período-coorte, analisando posteriormente se as mudanças que se produzirão no futuro serão decorrentes da exposição aos fatores de risco e/ou da estrutura da população exposta ao risco. Todas as análises também foram aplicadas para o conjunto de todos os óbitos por câncer (com exceção dos cânceres de pele não-melanoma). Para o Brasil, a mortalidade pelos cânceres de pênis (APC=1,5% IC95% 0,7;2,3 p<0,05), testículos (APC=1,6% IC95% 0,5;2,8 p<0,05) e ovários (APC=0,8% IC95% 0,1; 1,5 p<0,05), mostraram tendência de aumento, enquanto os cânceres de vulva e vagina (APC=-0,1% IC95% -0,9; 0,7 p=0,8), corpo de útero (APC= -0,3 IC95% -1,0; 0,5 p=0,4), mama (APC=0,4% IC95% -0,2;1,0 p=0,2) e de próstata (AAPC= 1,1% IC95% -0,2; 2,4 p=0,1) apresentaram tendência de estabilidade. A mortalidade por câncer de colo de útero apresentou tendência de redução (APC=-1,7% IC95%-2,2; -1,1 p<0,05). A análise do agrupamento de todos os óbitos por câncer observou tendência de aumento na mortalidade para o sexo masculino até o ano de 2006 (APC= 1,2% IC95% 0,6;1,8 p<0,01), seguido de um período de estabilidade. Para o sexo feminino, a tendência é de estabilidade (APC=0,4% IC95% -0,2;-1,8 p=0,2). As taxas de mortalidade para todos os cânceres analisados mostraram, de maneira geral, tendência de redução nas regiões sul e sudeste, tendência de aumento nas regiões norte e nordeste, e estabilidade para a região centro oeste. Na projeção da mortalidade para o ano 2030, as regiões norte e nordeste responderão pelas maiores taxas de mortalidade para os cânceres analisados; todavia, para as demais regiões, será observada redução nas taxas em comparação com o último período observado. Destacase o câncer de testículo, para o qual será observado aumento de 33% na carga da mortalidade até o ano 2030. Para os demais cânceres, não serão observadas variações consideráveis nas taxas de mortalidade para o Brasil entre o último período observado e o último período projetado. A estrutura e o tamanho da população brasileira serão os fatores que explicarão os padrões de mortalidade por esses cânceres no futuro, embora para a região nordeste, as variações serão explicadas, em maior medida, pelo aumento do risco para esses cânceres. Conclui-se, portanto, que existe uma marcante desigualdade na distribuição da mortalidade pelos cânceres específicos ao gênero no Brasil, onde as regiões mais pobres apresentam um quadro de aumento significativo do número de óbitos ao longo de uma série histórica, e que em 2030, essas regiões responderão pelas maiores taxas de mortalidade no país, com ênfase para os cânceres de pênis, testículos e ovários.Artigo The effect of lockdown on the outcomes of COVID-19 in Spain: an ecological study(Plos One, 2020) Souza, Dyego Leandro Bezerra de; Siqueira, Camila Alves dos Santos; Freitas, Yan Nogueira Leite de; Cancela, Marianna de Camargo; Carvalho, Monica; Fabregas, Albert Oliveras; https://orcid.org/0000-0001-8426-3120It is paramount to expand the knowledge base and minimize the consequences of the pandemic caused by the new Coronavirus (SARS-Cov2). Spain is among the most affected countries that declared a countrywide lockdown. An ecological study is presented herein, assessing the trends for incidence, mortality, hospitalizations, Intensive Care Unit admissions, and recoveries per autonomous community in Spain. Trends were evaluated by the Joinpoint software. The timeframe employed was when the lockdown was declared on March 14, 2020. Daily percentage changes were also calculated, with CI = 95% and p<0.05. An increase was detected, followed by reduction, for the evaluated indicators in most of the communities. Approximately 18.33 days were required for the mortality rates to decrease. The highest mortality rate was verified in Madrid (118.89 per 100,000 inhabitants) and the lowest in Melilla (2.31). The highest daily percentage increase in mortality occurred in Catalonia. Decreasing trends were identified after approximately two weeks of the institution of the lockdown by the government. Immediately the lockdown was declared, an increase of up to 33.96% deaths per day was verified in Catalonia. In contrast, Ceuta and Melilla presented significantly lower rates because they were still at the early stages of the pandemic at the moment of lockdown. The findings presented herein emphasize the importance of early and assertive decision-making to contain the pandemicArtigo Trend analyses of electricity load changes in Brazil due to COVID-19 shutdowns(Elsevier, 2020) Souza, Dyego Leandro Bezerra de; Delgado, Danielle Bandeira de Mello; Lima, Karollyne Marques de; Cancela, Marianna de Camargo; Siqueira, Camila Alves dos Santos; Carvalho, Monica; https://orcid.org/0000-0001-8426-3120This study aims to calculate and assess the electricity load trends for Brazil and its geographic regions, considering the changes due to the COVID-19 pandemic. Statistical trends were evaluated by the Joinpoint software, and the analysis comprehended the period between January 1 and September 29, 2020. Daily load data were grouped into weeks, with the calculation of weekly percentage changes considering a 95% confidence interval and p<0.05. The weekly electricity loads were compared in the periods before and after physical distancing decrees were enforced in Brazil (March 15, 2020). The decreases were different across the regions: the South subsystem presented the highest drop, with -19% when comparing the medians before and after implementation of the physical distancing measures. The Southeast and Northeast regions accompanied the decline, with decreases of -15% and -14% , respectively. The North region, however, has almost returned to initial levels, with a decrement of -3%Artigo Trends of multimorbidity in 15 European countries: a population-based study in community-dwelling adults aged 50 and over(Bmc Public Health, 2021) Souza, Dyego Leandro Bezerra de; Fabregas, Albert Oliveras; Molina, Eduard Minobes; Cancela, Marianna de Camargo; Estragués, Paola Galbany; Jerez-Roig, Javier; https://orcid.org/0000-0001-8426-3120Background: The objective of this work was to analyse the prevalence trends of multimorbidity among European community-dwelling adults. Methods: A temporal series study based on waves 1, 2, 4, 5, 6 and 7 of the Survey of Health, Ageing and Retirement in Europe (SHARE) was conducted, and community-dwelling participants aged 50+ (n = 274,614) from 15 European countries were selected for the period 2004–2017. Prevalence, adjusted by age, Average Annual Percentage Change (APC) and 95% confidence interval (95% CI) were all calculated. Trend analyses were realised by period, age groups and groups of diseases. Results: The results showed a large variability in the prevalence of multimorbidity in adults aged 50 and over among European countries. Increase in the prevalence of multimorbidity in the countries of central Europe (Austria, Belgium, Czech Republic, France, Germany and Switzerland) and Spain in both sexes, and in the Netherlands among men. Stability was observed in northern and eastern European countries. Musculoskeletal and neurodegenerative groups showed more significant changes in the trend analyses. Conclusions: This information can be useful for policy makers when planning health promotion and prevention policies addressing modifiable risk factors in health