Análise de riscos competitivos da sobrevida-específica de pacientes diagnosticados com câncer de próstata no Espírito Santo : estudo de coorte retrospectivo
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Data
2024-03-27
Autores
Grippa, Wesley Rocha
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Universidade Federal do Espírito Santo
Resumo
Background: Prostate cancer is one of the most common cancers in the world, being one of the main causes of premature death in men. Advances in survival analysis techniques have played an important role in recent years, especially after the development and improvement of statistical methods, with direct applications in Public Health and Oncology. Objective: To analyze the specific survival probability of patients with prostate cancer and the factors associated with the risk of death from cancer or other causes in patients diagnosed with prostate cancer who started treatment at the Oncological Care Network (OCN) in the state of Espírito Santo (ES), Brazil. Methods: This is a retrospective observational cohort study. Retrospective observational cohort study. Secondary data were collected via the Tumor Registration Form (TRF) from the Hospital-based Cancer Records (HCR) of patients who received care in a hospital in the OCN of ES, and from the Mortality Information System (SIM/ES), in the period between 2000 and 2020. All occurrences of prostate cancer proven by anatomopathological examinations (ICD-10) were included and analyzed. For data analysis, a descriptive analysis of the epidemiological profile of patients diagnosed with prostate cancer was carried out, in addition to an analysis of completeness of the epidemiological variables from HCR of the ES, which data incompleteness was classified as excellent (< 5%), good (between 5% and 10%), regular (between 10% and 20%), bad (between 20% and 50%) and very bad (> 50%), according to the percentage of missing information. For survival analysis, the deterministic linkage method was done, using the TRF records from the Integrator of the Brazilian Cancer Hospital Registry (SIS-RHC) with the records from the Mortality Information System (SIM/ES). To estimate overall specific survival, the Kaplan-Meier method and multivariate analyzes were used, based on the Cox proportional hazards model and the Fine and Gray competing risks model, in order to investigate the probability of specific death from prostate cancer. In the analysis of the adjusted models, a 5% significance level was adopted to evaluate the significant effect of each of the variables studied. All statistical analyzes were performed using the free software R and RStudio. Approved was obtained by the CCS-UFES Research Ethics Committee (Opinion Number: 5,533,541). Results: The initial dataset included 13,519 cases of prostate cancer in the HCR, recorded with diagnoses between 2000 and 2020. Conclusions: Most variables in the HCR exhibited excellent completeness, but important variables had high percentages of incompleteness, such as TNM and clinical staging, as well as alcoholism and smoking. There was a growing trend in prostate cancer incidence over the years in the ES, with a predilection for older, married men with low educational levels. Furthermore, survival analysis revealed an overall specific survival of 87.7%, and age, educational level, distant metastasis, surgery, radiotherapy, and hormone therapy were associated with the risk of specific mortality among prostate cancer patients. Taken together, these data can assist in decision-making by managers and stakeholders, to support screening and treatment programs, in addition to guiding the improvement of public policies in the area of Oncology, with a view to planning effective actions for cancer surveillance in the various assistance levels of the Health Care Network, in order to improve men’s health care.
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Câncer de próstata , Análise de Sobrevida , Mortalidade , Riscos Competitivos , Neoplasias