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      Análise do efeito idade-período-coorte na mortalidade por câncer colorretal no Estado do Rio de Janeiro, Brasil, no período 1980 a 2014 Translated title: Análisis del efecto edad-período-cohorte en la mortalidad por cáncer colorrectal en el Estado de Río de Janeiro, Brasil, durante el período 1980 a 2014 Translated title: Analysis of the age-period-cohort effect on mortality from colorectal cancer in Rio de Janeiro State, Brazil, from 1980 to 2014

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          Abstract

          O objetivo deste trabalho foi estimar a contribuição do efeito da idade, do período e da coorte de nascimento na mortalidade por câncer colorretal. Foram analisados dados de óbitos pela neoplasia entre indivíduos com mais de 35 anos de idade do Estado do Rio de Janeiro, Brasil, extraídos do Sistema de Informações sobre Mortalidade (SIM) entre 1980 e 2014. As taxas de mortalidade foram calculadas por gênero e faixa etária. O efeito da idade, período e coorte de nascimento foi estimado pelo método que utiliza funções estimáveis: desvios, curvaturas e drift, na biblioteca Epi do software R. As taxas de mortalidade por câncer colorretal padronizadas foram 27,37/100 mil homens e 21,83/100 mil mulheres em 2014. Verificou-se aumento da mortalidade pela neoplasia entre 1980 e 2014, sendo as taxas de mortalidade entre homens superiores às das mulheres após a década de 1990. O efeito idade foi observado com o aumento das taxas e o envelhecimento. A análise das gerações mostrou o menor risco de óbito nas coortes mais antigas comparadas às mais recentes coortes, o que pode estar ligado à adoção do estilo de vida ocidental. Tal cenário aponta a relevância da implantação de estratégias de rastreamento visando ao diagnóstico e ao tratamento precoce de lesões precursoras da doença.

          Translated abstract

          El objetivo de este trabajo fue estimar la contribución del efecto de la edad, del período y de la cohorte de nacimiento en la mortalidad por cáncer colorrectal. Se analizaron datos de óbitos por la neoplasia entre individuos con más de 35 años de edad del estado de Río de Janeiro, Brasil, extraídos del Sistema de Informaciones sobre Mortalidad (SIM) entre 1980 y 2014. Las tasas de mortalidad fueron calculadas por género y franja de edad. El efecto de la edad, período y cohorte de nacimiento fue estimada por el método que utiliza funciones estimables: desvíos, curvaturas y drift, en la biblioteca Epi del software R. Las tasas de mortalidad por cáncer colorrectal estandarizadas fueron 27,37/100 mil hombres y 21,83/100 mil mujeres en 2014. Se verificó un aumento de la mortalidad por la neoplasia entre 1980 y 2014, siendo las tasas de mortalidad entre hombres superiores a las de las mujeres tras la década de 1990. El efecto edad se observó con el aumento de las tasas y el envejecimiento. El análisis de las generaciones mostró un menor riesgo de óbito en las cohortes más antiguas, comparadas con las cohortes más recientes, lo que puede estar vinculado a la adopción del estilo de vida occidental. Tal escenario apunta la relevancia de la implantación de estrategias de monitoreo con el objetivo del diagnóstico y el tratamiento precoz de lesiones precursoras de la enfermedad.

          Translated abstract

          The aim of this study was to estimate the contribution of the effect of age, period, and birth cohort on mortality from colorectal cancer. The study analyzed data on deaths from this cancer in individuals over 35 years of age in Rio de Janeiro State, Brazil, obtained from the Mortality Information System (SIM) from 1980 to 2014. Mortality rates were calculated by gender and age bracket. The effect of age, period, and birth cohort was estimated by the method that uses estimable functions: deviations, curves, and drift in the Epi library of the R software. Standardized mortality rates from colorectal cancer were 27.37/100,000 men and 21.83/100,000 women in 2014. The data showed an increase in mortality from this cancer from 1980 to 2014, and mortality rates were higher in men than in women after the 1990s. Age effect was observed with an increase in the rates and aging. Generational analysis showed lower risk of death in older versus younger cohorts, possibly related to the adoption of the Western lifestyle. This scenario underscores the need for screening strategies aimed at early diagnosis and treatment of precursor lesions.

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          Most cited references36

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          Analysis of rates from disease registers are often reported inadequately because of too coarse tabulation of data and because of confusion about the mechanics of the age-period-cohort model used for analysis. Rates should be considered as observations in a Lexis diagram, and tabulation a necessary reduction of data, which should be as small as possible, and age, period and cohort should be treated as continuous variables. Reporting should include the absolute level of the rates as part of the age-effects. This paper gives a guide to analysis of rates from a Lexis diagram by the age-period-cohort model. Three aspects are considered separately: (1) tabulation of cases and person-years; (2) modelling of age, period and cohort effects; and (3) parametrization and reporting of the estimated effects. It is argued that most of the confusion in the literature comes from failure to make a clear distinction between these three aspects. A set of recommendations for the practitioner is given and a package for R that implements the recommendations is introduced. Copyright 2006 John Wiley & Sons, Ltd.
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              The epidemiology and molecular biology of colorectal cancer are reviewed with a view to understanding their interrelationship. Risk factors for colorectal neoplasia include a positive family history, meat consumption, smoking, and alcohol consumption. Important inverse associations exist with vegetables, nonsteroidal anti-inflammatory drugs (NSAIDs), hormone replacement therapy, and physical activity. There are several molecular pathways to colorectal cancer, especially the APC (adenomatous polyposis coli)-beta-catenin-Tcf (T-cell factor; a transcriptional activator) pathway and the pathway involving abnormalities of DNA mismatch repair. These are important, both in inherited syndromes (familial adenomatous polyposis [FAP] and hereditary nonpolyposis colorectal cancer [HNPCC], respectively) and in sporadic cancers. Other less well defined pathways exist. Expression of key genes in any of these pathways may be lost by inherited or acquired mutation or by hypermethylation. The roles of several of the environmental exposures in the molecular pathways either are established (e.g., inhibition of cyclooxygenase-2 by NSAIDs) or are suggested (e.g., meat and tobacco smoke as sources of specific blood-borne carcinogens; vegetables as a source of folate, antioxidants, and inducers of detoxifying enzymes). The roles of other factors (e.g., physical activity) remain obscure even when the epidemiology is quite consistent. There is also evidence that some metabolic pathways, e.g., those involving folate and heterocyclic amines, may be modified by polymorphisms in relevant genes, e.g., MTHFR (methylenetetrahydrofolate reductase) and NAT1 (N-acetyltransferase 1) and NAT2. There is at least some evidence that the general host metabolic state can provide a milieu that enhances or reduces the likelihood of cancer progression. Understanding the roles of environmental exposures and host susceptibilities in molecular pathways has implications for screening, treatment, surveillance, and prevention.
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                Author and article information

                Journal
                csp
                Cadernos de Saúde Pública
                Cad. Saúde Pública
                Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (Rio de Janeiro, RJ, Brazil )
                0102-311X
                1678-4464
                2018
                : 34
                : 3
                : e00038017
                Affiliations
                [2] Rio de Janeiro Rio de Janeiro orgnameInstituto Nacional do Câncer Brazil
                [3] Lyon orgnameInternational Agency for Research on Cancer orgdiv1Section of Cancer Surveillance France
                [1] Rio de janeiro orgnameFundação Oswaldo Cruz orgdiv1Escola Nacional de Saúde Pública Sergio Arouca Brazil
                Article
                S0102-311X2018000305016 S0102-311X(18)03400305016
                10.1590/0102-311x00038017
                6887a4d8-3ff6-486d-af57-aec104b0db71

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 05 March 2017
                : 09 October 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 53, Pages: 0
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                SciELO Public Health

                Self URI: Texto completo somente em PDF (PT)

                Efeito Período,Efeito Idade,Neoplasias Colorretais,Efeito de Coortes,Neoplasias Colorrectales,Efecto Edad,Efecto Periodo,Efecto de Cohortes,Colorectal Neoplasms,Age Effect,Period Effect,Cohort Effect

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