OBJECTIVES: Bone cancers occur frequently in children, adolescents, and young adults aging 15 to 29 years. Osteosarcoma and Ewing sarcoma are the most frequent subtypes in this population. The aim of this study was to describe incidence and mortality trends of bone cancers among Brazilian children, adolescents and young adults. METHODS: Incidence information was obtained from 23 population-based cancer registries. Mortality data were extracted from the Atlas of Cancer Mortality from 1979 to 2013. Specific and adjusted rates per million were analyzed according to gender, morphology and age at diagnosis. Median rates were used as a measure of central tendency. Joinpoint regression was applied to analyze trends. RESULTS: Median incidence rates were 5.74 and 11.25 cases per million in children and young adults respectively. Osteosarcoma in the 15-19 years aged group had the highest incidence rates. Stable incidence rates were observed among five registries in 0-14 year's age group. Four registries had a decreased incidence trend among adolescents and young adults. Median mortality rates were 1.22 and 5.07 deaths per million in children and young adults respectively. Increased mortality was observed on the North and Northeast regions. Decreased mortality trends were seen in the South (children) and Southeast (adolescents and young adults). CONCLUSION: Osteosarcoma and Ewing Sarcoma are the most incident bone cancers in all Brazilian regions. Bone cancers showed incidence and mortality patterns variation within the geographic regions and across age groups, although not significant. Despite limitations, it is crucial to monitor cancer epidemiology trends across geographic Brazilian regions.

Resumo Objetivos: Os registros de câncer de base populacional (RCBP) e o Sistema Nacional de Nascidos Vivos (SINASC) possuem informações que possibilitam testar hipóteses sobre fatores de riscos associados às leucemias. O objetivo principal deste projeto é identificar quais as características ao nascimento das crianças que estariam associadas ao risco de desenvolver Leucemia Aguda (LA) na primeira infância. Métodos: Foram utilizadas informações de 12 RCBP e do Sistema de Informação de Nascidos Vivos das mesmas localidades. Foram elegíveis 272 casos e 1.088 controles no período de 1996 a 2010. As associações de riscos de LA foram agrupadas em, (i) características da criança ao nascer, e (ii) características de exposição materna durante a gestação da criança. A relação de casos e controles foi de 1:4. As análises para padronização, estruturação do banco de dados e análises estatísticas foram realizadas através dos aplicativos Excel, R-Studio e SPSS 21. Resultados: Houve associação entre anomalias congênitas (RC 3,62, IC95% 1,19-11,00) e exposição ocupacional materna a produtos químicos (OR 2,18, p 0,002) com o risco do desenvolvimento de LA. Conclusão: A utilização de banco de dados secundários populacionais para a identificação de fatores de risco para LA fortaleceu o intercâmbio de conhecimentos e melhoria das bases de dados, e contribuiu para investigações sobre as associações de riscos nas leucemias agudas em contexto mundial.

Abstract Objective: The population-based cancer registries (PBCR) and the Information System on Live Births in Brazil (Sistema de Informações sobre Nascidos Vivos [SINASC]) have information that enables the test for risk factors associated with leukemia at an early age. The aim of this study was to identify maternal and birth characteristics associated with early-age acute leukemia (EAL) in Brazil. Methods: A case-cohort study was performed using secondary dataset information of PBCR and SINASC. The risk association variables were grouped into (i) characteristics of the child at birth and (ii) characteristics of maternal exposure during pregnancy. The case-control ratio was 1:4. Linkage was performed using R software; odds ratio (OR) and 95% confidence interval (CI) were calculated by logistic regression models. Results: EAL was associated with maternal occupational exposure to chemicals (agricultural, chemical, and petrochemical industry; adjOR: 2.18, 95% CI: 1.16-4.10) and with birth defects (adjOR: 3.62, 95% CI: 1.19-11.00). Conclusions: The results of this study, with the identification of EAL risk factors in population-based case-cohort study, strengthen the knowledge and improve databases, contributing to investigations on risk factors associated with childhood leukemia worldwide.

OBJECTIVES: Childhood cancer mortality has substantially declined worldwide as a result of significant advances in global cancer care. Because limited information is available in Brazil, we analyzed trends in childhood cancer mortality in five Brazilian regions over 29 years. METHODS: Data from children 0-14 years old were extracted from the Health Mortality Information System for 1979 through 2008. Age-adjusted mortality rates, crude mortality rates, and age-specific mortality rates by geographic region of Brazil and for the entire country were analyzed for all cancers and leukemia. Mortality trends were evaluated for all childhood cancers and leukemia using joinpoint regression. RESULTS: Mortality declined significantly for the entire period (1979-2008) for children with leukemia. Childhood cancer mortality rates declined in the South and Southeast, remained stable in the Middle West, and increased in the North and Northeast. Although the mortality rates did not unilaterally decrease in all regions, the age-adjusted mortality rates were relatively similar among the five Brazilian regions from 2006-2008. CONCLUSIONS: Childhood cancer mortality declined 1.2 to 1.6% per year in the South and Southeast regions.

O objetivo foi descrever a distribuição da incidência de câncer de cólon e reto em Fortaleza, Ceará, e Porto Alegre, Rio Grande do Sul, no Brasil, e a tendência temporal da doença entre 1990-1999. Foram calculadas taxas médias anuais de incidência ajustadas por idade e a variação percentual anual estimada (estimated annual percent change - EAPC) das taxas, por sexo, utilizando-se os registros de câncer de base populacional. O EAPC apontou aumento das taxas em Porto Alegre e Fortaleza para homens, +4,2% (p = 0,14) e +9,3% (p < 0,001), e mulheres, +4,6% (p = 0,11) e +5,3% (p = 0,15), respectivamente. As taxas médias de incidência ajustadas foram cerca de três vezes maiores em Porto Alegre do que em Fortaleza, tanto para homens (25,1 vs. 8,6/100 mil) quanto para mulheres (19,9 vs. 7,1/100 mil). O aumento das taxas de incidência pode ser devido a estratégias de detecção precoce do câncer, mudanças no estilo de vida das pessoas e a alterações da estrutura etária da população. Um perfil populacional semelhante ao de países desenvolvidos pode justificar as maiores taxas de incidência encontradas em Porto Alegre. Apesar disso, Fortaleza apresentou os maiores incrementos para o período.

The aim of this study was to describe the incidence distribution of colorectal cancer in Fortaleza, Ceará State, and Porto Alegre, Rio Grande do Sul State, Brazil, and the time trend in the disease from 1990 to 1999. Mean annual age-adjusted incidence rates and estimated annual percent change were calculated by gender, using population-based cancer registries. EAPC showed an increase in the rates in Porto Alegre and Fortaleza for men, +4.2% (p = 0.14) and +9.3% (p < 0.001), and women, +4.6% (p = 0.11) and +5.3% (p = 0.15), respectively. The mean adjusted incidence rates were three times higher in Porto Alegre than in Fortaleza both for men (25.1 vs. 8.6/100 thousand) and women (19.9 vs. 7.1/100 thousand). This rise in incidence rates may be due to early cancer detection strategies, lifestyle changes, and alterations in the population age structure. A population profile similar to that of developed countries may explain the higher incidence rates in Porto Alegre. However, Fortaleza showed the largest increases during the period studied.

O objetivo foi descrever a distribuição da incidência de câncer de cólon e reto em Fortaleza, Ceará, e Porto Alegre, Rio Grande do Sul, no Brasil, e a tendência temporal da doença entre 1990-1999. Foram calculadas taxas médias anuais de incidência ajustadas por idade e a variação percentual anual estimada (estimated annual percent change - EAPC) das taxas, por sexo, utilizando-se os registros de câncer de base populacional. O EAPC apontou aumento das taxas em Porto Alegre e Fortaleza para homens, +4,2% (p = 0,14) e +9,3% (p < 0,001), e mulheres, +4,6% (p = 0,11) e +5,3% (p = 0,15), respectivamente. As taxas médias de incidência ajustadas foram cerca de três vezes maiores em Porto Alegre do que em Fortaleza, tanto para homens (25,1 vs. 8,6/100 mil) quanto para mulheres (19,9 vs. 7,1/100 mil). O aumento das taxas de incidência pode ser devido a estratégias de detecção precoce do câncer, mudanças no estilo de vida das pessoas e a alterações da estrutura etária da população. Um perfil populacional semelhante ao de países desenvolvidos pode justificar as maiores taxas de incidência encontradas em Porto Alegre. Apesar disso, Fortaleza apresentou os maiores incrementos para o período.

The aim of this study was to describe the incidence distribution of colorectal cancer in Fortaleza, Ceará State, and Porto Alegre, Rio Grande do Sul State, Brazil, and the time trend in the disease from 1990 to 1999. Mean annual age-adjusted incidence rates and estimated annual percent change were calculated by gender, using population-based cancer registries. EAPC showed an increase in the rates in Porto Alegre and Fortaleza for men, +4.2% (p = 0.14) and +9.3% (p < 0.001), and women, +4.6% (p = 0.11) and +5.3% (p = 0.15), respectively. The mean adjusted incidence rates were three times higher in Porto Alegre than in Fortaleza both for men (25.1 vs. 8.6/100 thousand) and women (19.9 vs. 7.1/100 thousand). This rise in incidence rates may be due to early cancer detection strategies, lifestyle changes, and alterations in the population age structure. A population profile similar to that of developed countries may explain the higher incidence rates in Porto Alegre. However, Fortaleza showed the largest increases during the period studied.