ABSTRACT Background Prostate cancer (PCa) remains one of the most frequently diagnosed malignancies worldwide and represents a major contributor to premature mortality among men. This study aimed to estimate survival and investigate factors associated with PCa‐specific mortality among men treated within the oncology care network of a Brazilian state. Material and Methods Retrospective cohort study was conducted using data obtained from hospital‐based cancer registries linked to the state Mortality Information System. The cohort included 10 556 men diagnosed with PCa between 2000 and 2016, with follow‐up through 2021. Outcomes were categorized as death from PCa, death from other causes, or alive at the end of follow‐up. Associations with PCa‐specific mortality were examined using cause‐specific Cox proportional hazards regression models. Results At the end of 2021, 6388 patients were alive, 1936 had died from PCa and 2232 deaths from other causes. The 5‐year PCa‐specific survival was 87.7%. In the multivariable analysis, increasing age at diagnosis (per 10‐year increment) was associated with a higher cause‐specific hazard of PCa mortality (HR = 1.14; 95% CI: 1.06–1.22). Lower educational level was also associated with increased mortality, while patients with basic education (HR = 0.82; 95% CI: 0.71–0.95) and middle or high education (HR = 0.64; 95% CI: 0.52–0.80) showed a lower risk of death compared to those with no formal education. Referral from non‐SUS services was associated with a slightly higher risk of PCa mortality (HR = 1.14; 95% CI: 1.00–1.30). Regarding treatment variables, surgery was associated with a lower cause‐specific hazard of mortality (HR = 0.41; 95% CI: 0.33–0.52), whereas hormone therapy was associated with an increased cause‐specific hazard of death (HR = 1.98; 95% CI: 1.75–2.24). Conclusions Age, educational level, presence of distant metastasis, referral source, and treatment modalities were associated with PCa‐specific mortality. However, treatment‐related associations should be interpreted with caution, as they likely reflect underlying disease severity and treatment selection patterns rather than causal effects. These findings highlight the importance of early diagnosis, reducing social inequalities in access to care, and strengthening oncology care networks to improve outcomes in patients with PCa.
Wesley Rocha Grippa, L. S. Dell'Antonio, C. Dell'Antônio et al.· Cancer Reports· 0 citations
BACKGROUND
Colorectal cancer (CRC) incidence varies in relation to social determinants of health and health system capacity, particularly in settings with territorial inequalities. This study aims to estimate CRC incidence at the municipal level in Brazil and assess its association with social, demographic, and health system determinants, accounting for spatial heterogeneity.
METHODS
Population-based cross-sectional ecological study with spatial analysis. Municipal CRC incidence for 2024 was estimated using corrected mortality data (1980-2023) and state-level incidence-mortality ratios from Population-Based Cancer Registries (PBCR). Estimated age-standardized incidence rates (estimated ASR) were calculated using the Segi-Doll standard population. Spatial autocorrelation was assessed using Global and Local Moran's I, while associations were examined using Ordinary Least Squares (OLS), spatial autoregressive (SAR), and Multiscale Geographically Weighted Regression (MGWR) models.
RESULTS
Higher estimated ASRs were observed in the South, Southeast, and parts of the Central-West, while lower rates predominated in the North and Northeast. In the SAR model, positive associations were observed for the Municipal Human Development Index (β = 1.48; p < 0.001), hospital beds (β = 0.023; p = 0.002), premature mortality due to neoplasms (β = 0.002; p < 0.001), and ultra-processed food consumption (β = 0.027; p < 0.001). Negative associations were found for under-1-year mortality (β = -0.009; p = 0.004), dependency ratio (β = -0.013; p < 0.001), and hospital admission rates (β = -0.002; p < 0.001). MGWR showed spatial heterogeneity, with MHDI and ultra-processed food consumption significant in all municipalities and dependency ratio and under-1-year mortality in over 98%, with stronger effects in the North and Northeast.
CONCLUSION
Estimated CRC ASRs showed marked territorial heterogeneity and was associated with socioeconomic, dietary, and health-system characteristics. Because the estimates were derived from mortality and state-assigned I/M ratios, the observed patterns may reflect a combination of disease occurrence, healthcare access, data quality, and model assumptions. These findings may support territorially tailored cancer surveillance and control planning.
Luís Ricardo Santos de Melo, Júlio dos Santos Pereira, L. A. Andrade et al.· Cancer Epidemiology· 0 citations
Older adults remain highly vulnerable to severe COVID‐19 outcomes due to immunosenescence and comorbidities. Although booster vaccination strategies have reduced hospitalizations and mortality, evidence regarding the effectiveness, safety, and immunogenicity of a second COVID‐19 vaccine booster dose in older adults remains fragmented. This systematic review and meta‐analysis protocol aims to critically evaluate the available evidence from randomized and nonrandomized clinical trials (NRCTs) regarding the effectiveness, safety, and immunogenicity of the second COVID‐19 vaccine booster in older adults worldwide.
Marieli Thomazini Piske Garcia, V. Valim, L. C. Lopes-Júnior· Health Science Reports· 0 citations
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