New GCI Study On Gynecologic Cancers in Brazil Finds Most Patients Present With Advanced Disease

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Hurdles include illiteracy, radiation machine shortage, and physician training

BOSTON - BostonChron -- Global Cancer Institute (GCI), which is focused on improving survival rates for underserved cancer patients worldwide, announced today a new study published in JCO Global Oncology.

The purpose of this study, titled, "Panorama of Gynecologic Cancer in Brazil," was to describe the whole scenario of women with gynecologic cancer in Brazil, including incidence, morbidity, and mortality, which could mirror other LMICs around the world, to inform future clinical management and local policy decisions. For incidence analysis, data from 30 Brazilian PBCRs with at least two years of consolidated information between 2000 and 2015 were obtained in February 2020. All new cancer cases diagnosed in permanent residents in a clearly defined geographic area were considered incident.

Highlights from the study include:
  • A rising problem in Brazil is Endometrial Cancer (EC). The incidence of EC is increasing in Brazil, potentially because of more Westernized lifestyles and higher rates of obesity, as well as an increase in life expectancy.
  • Most Brazilian patients with gynecologic cancer, with the exception of EC, are diagnosed with locally advanced disease. For cervical and ovarian cancer patients, the figure is 70 percent.
  • Focusing on cervical cancer, the high illiteracy rate of the current population, coupled with the lower than expected screening coverage in the Brazilian population (79 percent, less than the 85 percent goal), help illustrate the core of the problem. It has been reported previously that screening acceptance is higher in women with better access to education.
  • Regarding access to treatment, Brazilian patients with gynecologic cancers face significant hurdles. Even after the so-called Law of Sixty Days, which guarantees treatment of patients within 60 days of diagnosis, no significant advances have been achieved, with as many as 39 percent of patients with gynecologic cancers starting treatment after 60 days of diagnosis, and 24 percent after 90 days. Treatment delay, together with advanced stage at diagnosis (46 percent in cervical cancers compared with 20.6 percent in American women), may help explain the high percentage of early deaths (13.2 percent) found in this cohort.

Dr. Paul Goss, founder of the Global Cancer Institute, a principal author of the study, believes that four specific actions could help improve treatment and survival rates:
  • Addressing the shortage of radiation machines – the country needs 135 machines to cover the need, but only has 22 (with 16 on order).
  • Special emphasis should be placed on HPV vaccination and Papanicolau test adherence, because cervical cancer continues to be at the core of the gynecologic cancer problem in Brazil.
  • Improving adherence to the national HPV vaccination program.
  • Encouraging older and less educated women to get screened.
  • Better training for physicians in Brazil, so they can adopt some of the best practices of physicians in high-income countries.

"Gynecologic cancers cause a significant burden in Brazil, and these data could mirror those of other LMICs," said Dr. Goss. "Most patients present with advanced-stage disease at diagnosis and face long waiting times to start treatment, and therefore, a high percentage of early deaths occur. These problems could be addressed with simple interventions that are common in the U.S., including patient navigation programs and tumor boards."

More on Boston Chron
Read the study at https://ascopubs.org/doi/full/10.1200/GO.20.00099.

About Global Cancer Institute

Global Cancer Institute (GCI) is focused on improving survival rates for underserved cancer patients worldwide. Today, cancer death rates in developing countries are double those in the U.S. – GCI is working to close that gap. GCI works directly with physicians in developing countries to propagate simple interventions and treatments that are common in the U.S today, and proven to accelerate diagnosis, access and treatment. Learn more about our programs at http://globalcancerinstitute.org/.

Contact
Michelle Faulkner
***@big-swing.com


Source: Global Cancer Institute
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