Perfil epidemiológico de pacientes com câncer de uma área com alto uso de agrotóxico

Pluth, Thaís Bremm; Zanini, Lucas Adalberto Geraldi; Battisti, Iara Denise Endruweit; Kaszubowski, Erikson

doi:10.1590/0103-1104202012705

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ORIGINAL ARTICLE • Saúde debate 44 (127) • Oct-Dec 2020 • https://doi.org/10.1590/0103-1104202012705 copy

Perfil epidemiológico de pacientes com câncer de uma área com alto uso de agrotóxico

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Pesticide consumption has increased considerably in the last years. Although pesticides have helped to increase the crops’ productivity, they have been associated with the incidence of cancers. The objective of this study was to describe the epidemiological profile of cancer patients living in an area with high use of pesticide. A retrospective cohort design was used to describe cancer cases. Patients were included whenever (i) diagnosed with any type of cancer between 2005 and 2016; (ii) living, at the time of diagnosis, in one of the 69 Brazilian cities studied; and (iii) aged 12 years old or over. A multilevel regression model was used to model the cancer morbidity coefficient. A total of 10,640 cancer patients were studied. Cancer morbidity coefficients increased with age and were significantly higher among people residing in rural areas than among those living in urban areas (p-value<0.0001). In both urban and rural areas, males showed significantly higher cancer morbidity coefficients than females. This study suggests that higher cancer incidence is related to factors of rural life, which can include pesticide exposure since the studied area is known for its agriculture based economy and high pesticide use.

KEYWORDS
Neoplasms; Agrochemicals; Rural population; Morbidity; Environmental health

ICD-10 group^a a According to the International Classification of Diseases and Related Health Problems-10th Revision	12-19 years old		20-29 years old		30-39 years old		40-49 years old		50-59 years old		60-69 years old		70-79 years old		≥ 80 years old
	Cases	CMC	Cases	CMC	Cases	CMC	Cases	CMC	Cases	CMC	Cases	CMC	Cases	CMC	Cases	CMC
C00-C14^b b Malignant neoplasms of lip, oral cavity and pharynx	0	0.0	2	3.3	12	22.1	73	128.6	150	302.9	106	325.6	45	261.3	14	213.9
C15-C26^c c Malignant neoplasms of digestive organs	0	0.0	6	10.0	28	51.5	146	257.2	355	716.8	413	1,268.6	270	1,568.1	79	1,207.1
C30-C39^d d Malignant neoplasms of respiratory and intrathoracic organs	0	0.0	1	1.7	6	11.0	33	58.1	157	317.0	233	715.7	176	1,022.1	35	534.8
C40-C41^e e Malignant neoplasms of bone and articular cartilage	2	3.6	1	1.7	0	0.0	0	0.0	1	2.0	3	9.2	1	5.8	0	0.0
C43-C44^f f Melanoma and other malignant neoplasms of skin	1	1.8	5	8.3	10	18.4	34	59.9	63	127.2	79	242.7	76	441.4	28	427.8
C45-C49^g g Malignant neoplasms of mesothelial and soft tissue	3	5.4	9	15.0	3	5.5	9	15.9	13	26.3	13	39.9	4	23.2	0	0.0
C50-C50^h h Malignant neoplasms of breast	0	0.0	1	1.7	0	0.0	1	1.8	4	8.1	7	21.5	7	40.7	2	30.6
C60-C63ⁱ i Malignant neoplasms of male genital organs	10	18.1	31	51.7	35	64.4	27	47.6	207	418.0	662	2,033.5	724	4,204.7	233	3,560.1
C64-C68^j j Malignant neoplasms of urinary tract	0	0.0	1	1.7	2	3.7	12	21.1	39	78.8	72	221.2	56	325.2	17	259.7
C69-C72^k k Malignant neoplasms of eye, brain and other parts of central nervous system.	5	9.0	6	10.0	21	38.6	18	31.7	28	56.5	20	61.4	22	127.8	2	30.6
C73-C75^l l Malignant neoplasms of thyroid and other endocrine glands	0	0.0	0	0.0	1	1.8	0	0.0	2	4.0	1	3.1	2	11.6	1	15.3
C76-C80^m m Malignant neoplasms of ill-defined, other secondary and unspecified sites	3	5.4	1	1.7	2	3.7	8	14.1	35	70.7	22	67.6	23	133.6	7	107.0
C81-C96ⁿ n Malignant neoplasms of lymphoid, hematopoietic and related tissue	9	16.3	32	53.4	35	64.4	41	72.2	65	131.3	98	301.0	67	389.1	22	336.1
D37-D48^o o Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes.	2	3.6	1	1.7	1	1.8	8	14.1	10	20.2	12	36.9	11	63.9	5	76.4
TOTAL	35	63.2	97	161.9	156	286.9	410	722.2	1,129	2,279.8	1,741	5,347.9	1,484	8,618.5	445	6,799.3

ICD-10 group^a a According to the International Classification of Diseases and Related Health Problems-10th Revision;	12-19 years old		20-29 years old		30-39 years old		40-49 years old		50-59 years old		60-69 years old		70-79 years old		≥ 80 years old
	Cases	CMC	Cases	CMC	Cases	CMC	Cases	CMC	Cases	CMC	Cases	CMC	Cases	CMC	Cases	CMC
C00-C14^b b malignant neoplasms of lip, oral cavity and pharynx;	0	0.0	2	3.4	4	7.1	8	13.5	25	48.6	13	37.1	17	80.3	7	64.5
C15-C26^c c malignant neoplasms of digestive organs;	2	3.8	9	15.2	28	49.8	88	148.9	200	388.9	227	648.3	234	1,105.8	78	718.8
C30-C39^d d malignant neoplasms of respiratory and intrathoracic organs;	0	0.0	4	6.7	9	16.0	27	45.7	69	134.2	113	322.7	64	302.4	9	82.9
C40-C41^e e malignant neoplasms of bone and articular cartilage;	2	3.8	0	0.0	0	0.0	3	5.1	0	0.0	0	0.0	3	14.2	1	9.2
C43-C44^f f melanoma and other malignant neoplasms of skin;	2	3.8	6	10.1	13	23.1	29	49.1	39	75.8	57	162.8	45	212.7	28	258.0
C45-C49^g g malignant neoplasms of mesothelial and soft tissue;	1	1.9	5	8.4	7	12.5	13	22.0	9	17.5	10	28.6	4	18.9	5	46.1
C50-C50^h h malignant neoplasms of breast;	0	0.0	28	47.2	158	281.3	528	893.4	585	1,137.5	477	1,362.4	267	1,261.8	100	921.5
C60-C63ⁱ i malignant neoplasms of male genital organs;	8	15.1	39	65.8	119	211.8	174	294.4	200	388.9	201	574.1	138	652.1	45	414.7
C64-C68^j j malignant neoplasms of urinary tract;	0	0.0	1	1.7	2	3.6	5	8.5	20	38.9	23	65.7	18	85.1	7	64.5
C69-C72^k k malignant neoplasms of eye, brain and other parts of central nervous system;	5	9.4	6	10.1	8	14.2	13	22.0	19	36.9	12	34.3	7	33.1	1	9.2
C73-C75^l l malignant neoplasms of thyroid and other endocrine glands;	0	0.0	0	0.0	0	0.0	1	1.7	2	3.9	4	11.4	1	4.7	0	0.0
C76-C80^m m malignant neoplasms of ill-defined and other secondary and unspecified sites;	0	0.0	2	3.4	2	3.6	11	18.6	17	33.1	27	77.1	26	122.9	4	36.9
C81-C96ⁿ n malignant neoplasms of lymphoid, hematopoietic and related tissue;	12	22.6	25	42.2	15	26.7	18	30.5	61	118.6	72	205.6	52	245.7	15	138.2
D37-D48^o o neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes.	1	1.9	1	1.7	3	5.3	2	3.4	5	9.7	15	42.8	14	66.2	2	18.4
TOTAL	33	62.2	128	215.9	368	655.1	920	1,556.7	1,251	2,432.5	1,251	3,573.0	890	4,205.9	302	2,783.0

Cancer group^a a According to the International Classification of Diseases and Related Health Problems-10th Revision;	Urban			Rural
	Cases (3,445)	%	CMC^p p average cancer morbidity coefficient based on the 2010 IBGE'census population.	Cases (2,038)	%	CMC^p p average cancer morbidity coefficient based on the 2010 IBGE'census population.
C60-C63^b b malignant neoplasms of male genital organs;	1,206	35.0	527.9	721	35.4	694.3
C15-C26^c c malignant neoplasms of digestive organs;	802	23.3	351.1	491	24.1	472.8
C30-C39^d d malignant neoplasms of respiratory and intrathoracic organs;	416	12.1	182.1	222	10.9	213.8
C00-C14^e e malignant neoplasms of lip, oral cavity and pharynx;	267	7.8	116.9	134	6.6	129.0
C81-C96^f f malignant neoplasms of lymphoid, hematopoietic and related tissue;	229	6.6	100.2	139	6.8	133.9
C43-C44^g g melanoma and other malignant neoplasms of skin;	178	5.2	77.9	117	5.7	112.7
C64-C68^h h malignant neoplasms of urinary tract;	131	3.8	57.3	68	3.3	65.5
C69-C72ⁱ i malignant neoplasms of ill-defined and other secondary and unspecified sites;	77	2.2	33.7	45	2.2	43.3
C76-C80^j j malignant neoplasms of eye, brain and other parts of central nervous system;	58	1.7	25.4	42	2.1	40.4
D37-D48^k k malignant neoplasms of mesothelial and soft tissue;	30	0.9	13.1	20	1.0	19.3
C45-C49^l l neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes;	29	0.8	12.7	25	1.2	24.1
C50-C50^m m malignant neoplasms of breast;	13	0.4	5.7	8	0.4	7.7
C73-C75ⁿ n malignant neoplasms of thyroid and other endocrine glands;	6	0.2	2.6	1	0.0	1.0
C40-C41^o o malignant neoplasms of bone and articular cartilage;	3	0.1	1.3	5	0.2	4.8

Cancer group^a a According to the International Classification of Diseases and Related Health Problems-10th Revision;	Urban			Rural
	Cases (3,645)	%	CMC^p p average cancer morbidity coefficient based on the 2010 IBGE'census population.	Cases (1,492)	%	CMC^p p average cancer morbidity coefficient based on the 2010 IBGE'census population.
C50-C50^b b malignant neoplasms of male genital organs;	1,561	42.8	623.8	581	38.9	606.2
C51-C58^c c malignant neoplasms of digestive organs;	667	18.3	266.5	256	17.2	267.1
C15-C26^d d malignant neoplasms of respiratory and intrathoracic organs;	588	16.1	235.0	276	18.5	288.0
C30-C39^e e malignant neoplasms of lip, oral cavity and pharynx;	222	6.1	88.7	72	4.8	75.1
C81-C96^f f malignant neoplasms of lymphoid, hematopoietic and related tissue;	173	4.7	69.1	97	6.5	101.2
C43-C44^g g melanoma and other malignant neoplasms of skin;	130	3.6	52.0	88	5.9	91.8
C76-C80^h h malignant neoplasms of urinary tract;	68	1.9	27.2	21	1.4	21.9
C64-C68ⁱ i malignant neoplasms of ill-defined and other secondary and unspecified sites;	61	1.7	24.4	15	1.0	15.7
C00-C14^j j malignant neoplasms of eye, brain and other parts of central nervous system;	51	1.4	20.4	25	1.7	26.1
C69-C72^k k malignant neoplasms of mesothelial and soft tissue;	44	1.2	17.6	27	1.8	28.2
C45-C49^l l neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes;	35	1.0	14.0	19	1.3	19.8
D37-D48^m m malignant neoplasms of breast;	32	0.9	12.8	11	0.7	11.5
C73-C75ⁿ n malignant neoplasms of thyroid and other endocrine glands;	7	0.2	2.8	1	0.1	1.0
C40-C41^o o malignant neoplasms of bone and articular cartilage;	6	0.2	2.4	3	0.2	3.1

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[1] thaisbremm@hotmail.com