Epidemiological profile of women with gynecological cancer in brachytherapy: a cross-sectional study

Rosa, Luciana Martins da; Hames, Maria Eduarda; Dias, Mirella; Miranda, Gisele Martins; Bagio, Camila Beltrame; Santos, Maristela Jeci dos; Kalinke, Luciana Puchalski

doi:10.1590/0034-7167-2020-0695

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 74 (5) • 2021 • https://doi.org/10.1590/0034-7167-2020-0695 copy

Epidemiological profile of women with gynecological cancer in brachytherapy: a cross-sectional study

Perfil epidemiológico de las mujeres com cáncer ginecológico em brachiterapia: um estúdio transversal

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze the sociodemographic and clinical profile of women with gynecological cancer in brachytherapy.

Method:

a cross-sectional study including records of 1,930 visits of women in brachytherapy assisted between 2006-2016 in Santa Catarina (Brazil). Collection was performed in 2019, in an institutional bank, submitted to frequency measurements, chi-square test, 95% confidence intervals, significance level of 0.05.

Results:

women aged 40-59 years (47.2%), white (93.3%); with elementary school (65%); cervical cancer (78.5%); stages II-III (73.3%) figured prominently. In the comparison of staging proportions in the topography variable, a higher proportion of malignant neoplasm of cervix uteri unspecified in the grouped III-IV staging (84.6%).

Conclusion:

the profile analysis shows the need for screening and health education for prevention and/or early detection of gynecological cancers and training of nurses specialized in radiotherapy to care for women’s health.

Descriptors:
Genital Neoplasms, Female; Epidemiology; Nursing; Brachytherapy; Radiotherapy

	n	% [95%CI]^* * Descriptive analysis; CI - 95% confidence interval.
Race/skin color
White	1801	93.3 [92.1; 94.4]
Black	43	2.2 [1.6; 3]
Yellow	2	0.1 [0; 0.3]
Mixed ethnicity	77	4 [3.2; 4.9]
No information	7	0.4 [0.2; 0.7]
Degree of education
None	79	4.1 [3.3; 5]
Incomplete elementary school	504	26.1 [24.2; 28.1]
Complete elementary school	751	38.9 [36.8; 41.1]
High school	306	15.9 [14.3; 17.5]
Incomplete higher education	25	1.3 [0.9; 1.9]
Complete higher education	108	5.6 [4.6; 6.7]
No information	157	8.1 [7; 9.4]
Marital status
Single	315	16.3 [14.7; 18]
Married	952	49.3 [47.1; 51.6]
Widowed	273	14.1 [12.6; 15.8]
Legally separated	210	10.9 [9.6; 12.3]
Consensual union	101	5.2 [4.3; 6.3]
No information	79	4.1 [3.3; 5]

	n	% [95%CI]*
Age at first consultation
18 \|--- 20	1	0.1 [0; 0.2]
20 \|--- 30	80	4.1 [3.3; 5.1]
30 \|--- 40	346	17.9 [16.3; 19.7]
40 \|--- 50	442	22.9 [21.1; 24.8]
50 \|--- 60	469	24.3 [22.4; 26.3]
60 \|--- 70	364	18.9 [17.2; 20.7]
70 \|---\| 95	227	11.8 [10.4; 13.3]
No information	1	0.1[0;0.2]
Previous diagnosis and treatment
No diagnostics/no treatment	22	1.1 [0.7; 1.7]
With diagnostics/without treatment	413	21.4 [19.6; 23.3]
With diagnosis/with treatment	1492	77.3 [75.4; 79.1]
Others	1	0.1 [0; 0.2]
No information	2	0.1 [0; 0.3]
Staging
In situ	15	0.8 [0.5; 1.3]
I	377	20.8 [19; 22.7]
II	648	35.8 [33.6; 38]
III	680	37.5 [35.3; 39.8]
IV	92	5.1 [4.1; 6.2]
No information	118	6.1 [5.1; 7.2]
Brachytherapy prescribed
2 sessions	90	4.7 [3.8; 5.7]
3 sessions	500	25.9 [24; 27.9]
4 sessions	1304	67.6 [65.5; 69.6]
5 sessions	35	1.8 [1.3; 2.5]
6 sessions	1	0.1 [0; 0.2]

	Total		Staging^ Chi-square test. In particular, the cases with standardized adjusted residue analysis greater than 1.96; C51.9 - Malignant neoplasm of vulva, unspecified; C52.9 - Malignant neoplasm of vagina; C53.0 - Malignant neoplasm of endocervix; C53.8 - Malignant neoplasm of overlappingsites of cervix uteri; C53.9 - Malignant neoplasm of cervix uteri, unspecified; C54.1 - Malignant neoplasm of endometrium; C54.2 - Malignant neoplasm of myometrium; C54.3 - Malignant neoplasm of bottom of the uterus; C54.8 - Malignant neoplasm of overlapping lesion ofcorpus uteri; C54.9 - Malignant neoplasm of corpus uteri,unspecified; C55.9 - Malignant neoplasm of uterus, part unspecified; C56.9 - Malignant neoplasm of unspecified ovary.			p
			in situ	I+II	III+IV
	n	% [95%CI]^* * Descriptive analysis;	n (%)	n (%)	n (%)
Age at diagnosis (N=1,807)						0.040
min \|--- 20	2	0.1[0; 0.4]	0(0)	1(0.1)	1(0.1)
20 \|--- 30	86	4.8[3.8; 5.8]	0(0)	42(4.1)	44(5.7)
30 \|--- 40	340	18.8[17.1; 20.7]	4(26.7)	192(18.8)	144(18.7)
40 \|--- 50	414	22.9[21; 24.9]	2(13.3)	221(21.6)	191(24.8)
50 \|--- 60	444	24.6[22.6; 26.6]	1(6.7)	258(25.3)	185(24)
60 \|--- 70	334	18.5[16.7; 20.3]	5(33.3)	210(20.6)	119(15.4)
70 \|---\| Max	187	10.3[9; 11.8]	3(20)	97(9.5)	87 (11.3)
Education level (N=1661)						0.542
None	75	4.5[3.6; 5.6]	1(7.7)	34(3.6)	40(5.6)
Incomplete elementary school	486	29.3[27.1; 31.5]	5(38.5)	266(28.4)	215(30.3)
Complete elementary school	689	41.5[39.1; 43.9]	5(38.5)	393(41.9)	291(41)
High school	286	17.2[15.5; 19.1]	2(15.4)	170(18.1)	114(16.1)
Incomplete higher education	25	1.5[1; 2.2]	0(0)	18(1.9)	7(1)
Complete higher education	100	6[5; 7.2]	0(0)	57(6.1)	43(6.1)
Origin (N=1,812)						0.343
Greater Florianópolis	628	34.7[32.5; 36.9]	4(26.7)	364(35.5)	260(33.7)
Northeast	203	11.2[9.8; 12.7]	4(26.7)	117(11.4)	82(10.6)
Vale do Itajaí	32	1.8[1.2; 2.5]	0(0)	16(1.6)	16(2.1)
North Plateau	60	3.3[2.6; 4.2]	0(0)	32(3.1)	28(3.6)
Itajaí River Mouth	7	0.4[0.2; 0.8]	0(0)	2(0.2)	5(0.6)
South	289	15.9[14.3; 17.7]	6(40)	158(15.4)	125(16.2)
Far West	268	14.8[13.2; 16.5]	0(0)	152(14.8)	116(15)
Midwest	222	12.3 [10.8; 13.8]	1(6.7)	120(11.7)	101(13.1)
Plateau	103	5.7[4.7; 6.8]	0(0)	64(6.2)	39(5.1)
Topography ICD-10*** (N=1812)						<0.001
C51.9	1	0.1[0; 0.3]	0(0)	0(0)	1(0.1)
C52.9	24	1.3[0.9; 1.9]	7(46.7)	11(1.1)	6(0.8)
C53.0	16	0.9[0.5; 1.4]	0(0)	8(0.8)	8(1)
C53.8	1	0.1[0; 0.3]	0(0)	1(0.1)	0(0)
C53.9	1404	77.5[75.5; 79.4]	8(53.3)	743(72.5)	653(84.6)
C54.1	342	18.9[17.1; 20.7]	0(0)	248(24.2)	94(12.2)
C54.2	1	0.1[0; 0.3]	0(0)	1(0.1)	0(0)
C54.3	1	0.1[0; 0.3]	0(0)	1(0.1)	0(0)
C54.8	1	0.1[0; 0.3]	0 (0)	0 (0)	1 (0.1)
C54.9	18	1[0.6; 1.5]	0(0)	11(1.1)	7(0.9)
C55.9	2	0.1[0; 0.4]	0(0)	1(0.1)	1(0.1)
C56.9	1	0.1[0; 0.3]	0(0)	0(0)	1(0.1)

Treatment types	n	% [95%CI]
Surgery	55	1.9 [1.5; 2.5]
Radiotherapy (brachytherapy and/or teletherapy)	2309	80.5 [79.0; 81.9]
Chemotherapy	503	17.5 [16.2; 18.9]
Hormone therapy	3	0.104 [0.03; 0.28]
Total	2870	100

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[1] Corresponding author: Luciana Martins da Rosa. E-mail: luciana.m.rosa@ufsc.br