Lung cancer in Brazil

Our plain-English summary of Lung cancer in Brazil, by E. Algranti, A.M. Menezes, A.C. Achutti (Seminars in Oncology, 2001).

The study

• Authors: E. Algranti, A.M. Menezes, A.C. Achutti
• Journal: Seminars in Oncology
• Published: 2001;28(2):143-52
• Type of article: Review
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Lung cancer is the second leading cause of death in Brazil, after exclusion of external causes. Registries in the country are not reliable because of under-registration and limited coverage. Incidence rates for Brazil are less then half those for selected areas with good registries. Crude and adjusted incidence and mortality rates for lung cancer are rising, particularly among women. The main reason is the acceleration in tobacco consumption and the spread of smoking among women. At present, approximately 40% of men and 25% of women, 15 years of age or older, are current smokers. In the state of Rio Grande do Sul, where registries are reliable, incidence and mortality for males are similar to US data and the figures for women are rapidly approaching those for men. Occupations associated with risks of exposure to respiratory carcinogens show a rise in the incidence of lung cancer in the industrialized area of São Paulo. The main occupational risk in Brazil is exposure to mineral dusts, silica, or asbestos. Although about 15 million Brazilians are exposed to pesticides, agricultural workers were not a risk group for lung cancer in a case-control study. Pesticides containing arsenic and dichlorodiphenyltrichloroethane (DDT) are banned. In recent years, a trend towards a decrease in male smoking has been noted, but there is still a high tobacco exposure burden in both males and females, with a forecast of a further increase in rates of lung cancer incidence and deaths. Control of respiratory carcinogens at work continues to be a problem, particularly in the present scenario of economic and political pressures on Brazil and other developing nations. Semin Oncol 28:143-152.

Copyright 2001 by W.B. Saunders Company.

In plain English

This article was a review of lung cancer in Brazil. It drew on national estimates, selected local registries (São Paulo, Porto Alegre and the state of Rio Grande do Sul), smoking surveys and published case-control studies. National estimates for 1999 gave lung cancer incidence of 18.9 per 100,000 for males and 6.0 per 100,000 for females. In Rio Grande do Sul, women's share of lung cancer deaths rose from 17.4% in 1980 to 25.4% in 1998. A 1989 survey found that 39.8% of men aged 15 and over smoked, and 25.4% of women. The authors described exposure to mineral dusts, including silica and asbestos, as the main lung cancer risk in Brazilian industry. Their estimates of workers potentially exposed to asbestos were 20-22,000 in the asbestos industry and 223,000 in vehicle brake, clutch and engine repair shops. Of the cited Brazilian and Uruguayan case-control studies that examined asbestos, only the Uruguayan one found a significant association with lung cancer. Published Brazilian studies of asbestos-related cancers were limited to case reports. The authors concluded that lung cancer incidence and mortality in Brazil were rising, smoking rates remained high, and data on occupational and environmental factors were very limited.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Review of registry data, smoking surveys and published studies on lung cancer in Brazil (not an original study)
• Who was studied: The population of Brazil, with registry data from the cities of São Paulo and Porto Alegre and the state of Rio Grande do Sul, mostly covering 1980 to 1998; other South American countries were included for comparison
• Exposure: Mainly tobacco smoking. Also occupational exposures (mineral dusts such as silica and asbestos, and pesticides) and air pollution
• Main results:
  • National estimates for 1999: lung cancer incidence of 18.9 per 100,000 for males and 6.0 for females; mortality of 12.1 and 4.2 per 100,000, respectively
  • In Rio Grande do Sul, women accounted for 17.4% of lung cancer mortality in 1980 and 25.4% in 1998
  • A 1989 population-based survey found smoking prevalence of 39.8% among men aged 15 and over and 25.4% among women (34% overall)
  • On a smoking maturity index, males in Rio Grande do Sul were similar to US males in 1986 and 1996, and the index for females was rising rapidly
  • In a cited São Paulo case-control study (316 cases, 536 controls), the cluster of mostly industrial jobs had an odds ratio of 1.97 (confidence interval 1.52 to 2.55) compared with the cluster of mostly nonindustrial jobs
  • Asbestos exposure was examined specifically in cited Brazilian and Uruguayan case-control studies; only the Uruguayan study showed a significant association with lung cancer
  • The authors' table estimated 20-22,000 workers potentially exposed to asbestos in the asbestos industry (mining, asbestos-cement, friction materials, textiles and others)
  • The same table estimated 223,000 workers potentially exposed to asbestos in vehicle brake, clutch and engine repair shops
  • The authors wrote that, per their table, the vehicle maintenance sector alone surpassed typical asbestos industry exposure by a factor of 10, and described exposures in these sectors as totally uncontrolled
  • Brazilian asbestos consumption rose from 1,082 to 1,296 g per inhabitant between 1985 and 1995
  • Published Brazilian studies of asbestos-related cancers were limited to case reports of bronchogenic carcinoma and mesothelioma
  • In a cited Brazilian case-control study, a third of cases were in agriculture, and agriculture showed a decreased odds ratio for lung cancer
• The authors' conclusion: The authors concluded that lung cancer incidence and mortality in Brazil were rising, that smoking rates were still high, and that data on occupational and environmental influences were very limited
• Limitations the authors state:
  • Cancer registries in Brazil are not accurate, which makes comparison of rates difficult
  • Different industry and occupation classifications limit comparisons between the case-control studies

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Lung Cancer, Incidence, Case-Control Study.

Related studies

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• Lung Cancer Mortality Trends in a Brazilian City with a Long History of Asbestos Consumption — G.A. Fernandes, E. Algranti, et al. (2019)
• Non-malignant consequences of decreasing asbestos exposure in the Brazil chrysotile mines and mills — E. Bagatin, J.A. Neder, et al. (2005)
• Asbestos and health in the Third World: the case of Brazil — D.M. Berman (1986)
• Asbestos: old foe in 21st century developing countries — L.V. Harris, I.A. Kahwa (2003)
• Scientific controversy and asbestos: making disease invisible — L. Braun, A. Greene, et al. (2003)

Browse more research in Seminars in Oncology, or return to medical research.