RESUMO
A case-control study was conducted in Uruguay, including 876 male cases of lung cancer and 876 male hospitalized controls, frequency matched for age (ten-year intervals), residence and hospital. The following explanatory variables were included in the study: fried red meat, barbecued red meat, boiled red meat, and salted red meat. These items were log transformed and energy-adjusted by the residuals method. The following potential confounders were included into the models: age, residence, hospital, education, family history of lung cancer, body mass index, smoking index, alcohol drinking, mate consumption, total energy intake, non-meat fatty foods and total fruits. The main objective was to estimate the odds ratios associated with lung cancer risk. Whereas fried meat, barbecued meat, and salted meat were positively associated with risk (OR of the highest quartile of salted meat versus the lowest, 2.90, 95 % CI 1.99-4.25, p-value for trend<0.0001), boiled red meat was mainly protective. We conclude that salted meat was the main risk factor. The mechanisms could be related to the content of N-nitroso compounds in salted meat.
Assuntos
Adenocarcinoma/etiologia , Carcinoma de Células Pequenas/etiologia , Carcinoma de Células Escamosas/etiologia , Culinária , Neoplasias Pulmonares/etiologia , Carne , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Criança , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Taxa de Sobrevida , UruguaiRESUMO
CONTEXT AND OBJECTIVE: Lung cancer is the commonest malignant tumor and is increasing in incidence by 2% a year. In 90% of diagnosed cases, it is associated with tobacco product consumption. It is the greatest cause of mortality among cancer types in Brazil. Knowledge of patients psychological representations is needed for evaluating treatments and educating patients. The aim here was to interpret how smokers with lung cancer interpret the possible causes of their illness and to understand their perceptions regarding cigarette use. DESIGN AND SETTING: Clinical-qualitative study (exploratory, non-experimental) at the Pulmonary Disease Service, General Hospital, Universidade Estadual de Campinas. METHODS: An intentional small sample of cancer inpatients was recruited. The group was closed with 11 subjects, following attainment of data saturation from interviews. These interviews were semi-directed, with in-depth open-ended questions on interviewees observations, applied in a confidential setting using a tape recorder. Interviewees responses were categorized using qualitative content analysis and the results were assessed using interdisciplinary theoretical concepts, particularly from medical psychology. RESULTS: Six males and five females aged between 46 and 68 years who presented diverse clinical conditions were interviewed. CONCLUSIONS: A broader approach towards the psychological comprehension of such patients is needed, considering that cigarette consumption involves conscious and unconscious motivations, sociocultural and educational factors, the glamour of tobacco advertising, and problems with psychophysical dependence. Such an approach would avoid the perception among patients that the healthcare team are "inquisitors". This would lead to better adherence to treatment and better quality of life.
Assuntos
Carcinoma de Células Pequenas/psicologia , Neoplasias Pulmonares/psicologia , Autoimagem , Fumar/psicologia , Idoso , Carcinoma de Células Pequenas/diagnóstico , Carcinoma de Células Pequenas/etiologia , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/etiologia , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Fatores SocioeconômicosRESUMO
CONTEXT AND OBJECTIVE: Lung cancer is the commonest malignant tumor and is increasing in incidence by 2 percent a year. In 90 percent of diagnosed cases, it is associated with tobacco product consumption. It is the greatest cause of mortality among cancer types in Brazil. Knowledge of patientsÆ psychological representations is needed for evaluating treatments and educating patients. The aim here was to interpret how smokers with lung cancer interpret the possible causes of their illness and to understand their perceptions regarding cigarette use. DESIGN AND SETTING: Clinical-qualitative study (exploratory, non-experimental) at the Pulmonary Disease Service, General Hospital, Universidade Estadual de Campinas. METHODS: An intentional small sample of cancer inpatients was recruited. The group was closed with 11 subjects, following attainment of data saturation from interviews. These interviews were semi-directed, with in-depth open-ended questions on intervieweesÆ observations, applied in a confidential setting using a tape recorder. IntervieweesÆ responses were categorized using qualitative content analysis and the results were assessed using interdisciplinary theoretical concepts, particularly from medical psychology. RESULTS: Six males and five females aged between 46 and 68 years who presented diverse clinical conditions were interviewed. CONCLUSIONS: A broader approach towards the psychological comprehension of such patients is needed, considering that cigarette consumption involves conscious and unconscious motivations, sociocultural and educational factors, the glamour of tobacco advertising, and problems with psychophysical dependence. Such an approach would avoid the perception among patients that the healthcare team are "inquisitors". This would lead to better adherence to treatment and better quality of life.
CONTEXTO E OBJETIVO: O câncer de pulmão é o mais comum dos tumores malignos, apresentando aumento de 2 por cento ao ano em sua incidência mundial. Em 90 por cento dos casos diagnosticados, está associado ao consumo de derivados de tabaco. No Brasil, é o câncer que mais faz vítimas fatais. É crucial aos médicos conhecer as representações psicológicas desses pacientes para preconizar tratamentos e educá-los. O objetivo deste trabalho é interpretar significados que fumantes com câncer de pulmão atribuem a possíveis causas da doença, bem como compreender percepções relacionadas ao uso do cigarro. TIPO DE ESTUDO E LOCAL: Desenho clínico-qualitativo (exploratório, não-experimental) realizado no Serviço de Pneumologia do Hospital das Clínicas da Universidade Estadual de Campinas, Campinas, São Paulo, Brasil. MÉTODOS: Amostra propositalmente pequena de pacientes internados com câncer; grupo fechado com 11 sujeitos quando ocorrida a saturação de informações das entrevistas. Entrevista semidirigida de questões abertas (entrevista em profundidade na observação acurada dos entrevistados) contendo poucos tópicos foi aplicada em ambiente confidencial, usando gravador de fita cassete. Após categorização do conjunto das falas, usando análise qualitativa de conteúdo, a discussão dos resultados empregou conceitos teóricos interdisciplinares, especialmente da psicologia médica. RESULTADOS: Entrevistamos seis homens e cinco mulheres, com idades variando entre 46 e 68 anos; sujeitos apresentando condições clínicas diversas. CONCLUSÃO: A compreensão psicológica desses pacientes exige uma abordagem mais ampla, considerando que o consumo de cigarros envolve motivações conscientes e inconscientes, fatores socioculturais e educacionais, glamourosa propaganda do tabaco e problemas de dependência físico-psíquica. Também evitaria o surgimento de figuras percebidas pelos pacientes como "inquisidores" dentre a equipe de saúde. Estas novas condições levariam à maior adesão ao tratamento e melhor qualidade de vida.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Carcinoma de Células Pequenas/psicologia , Neoplasias Pulmonares/psicologia , Autoimagem , Fumar/psicologia , Carcinoma de Células Pequenas/diagnóstico , Carcinoma de Células Pequenas/etiologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/etiologia , Pesquisa Qualitativa , Fatores SocioeconômicosRESUMO
In the time period 1988-2000, a case-case study on environmental factors and lung cancer risk was conducted in Montevideo, Uruguay. This study was designed in order the establish possible differences between squamous cell carcinomas (SCC) and small cell carcinomas (SCLC) of the lung in relation to tobacco smoking. Three hundred and ninety one (391) patients with small cell carcinoma were compared with 1187 patients with squamous cell carcinoma. Regarding sex, the study included a small number of women (26 with SCLC and 20 with SCC). SCLC was associated with higher risks for smoking status, smoking intensity and cumulative exposure to tobacco smoking when compared with SCC. These three tobacco variables were significantly different between both cell types in men. Smoking duration was significantly higher among SCLC compared with SCC only in women. With decreasing age at starting to smoke, the proportion of SCLC increases at the expense of SCC. Finally, types of tobacco and cigarette were not different between cell types in both sexes. It should be noted that these tobacco variables were not associated with increased risks among SCC, when this cell type was compared with SCLC. These results suggests that SCLC display the strongest relation with tobacco smoking than SCC.
Assuntos
Carcinoma de Células Pequenas/etiologia , Carcinoma de Células Pequenas/patologia , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/patologia , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/patologia , Fumar/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Pequenas/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Uruguai/epidemiologiaRESUMO
Evidence from animal studies indicates that various N-nitroso compounds are carcinogenic. We investigated whether consumption of nitrosodimethylamine (NDMA) and foods and beverages containing NDMA are carcinogenic for the lung. In a hospital-based case-control study in Uruguay, dietary intake of NDMA and its food sources was measured in 320 cases of lung cancer and 320 controls afflicted with diseases not related with tobacco use and diet. After adjusting for tobacco smoking and total energy intake, NDMA displayed a significant dose-response pattern, with a 3-fold increase in risk for the higher category of intake. The risks were slightly more elevated for adenocarcinoma of the lung. Also, salted meat consumption and beer intake were associated with an increased risk of lung cancer.
Assuntos
Carcinógenos/efeitos adversos , Dieta/efeitos adversos , Dimetilnitrosamina/efeitos adversos , Neoplasias Pulmonares/etiologia , Adenocarcinoma/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cerveja/efeitos adversos , Bebidas , Carcinógenos/administração & dosagem , Carcinoma de Células Pequenas/etiologia , Carcinoma de Células Escamosas/etiologia , Estudos de Casos e Controles , Dimetilnitrosamina/administração & dosagem , Relação Dose-Resposta a Droga , Ingestão de Energia , Feminino , Alimentos , Conservação de Alimentos , Humanos , Masculino , Carne/efeitos adversos , Pessoa de Meia-Idade , Fatores de Risco , Fumar/efeitos adversos , Cloreto de Sódio , UruguaiRESUMO
During the time period January 1989-December 1992, a case-control study involving 476 cases of lung cancer and 561 controls was carried out at the Instituto Nacional de Oncología, Montevideo, Uruguay, in order to analyze the patterns of risk of the different cell types of lung cancer, associated with smoking manufactured and hand-rolled cigarettes. Lifelong smokers of hand-rolled cigarettes displayed a non-significant 30% increased risk, compared with smokers of commercial cigarettes, for all types of lung cancer combined. The analysis for cell-type disclosed a fourfold increase in the risk of small cell lung carcinoma associated with lifelong smoking of hand-rolled products. The possibilities of a chance finding and of misclassification of the disease appears to be an unlikely explanation of this strong and rather specific association.
Assuntos
Carcinoma de Células Pequenas/epidemiologia , Neoplasias Pulmonares/epidemiologia , Fumar/efeitos adversos , Adenocarcinoma/epidemiologia , Adenocarcinoma/etiologia , Adulto , Idoso , Carcinoma de Células Pequenas/etiologia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/etiologia , Estudos de Casos e Controles , Humanos , Neoplasias Pulmonares/etiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Uruguai/epidemiologiaAssuntos
Humanos , Carcinoma de Células Pequenas , Carcinoma de Células Pequenas/química , Carcinoma de Células Pequenas/classificação , Carcinoma de Células Pequenas/complicações , Carcinoma de Células Pequenas/diagnóstico , Carcinoma de Células Pequenas/tratamento farmacológico , Carcinoma de Células Pequenas/epidemiologia , Carcinoma de Células Pequenas/etiologia , Carcinoma de Células Pequenas/fisiopatologia , Carcinoma de Células Pequenas/cirurgia , Carcinoma de Células Pequenas/terapia , Cisplatino/administração & dosagem , Cisplatino/uso terapêutico , Ifosfamida/administração & dosagem , Ifosfamida/uso terapêutico , Mitomicina/administração & dosagem , Mitomicina/uso terapêuticoRESUMO
A high mortality rate for lung cancer (62.7 per 100,000) is found in Rosario, Argentina. To investigate the reasons for this high rate, a case-control study was carried out among 215 male cases with histologically confirmed lung cancer and 433 hospitalized controls for conditions unrelated to tobacco consumption. Odds ratios (OR) of squamous cell (SQ), adenocarcinoma (AD), and small cell (SM) carcinoma of the lung associated with different characteristics of the smoking habit were quantified. Ninety-eight percent of the cases had smoked regularly. Smokers were significantly younger at diagnosis than ex-smokers (P < 0.0001), a pattern consistent for all cell types. The ORs for the heaviest cf the lowest consumption categories were 15.3 for SQ, 11.6 for AD, and 11.6 for all lung cancer (P < 0.0001). Risks associated with the use of unfiltered cigarettes were three to five times higher than those for filtered cigarettes, depending on cell types. For ex-smokers, risks after 10 years of nonsmoking were about 12 times lower than those of current smokers (P < 0.001). To halt further increases in lung cancer, preventive measures in Argentina should be directed primarily towards smoking control.
Assuntos
Adenocarcinoma/epidemiologia , Carcinoma de Células Pequenas/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Pulmonares/epidemiologia , Fumar/efeitos adversos , Adenocarcinoma/etiologia , Adenocarcinoma/patologia , Adulto , Fatores Etários , Argentina/epidemiologia , Carcinoma de Células Pequenas/etiologia , Carcinoma de Células Pequenas/patologia , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/patologia , Estudos de Casos e Controles , Humanos , Modelos Logísticos , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fumar/epidemiologia , Prevenção do Hábito de FumarRESUMO
A hospital-based case-control study of the association between alcohol drinking and lung cancer was carried out in Uruguay between January 1988 and December 1990. The sample included 327 men with lung cancer and 350 male controls. Personal interviews were conducted in the Institute of Oncology by trained personnel using a structured questionnaire. The results showed a significant positive association between beer intake and the risk of lung cancer. The odds ratio for beer drinkers in the highest quartile was 3.4 (95% confidence limits, 1.3-6.6) after adjustment for tobacco. The association between beer and lung cancer was consistent for all the cell types, analyzed separately. A moderate effect for total alcohol consumption was also observed, with a relative risk of 2.2 for those subjects in the highest quartile.