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Characteristics of patients diagnosed with cervical cancer in Brazil: preliminary results of the prospective cohort EVITA study (EVA001/LACOG 0215)
  1. Angélica Nogueira Rodrigues1,2,3,
  2. Andréia Cristina de Melo2,3,4,
  3. Aknar Freire de Carvalho Calabrich2,3,5,
  4. Eduardo Cronenberger2,6,
  5. Kátia Luz Torres7,
  6. Fernanda Damian2,8,
  7. Rachel Cossetti9,
  8. Carla Rameri Alexandre Silva de Azevedo10,
  9. Allex Jardim da Fonseca11,
  10. Yeni Nerón12,
  11. João Nunes13,
  12. André Lopes14,
  13. Felipe Thomé15,
  14. Renato Leal16,
  15. Giuliano Borges17,
  16. Arthur Ferreira da Silva2,
  17. Matheus Füehr Rodrigues2,
  18. Paulo Ricardo Santos Nunes Filho2,
  19. Facundo Zaffaroni2,
  20. Raquel Dal Sasso Freitas2,
  21. Gustavo Werutsky2 and
  22. Fernando Maluf2,3,18
  1. 1Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  2. 2Latin American Cooperative Oncology Group, Porto Alegre, Rio Grande do Sul, Brazil
  3. 3EVA - Brazilian Gynecologic Oncology Group, Belo Horizonte, Brazil
  4. 4Brazilian National Cancer Institute – INCA, Rio de Janeiro, Brazil
  5. 5Clínica Assistência Multidisciplinar em Oncologia, Salvador, Brazil
  6. 6Clinical Research, Centro Regional Integrado de Oncologia, Fortaleza, Ceara, Brazil
  7. 7Fundação Centro de Controle de Oncologia do Estado do Amazonas, Manaus, Brazil
  8. 8Centro de Pesquisa em Oncologia, Porto Alegre, Brazil
  9. 9Hospital do Cancer Aldenora Bello, Sao Luis, Brazil
  10. 10Medical Oncology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil
  11. 11Hospital Geral de Roraima, Boa Vista, Brazil
  12. 12Centro de Pesquisas Oncologicas, Florianopolis, Santa Catarina, Brazil
  13. 13Hospital Erasto Gaertner, Curitiba, Paraná, Brazil
  14. 14Instituto Brasileiro de Controle do Cancer, Sao Paulo, São Paulo, Brazil
  15. 15Hospital Sao Vicente de Paulo, Passo Fundo, RS, Brazil
  16. 16Universidade Federal do Ceara Hospital Universitario Walter Cantidio, Fortaleza, CE, Brazil
  17. 17Clínica Neoplasias Litoral, Itajaí, Brazil
  18. 18Hospital Beneficência Portuguesa de São Paulo, São Paulo, Brazil
  1. Correspondence to Dr Angélica Nogueira Rodrigues, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; angelica.onco{at}me.com

Abstract

Objectives Cervical cancer is the fourth most common cancer in women worldwide. Epidemiological and quality of life (QoL) data in patients with cervical cancer from low- and middle-income countries are scarce. We aimed to describe sociodemographic and clinicopathological characteristics and quality of life of patients with cervical cancer at diagnosis in Brazil.

Methods EVITA is a prospective cohort study of newly diagnosed patients with cervical cancer from May 2016 to December 2017, stages I–IVB, from 16 Brazilian sites representing the five Brazilian regions. At baseline, medical evaluation was performed and European Organization for Research and Treatment of Cancer (EORTC) QLQ-CX24/C30 questionnaires were administered.

Results A total of 631 patients were included. Mean±SD age was 49.3±13.9 years; skin color was non-white in 65.3%, and 68.0% had ≤8 years of formal education. In total, 85.1% of patients had a Pap smear. The main reasons reported by patients for not having a Pap smear were: lack of interest (46.9%), shame or embarrassment (19.7%), lack of knowledge (19.7%), and difficulty with access (9.1%). Most patients were diagnosed with locally advanced or metastatic disease (FIGO clinical stage II–IV in 81.8%– stage II in 35.2%, stage III in 36.1%, and stage IV in 10.5%). Patients with clinical stage III–IV had worse physical functioning and role functioning.

Conclusions Cervical cancer in Brazil is usually diagnosed at an advanced stage. Most patients have low formal education and are unemployed. Lack of interest was identified as a main reason for not having a screening test, and limited access was reported as a reason by <10% of the patients. Awareness campaigns must be a governmental priority, specially focused on the needy population, along with wide access to treatment.

  • cervical cancer

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Contributors ANR, ACM, AFCC, GW, and FM were responsible for the design and conducting of the study, data collection, analysis and interpretation of data. EC, KLT, FD, RC, CRASA, AJF, YN, JN, AL, FT, RL, GB, AFS, MFR, and PRSNF participated in data collection. FZ was the statistician responsible for data planning and analysis. RDSF was responsible for data management at LACOG. All authors have read, provided input, and approved the manuscript.

  • Funding F Hoffmann-La Roche AG.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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