IPTSP - Artigos publicados em periódicos

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Agora exibindo 1 - 20 de 1862

Prediction factors of fear of falling in older adults assessed by the icf domains: gender, social participation, and walking speed
(2025) Bueno, Guilherme Augusto Santos; Menezes, Ruth Losada de; Martins, Anabela Correia
Objective: The International Classification of Function, Disability, and Health (ICF) may be an ideal comprehensive model for fall risk assessment. However, information associating ICF and fear of falling among community-dwelling older adults remains unclear. This study aimed to investigate the associated factors that predict the fear of falling in the older adults classified by the ICF. Materials and Methods: Data were collected from 340 community-dwelling older adults aged 65 years and older. They were assessed for their personal aspects, health status, functional skills, and social participation profile; the fear of falling was self- reported. Multivariate logistic regression analysis was used to determine prediction models for fear of falling. Results: Gender (OR 2.77; 95%CI 1.62 - 4.72, p < 0.001), walking speed (OR 0.19; 95%CI 0.09 - 042, p<0,001), and social participation (OR 2.35; 95%CI 1.39 - 3.95, p p<0,001), composed a model that may predict up to 64% (AUC = 0.794, p<0,001) of the fear of falling among community-dwelling older adults. Conclusion: The association of the predictors of fear of falling identified that women have more restriction on social participation and reduced walking speed as factors that contribute to increased fear of falling in community-dwelling older adults.
Gait changes after intramedullary nailing versus total hip arthroplasty for hip fractures in older adults
(2025) Fagotti, Lorenzo; Menezes, Ruth Losada de; Ribeiro, Darlan Martins; Santana, Maykon Lacerda de; Maranho, Daniel Augusto Carvalho; Funghetto, Silvana Schwerz
This study aimed to investigate potential differences in spatiotemporal gait parameters and clinical outcomes between older adults undergoing intramedullary nailing (IN) and those undergoing total hip arthroplasty (THA) for unilateral hip fractures. A secondary objective was to identify predictors of postoperative falls in older adults following surgical treatment for hip fractures. We conducted a prospective study involving 42 community-dwelling older adults, assessed 6 months post-surgery. Of these participants, 21 (14 females, 7 males; mean age 76.0 ± 8.6 years) underwent IN, while the remaining 21 (10 females, 11 males; mean age 75.3 ± 7.7 years) received THA. Primary outcomes included gait speed and step width for both treatment groups, while secondary outcomes included the incidence of postoperative falls and additional clinical and spatiotemporal gait parameters. The mean gait speed was 73.5 ± 26.8 cm/s for the IN group and 79.7 ± 27.5 cm/s for the THA group (P = .46). Step width was significantly lower in the IN group (15.7 ± 2.7 cm) compared to the THA group (17.9 ± 3.3 cm; P < .05, effect size = 0.7). Postoperative falls were reported by 13 patients (31%) overall, with no significant differences between the 2 treatment groups. Multivariate logistic regression analysis identified an increased step width (≥18 cm, OR = 5.24; 95% CI: 0.98–27.97; χ² = 1.66, P = .05) as a potential independent risk factor for postoperative falls, while a higher modified Harris Hip score (≥80 points) was an independent protective factor (OR = 0.18; 95% CI: 0.03–0.97; χ² = ‐1.69; P = .04). The area under the curve was 0.889 (95% CI: 0.809–0.989; P < .001). The optimal cutoff point for the highest sensitivity (100%) and specificity (65.5%) was 0.217. Model accuracy for predicting postoperative falls was 76.2%. In conclusion, both IN and THA resulted in favorable clinical outcomes and comparable gait speeds following hip fracture surgery in older adults, though step width was greater in the THA group. Despite the high overall incidence of postoperative falls, no significant differences in fall occurrence were observed between the 2 treatment groups. Abbreviations: BMI = body mass index, GDS = geriatric depression scale, IN = intramedullary nailing, mHHS = modified Harris Hip score, MMSE = minimental state examination, THA = total hip arthroplasty.
The effects of the Home-based Older People’s Exercises (HOPE) protocol on functional capacity, falls risk, fear of falling, and quality of life in older Brazilian women with sarcopenia
(2025) Pinheiro, Hudson Azevedo; Martins, Larissa de Souza; Dias, Maria Paula Bastos; Menezes, Ruth Losada de
This study aimed to investigate the effects of the Home-based Older People’s Exercise (HOPE) program on functional capacity, falls risk, fear of falling, and quality of life in sarcopenic older women living in the Brazilian Federal District. The intervention involved 20 elderly women diagnosed with sarcopenia who participated in a 12-week exercise regimen, twice a week, focusing on functional mobility, strength, and balance. Results showed significant improvements in functional capacity, including better performance in mobility tests and increased muscle strength. Specifically, the Short Physical Performance Battery (SPPB) and handgrip strength improved, and the risk of falls, as well as the fear of falling, decreased significantly. However, no changes were observed in muscle mass. Additionally, quality of life, assessed through the EQ-5D scale, showed marked improvement. Despite the lack of muscle mass changes, the program demonstrated its efficacy in improving mobility, strength, and psychological aspects related to fall risk. The findings suggest that the HOPE protocol can be a valuable, low-cost intervention for improving the health and independence of frail, sarcopenic older adults.
Mental health and aging: identifying risk and protective factors of anxiety and depression in older women
(2025) Bueno, Guilherme Augusto Santos; Silva, Renato Canevari Dutra da; Camargo Júnior, Elton Brás; Bueno, Stephany Kindorly de Oliveira; Martins, Anabela Correia; Menezes, Ruth Losada de
Objective: To identify risk and protective factors associated with anxiety and depression symptoms in older adult women, con- sidering clinical, functional, and electrophysiological parameters. Methods: This cross-sectional observational study involved 91 women aged 65 or older. Assessments included EEG-derived valence and excitation levels, motor reaction time, body composition, and functional performance. Anxiety and depression were screened using the mind over mood anxiety inventory and the geriatric depression scale, respectively. Results: Anxiety symptoms were present in 28.6% of participants and depressive symptoms in 27.5%. Risk factors for anxi- ety included fear of falling (OR=2.023, 95% CI=1.554–2.944, p=0.007), presence of depressive symptoms (OR=2.254, 95% CI=1.983–3.085, p=0.008), and body fat percentage (OR=1.543, 95% CI=1.253–3.111, p=0.011). Protective factors included valence (OR=0.311, 95% CI=0.272–0.544, p=0.003), gait speed (OR=0.674, 95% CI=0.482–0.782, p=0.023), and maximal ex- piratory pressure (OR=0.755, 95% CI=0.693–0.823, p=0.027). For depressive symptoms, risk factors included fear of falling (OR=1.983, 95% CI=1.865–3.801, p=0.023) and anxiety symptoms (OR=1.765, 95% CI=1.563–1.983, p=0.008), while pro- tective factors were cortical excitation (OR=0.523, 95% CI=0.425–0.693, p=0.023) and expiratory pressure (OR=0.635, 95%CI=0.491–0.723, p=0.021). Conclusion: Functional and emotional parameters, particularly valence and gait performance, suggest a potential protective role against anxiety and depression in aging women. The findings reinforce the importance of integrated assessments to support early detection and guide intervention planning, while further studies are recommended to strengthen these observations.
Prevalência e fatores associados à sarcopenia em pessoas idosas encaminhadas pela Atenção Primária em Saúde a um serviço especializado em determinada região do Distrito Federal, 2015-2017
(2025) Pinheiro, Hudson Azevedo; Cerceau, Vera Regina; Pinheiro, Luana de Azevedo; Pagotto, Valéria; Menezes, Ruth Losada de
Prefrontal cortical asymmetry and motor slowing in older women: evidence that fear of falling modulates emotional valence and reaction time
(2026) Bueno, Guilherme Augusto Santos; Costa, Murielle Celestino da; Costa, Katarine Souza; Silva, Renato Canevari Dutra da; Camargo Júnior, Elton Brás; Esteves, Germano Gabriel Lima; Menezes, Ruth Losada de
Aim: To investigate the relationship between cortical activation and motor performance in older women with different levels of fear of falling (FoF) and fall history. Methods: Fifty-five participants were evaluated, including 40 older adults divided into four groups (NotFall-LFoF, NotFall-HFoF, Fall-LFoF, Fall-HFoF) and 15 younger controls. Motor reaction time was assessed using adapted TRT_S2012 software, while cortical activity was recorded via EEG (EMOTIV EPOC+). Cortical arousal was indexed by the β/α ratio, and valence by (αF4/βF4) − (αF3/βF3) asymmetry. Statistical analyses included ANOVA and Pearson's correlation (α ≤ 0.05). Results: Groups were homogeneous in demographic and cognitive characteristics. Significant differences were observed in cortical arousal (p = 0.014) and valence (p = 0.004). Higher FoF levels were associated with reduced prefrontal symmetry and slower reaction times. Strong negative correlations were found between valence and reaction times (r > −0.9). FES-I scores showed positive correlations with motor latency (r = 0.8–0.9) and negative correlations with cortical indices (r = −0.7 to −0.9). Conclusions: Fear of falling modulates prefrontal cortical activation, shifting motor control from automatic to more conscious processing, which impairs motor efficiency. FoF emerges as a potential cortical biomarker of motor vulnerability, reinforcing the importance of neurorehabilitation strategies integrating emotional and cortical regulation to improve mobility and reduce fall risk in aging populations.
Síndrome da fragilidade em idosos com histórico de quedas seguidas de fratura de quadril e tratamento cirúrgico: comparação com a idade
(2025) Carvalho, Matheus Marinho; Silva, Victor Fernando Rodrigues da; Costa, Katarine Souza; Costa, Murielle Celestino da; Fagotti, Lorenzo; Ribeiro, Darlan Martins; Andrade, Ana Carolina do Couto; Menezes, Ruth Losada de
Frailty is a geriatric syndrome characterized by various physical, functional, physiological, cognitive, emotional, and social markers. Objective: To assess the presence of frailty syndrome in older adults with a history of falls followed by hip fracture and surgical treatment, and to examine the correlation with age. Methodology: This cross-sectional study involved patients aged ≥60 years who underwent surgery for hip fracture after a fall from standing height. To evaluate the frailty phenotype, five criteria proposed by Fried et al. were applied: (1) Weight loss: self-reported unintentional weight loss over the past year greater than 4 kg; (2) Exhaustion through self-reported fatigue; (3) Physical Activity Level (IPAQ short version); (4) Decreased muscle strength (hydraulic dynamometer); (5) Slow gait speed (2.44 m), in addition to the assessment of functionality through the Short Physical Performance Battery (SPPB) and the Timed Up and Go (TUG) test. Individuals scoring 3, 4, or 5 items were considered frail, those with 1 or 2 items pre-frail, and those with no score on any items non-frail. Data analysis was conducted using Jamovi® software. Results: The sample consisted of 47 patients with a mean age of 76.2 years, of whom 57.4% were female. Among those aged 70–79, there was a higher concentration of pre-frail individuals, and in the age group of 80 and older, a higher prevalence of frail individuals. Frailty was more common among females (n = 12) compared to males (n = 5). A significant difference was observed between age and frailty levels, as well as between the mean ages of the pre-frail and frail groups, demonstrating that frailty increases with age. Conclusion: The presence of frailty syndrome is evident among older adults with a history of falls followed by hip fracture and surgical treatment. Age and the time to sit and stand five times (SPPB) are variables that directly influence frailty.
Habilidades pragmáticas em crianças com transtorno do espectro do autismo
(2025) Borges, Marcos Henrique; Guimarães, Valeriana de Castro; Perilo, Deborah Branco Ferreira; Fernandes, Edson Júnior de Melo; Oliveira, Angelina Emiliano; Sousa, Ivone Felix; Fernandes, Fernanda Dreux Miranda
Objective: To evaluate pragmatic skills in children diagnosed with autism spectrum disorder, using the Protocol for the Assessment of Pragmatic Skills of Children with Autism Spectrum Disorders. Method: The convenience sample included 115 children with autism spectrum disorder, of both sexes, whose data were collected by nine speech therapists at a speech therapy clinic in the Midwest Region of Brazil. For statistical analyses, the basic assumptions of the results obtained in the application of Protocol for the Assessment of Pragmatic Skills of Children with Autism Spectrum Disorders were evaluated. The one-sample binomial, chi-square, and Kolmogorov-Smirnov tests were used to assess the occurrence of statistical difference between the social communication skills observed in children with autism spectrum disorder when only two different responses were obtained, when more than two types of responses were obtained, and between the different types of responses to assess social communication skills for each child, respectively. Results: Of the 115 participating children, 98 (85.7%) are male, 59 (84.3%) attended school, and their ages ranged between 3 and 12 years. Of the 29 questions that make up the five Protocol for the Assessment of Pragmatic Skills of Children with Autism Spectrum Disorders factors, i.e. language, inadequacy, interactivity, functionality, and responsiveness, we observed that the null hypothesis was rejected in 79.3% of the responses from the speech therapists who collected the data. The adoption of the null hypothesis indicates that no statistically significant difference was found in the perception of the performance of the children evaluated in relation to pragmatic skills, an outcome corroborated by the literature when identifying heterogeneity and uniqueness in the communication of people with autism spectrum disorder. Conclusion: The identification of unique points of difficulty in social (pragmatic) communication should contribute to raising awareness of the need to offer children with autism spectrum disorder interventions that stimulate and train their broader communicative skills, social cognition, and verbal capacity, i.e. their ability to conversation.
Equilíbrio postural em pacientes com esclerose múltipla e sua associação com quedas: estudo caso controle
(2025) Gléria, Pedro Deyvid Marinho Pereira; Lima, Lucas Monteiro; Guimarães, Valeriana de Castro; Garcia Zapata, Marco Tulio Antonio; Ramos, Gabrielly Craveiro
El objetivo del presente estudio fue evaluar el equilibrio postural en personas con esclerosis múltiple (EM) y asociarlo con el riesgo de caídas. En este caso, se llevó a cabo una investigación transversal de casos y controles, en la que participaron 41 personas sanas y 41 con esclerosis múltiple recurrente-remitente, todas evaluadas mediante la Escala Ampliada del Estado de Discapacidad (EDSS). La muestra estuvo compuesta por nueve hombres y 32 mujeres, tratados en un hospital comunitario. Se utilizó el índice dinámico de marcha (IDM) para medir la capacidad de adaptar los patrones de marcha, y las puntuaciones ≤19 indican una inestabilidad postural significativa y un alto riesgo de caídas. La edad promedio de los participantes fue de 38 años (±9,37), con un predominio de mujeres (78%). En el grupo EM, el tiempo de diagnóstico osciló entre 1 y 17 años, y los niveles de discapacidad, medidos por la EDSS, estuvieron entre 1 y 5. Además, 18 personas (el 43,9%) de este grupo obtuvieron una puntuación de ≤19 en el IDM. Estos participantes tenían un riesgo de caídas 37 veces mayor en comparación con el grupo de control (p = 0,01). Las personas con esclerosis múltiple tenían un alto riesgo de sufrir inestabilidad postural y caídas, lo que reforzaba la importancia de las estrategias preventivas y de la rehabilitación específica para esta población.
Nível de atividade física e fatores associados em trabalhadores usuários de terminais de computador
(2025) Rosal, Amanda Fernandes Alves; Arruda, Zíngarah Májory Tôrres de; Costa, Murielle Celestino da; Romão, Juliana de Faria Fracon e; Menezes, Ruth Losada de
Background: The increase in sedentary work, especially among computer users, has been associated with health risks, including musculoskeletal disorders, cardiometabolic diseases, and lower limb edema. Objective: To investigate the physical activity level of computer users at an institution in the Central-West region of Brazil and analyze its associations with personal, work, and institutional factors. Methodology: Observational, analytical, and cross-sectional study involving 209 adult workers. Sociodemographic, work, and health data were collected, and the International Physical Activity Questionnaire (IPAQ – short version) was administered. Statistical analysis included chi-square, Fisher's exact, and Kruskal-Wallis tests, with a significance level of 5%. Results: The sample had a mean age of 37.3 years and a mean BMI of 26.3 kg/m2. Women predominated (56.9%) and had a high level of education (81.3%). The majority reported physical activity (64.6%), mainly weight training, walking, and running. Using the IPAQ, 66.8% were classified as "active" or "very active." A significant association was observed between lower levels of physical activity and a higher frequency of lower limb edema, as well as between IPAQ classification and physical activity practice/frequency. Leisure activities, although present in more than half of the sample, were predominantly sedentary. Conclusion: Administrative workers who use computers have moderate to high levels of physical activity, but remain exposed to sedentary behaviors, especially during leisure time. Regular physical activity appears to act as a protective factor against lower limb edema. The findings reinforce the need for occupational health promotion strategies that encourage a reduction in sedentary lifestyles and an increase in physical activity in the workplace.
Transcranial direct current stimulation neuromodulation in elderly individuals and its impact on anxiety and depression symptoms
(2025) Bueno, Guilherme Augusto Santos; Bomfim, Arthur Dutra do; Menezes, Ruth Losada de; Silva, Renato Canevari Dutra da; Camargo Júnior, Elton Brás; Silva, Henrique Salmazo da
To evaluate the effects of anodal transcranial direct current stimulation (tDCS) over the left prefrontal cortex, combined with computerized cognitive training, on cognitive performance, anxiety, depression, motor reaction time, and neurophysiological markers in elderly women with subjective cognitive decline or preserved cognition. Methods This was a randomized double-blind clinical trial involving 30 elderly women allocated to three groups: active tDCS, sham tDCS, and controls. The intervention consisted of nine sessions of tDCS combined with cognitive training. Cognitive aspects (Addenbrooke's Cognitive Examination-Revised), depressive symptoms (CES-D), anxiety symptoms (GAI), motor reaction times, and neurophysiological aspects (EEG) were assessed. Statistical analyses included ANOVA and paired t-tests for between-group comparisons. Results The tDCS group exhibited significant improvements in global cognition, episodic memory, verbal fluency, and language. Additionally, there was a significant reduction in anxiety and depression scores compared to those in the sham and control groups. The motor reaction time was reduced in the tDCS group, indicating improved sensorimotor integration. The EEG data demonstrated increased cortical excitation and improved emotional valence in the tDCS group. Conclusion Anodal tDCS associated with computerized cognitive training has proven to be an effective strategy for optimizing performance in memory tasks, verbal fluency, and decision-making as well as for reducing anxiety and depression symptoms in elderly individuals with or without subjective cognitive decline. Based on these findings, tDCS is a promising and safe tool for developing cognitive interventions for the elderly. Future studies should explore the long-term effects and impact of different stimulation protocols.
The burden of pancreatic cancer in Latin America and the Caribbean: trends in incidence, mortality and DALYs from 1990 to 2019
(2025) Silva, Diego Rodrigues Mendonça e; Oliveira, Max Moura de; Fernandes, Gisele Aparecida; Curado, Maria Paula
mortality and disability-adjusted life years (DALYs), as well as the proportion of pancreatic cancer deaths attributable to behavioural and metabolic risk factors in Latin America and the Caribbean (LAC) countries. Methods: This study focuses on pancreatic cancer using the Global Burden of Disease 2019 study database. Results were described for 23 LAC countries for 1990–2019, evaluating their age-standardised incidence rates, mortality rates, DALYs, average annual percent change and the fraction of deaths attributable to behavioural and metabolic risk factors. Results: We observed that in LAC, pancreatic cancer incidence rates ranged from 1.2 in Haiti to 15.8/100,000 in Uruguay among men. The highest increase in incidence rate was observed in Trinidad and Tobago: 7.7% per year. The mortality rate was higher in Uruguay and lower in Haiti, for both sexes. The highest rise in the numbers of DALYs in 2019 was observed in Brazil and Mexico. The proportion of pancreatic cancer deaths attributable to smoking was reduced between 1990 and 2019 for both sexes in LAC countries; however, it increased for metabolic risk factors. Conclusion: The increasing trend in pancreatic cancer observed in LAC may be associated with a rise in risk factors such as high fasting plasma glucose and high body mass index in both sexes. This trend will likely have a substantial impact on the healthcare system in the coming decades.
Correction: exploring the link between dietary patterns and gastric adenocarcinoma in Brazil: a mediation analysis
(2025) Silva, Alex Richard Costa; Alicandro, Gianfranco; Guandalini, Valdete Regina; Grili, Patrícia Paula da Fonseca; Assumpção, Paulo Pimentel de; Barbosa, Mônica Santiago; Sant'Ana, Rosane Oliveira de; Coimbra, Felipe José Fernández; Curado, Maria Paula
Dietary vitamin D and gastric cancer risk within the stomach cancer pooling (stop) project
(2025) Santucci, Claudia; Natale, Arianna; Pelucchi, Claudio; Bonzi, Rossella; Lunet, Nuno Miguel de Sousa; Morais, Samantha Ferreira; Vioque López, Jesús; González Palacios, Sandra; Aragonés Sanz, Nuria; Castaño-Vinyals, Gemma; Curado, Maria Paula
Purpose The evidence regarding the role of vitamin D on gastric cancer (GC) is controversial. Within the Stomach cancer Pooling (StoP) Project, a global consortium of epidemiological studies on GC, we aimed to evaluate the relationship between dietary vitamin D and GC risk. Methods Five case–control studies were included in the analysis, accounting for 1875 cases and 5899 controls. Odds ratios (OR) of GC and the corresponding 95% confidence intervals (CI) for tertiles of vitamin D intake were computed using logistic regression models adjusted for relevant confounders, including energy intake. The pooled ORs were computed using random-effect models. Results The pooled OR of GC for the highest compared to the lowest tertile of vitamin D intake was 1.06 (95% CI 0.80– 1.39), with a p for heterogeneity of 0.019. No significant association was found across strata of sex, age, socioeconomic status, smoking status, alcohol intake, and vegetable and fruit consumption. Conclusions Our pooled analysis indicates that there is no association between dietary vitamin D and the risk of GC.
Systemic impact of Helicobacter pylori: a cross-sectional study
(2025) Ramos, Amanda Ferreira Paes Landim; Santiago, Silvana Barbosa; Moraes, Felipe Augusto de Sousa; Soares, Giovana Alice Sampaio; Fernandes, Gisele Aparecida; Curado, Maria Paula; Germano, Janaina Naiara; Barbosa, Mônica Santiago
Background and Aim: Helicobacter pylori is an oncobacteria that infects about half of the world's population and has a well-established role in the etiology of gastric diseases. Lately, this infection has also been associated with extragastric diseases, such as neuropsychiatric, cardiovascular, metabolic, hematological, and dermatological comorbidities. Elucidating risk factors for comorbidities can contribute to reducing mortality and public health costs. Therefore, the aim of this study is to investigate the association between H. pylori infection and extragastric comorbidities. Materials and Methods: This is a cross-sectional hospital-based case–control study that was conducted in Goiás from 2019 to 2022. The study patients were classified into H. pylori-negative and H. pylori-positive groups. Results: A total of 156 participants were included in the study, and the prevalence of the bacteria was 45.5%. In the H. pylori-positive group, the most frequent diseases were hypertension, anemia, rheumatic disease, and diabetes. The presence of comorbidities was similar between the groups, with the exception of psychiatric illnesses. The male patients were more likely to be infected with H. pylori (odds ratios [ORs] = 2.63, 95% CI: 1.26–5.50), while the H. pylori-positive group was less likely to have psychiatric illnesses (OR = 0.32, 95% CI: 0.11–0.92). Conclusion: The prevalence of H. pylori infection was 45.5%, and males were more likely to be infected by the bacteria. The most frequent comorbidities in the H. pylori-positive group were hypertension, anemia, rheumatic disease, and diabetes. H. pylori-negative patients were more likely to have psychiatric illnesses.
Advanced stage head and neck cancer diagnosis: HEADSpAcE consortium health systems benchmarking survey
(2025) Creaney, Grant; Goulart, Mariél de Aquino; McMahon, Alex; Paterson, Claire; McCaul, James; Perdomo, Sandra J.; Mendoza Torres, Laura Patricia; Vilches, Laia Alemany; Arantes, Lidia Maria Rebolho; Rodriguez Urrego, Paula Andrea; Curado, Maria Paula
Background: Globally, most people with head and neck cancers (HNCs) are diagnosed with advanced-stage disease. HNC diagnostic stage has multifactorial explanations, with the role of health system factors not yet fully investigated. Methods: HNC centres (n = 18) from the HEADSpAcE Consortium were surveyed via a bespoke health system questionnaire covering a range of factors. Centres were compared using the least square means for the presence/absence of each health system factor to their proportion of advanced-stage HNC. Results: Health system factors associated with lower proportion in advanced-stage diagnosis were formal referral triaging (14%, 95% CI-0.26, −0.03), routine monitoring of time from referral to diagnosis (16%, 95% CI-0.27, −0.05), and fully publicly funded systems (17%, 95% CI-0.29, −0.06). Several health systems factors had no routinely available data. Conclusions: Through identifying and monitoring health systems factors associated with lower proportions of advanced stage HNC, interventions could be developed, and systems redesigned, to improve early diagnosis.
Incidence and trends of multiple myeloma (MM) in Brazil – 1988–2020
(2025) Oliveira, Dandara Menezes de Araujo; Mendoza López, Rossana Verónica; Aristizabal Arboleda, Lady Paola; Curado, Maria Paula
Background: Multiple myeloma (MM) is a chronic hematological malignancy caused by adifferentiated plasma cell disorder (Pawlyn, 2019). As a consequence of population aging, there has been an increase in incidence rates (Turesson et al 2018). In 2022, there were 187,744 new cases (Bray et al 2024). The incidence of MM in Brazil has not been estimated by the National Cancer Institute (INCA). Objective: To analyse the incidence rates and trends of MM across states in Brazil from Population-Based Cancer Registries (PBCRs). Methodology: Information was extracted from PBCR/INCA for the 1988–2020 period. Sociodemographic data were extracted from records of the Brazilian Institute of Geography and Statistics. Age-standardised incidence rates were calculated using the Segi global standard population. Trend analysis was performed using Join point Regression, version 4.7.0.0. Results: The highest incidence rates of MM in males were observed in the cities of Natal (Rio Grande do Norte state) and Jaú (São Paulo state) at 3.55/100,000 and 2.9/100,000, respectively. In females, rates were highest in the cities of Natal (Rio Grande do Norte state) and Aracajú (Sergipe state) at 2.66/100,000 and 2.21/100,000, respectively. Trends showed an annual increase of 10.45% in Campinas for males and 9.04% for females. Median age at diagnosis in Brazil was 65 years for both sexes, while the North region had the lowest average age at 63.2 years, and the South region the highest at 68.0 years. Porto Alegre city (Rio Grande do Sul state) had the highest average of 70.0 years for females and 67.1 for males, while Roraima had the lowest at 61.2 years for females and 54.2 for males. Conclusion: In Brazil, the average age of incidence varies by geographic region, but is higher among males. Incidence rates are highest in the Northeast and Southeast regions, whereas the greatest upward trends are in the Southeast and Midwest regions.
Body mass index and gastric cancer risk: results from the Stomach Cancer Pooling Project Consortium
(2025) Pastorino, Roberta; Marafon, Denise Pires; Gris, Angelica Valz; Lentini, Nicolò; Cristiano, Antonio; Aragonés Sanz, Nuria; Martín Sánchez, Vicente; Zaridze, David Georgievich; Maximovich, Dmistry; Vioque López, Jesús; Curado, Maria Paula
Background: Body mass index (BMI) has been associated with gastric cancer (GC), though results are conflicting regarding the GC subsites of cardia and non-cardia. This study aims to evaluate the associations between BMI and GC risk, focusing on these distinct anatomical subsites. Methods: We pooled data from seven case–control studies from the Stomach Cancer Pooling (StoP) Project. Pooled odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of GC risk across BMI categories (normal weight, overweight, obesity) were calculated by pooling study-specific ORs through random-effects meta-analytic models. The dose–response relationship between BMI and the risk of GC cancer was assessed by using a one-stage mixed-effects logistic regression model. Results were stratified according to cardia and non-cardia GC. Results: The analysis comprised 1478 GC cases, including 511 cardia and 967 non-cardia cases, and 6671 controls. There was an increased risk of cardia GC among obese patients (OR 1.57, 95% CI 1.20–2.06), while no association was found for non-cardia GC (OR 0.82, 95% CI 0.66– 1.01). Restricting the analysis to population-based studies, the association for cardia GC became stronger for obese (OR 1.65, 95% CI 1.09– 2.48) and overweight (OR 1.62, 95% CI 1.10–2.39) patients. The dose–response meta-analysis showed an increased risk of cardia GC with increasing BMI values, ranging from a null effect at a BMI of 21.75 to an OR of 2.06 (95% CI 1.22–3.48) for a BMI of ≥40. Conclusion: Our results indicate an association between higher BMI categories and the risk of cardia GC, whereas no association was found with non-cardia GC.
Overall and disease-free survival in patients with HPV-positive and HPV-negative oropharyngeal cancer
(2025) Abreu, Matheus de; Oliveira, Dandara Menezes de Araujo; Bastos Neto, Bartolomeu Conceição; Germano, Janaina Naiara; Kowalski, Luiz Paulo; Curado, Maria Paula
Objective: To analyze the overall and disease-free survival of patients with oropharyngeal squamous cell carcinoma. Methods: Sociodemographic and clinical data, HPV status, and alcohol/tobacco consumption were assessed among patients treated at AC Camargo Cancer Center, São Paulo, Brazil. Absolute and relative frequencies, overall survival, and disease-free survival at 5 and 7 years were calculated using Kaplan-Meier analysis, and Cox regression was used to estimate the risk of death. Results: The 7-year overall survival rate was 61.6% for patients with oropharyngeal squamous cell carcinoma (67.5% for HPV-positive cases and 51.1% for HPV-negative cases). Among HPV-positive cases, the risk of death was 5.29-fold higher for smokers than that for non-smokers (p<0.001) and 4.42-fold higher for patients with metastasis than that for those without (p=0.108). Among HPV-cases, those with clinical stage T3/T4 disease had a 1.8-fold higher risk of death than those with T1/T2 disease (p=0.039), and those with metastasis exhibited a 4.62-fold higher risk than those without (p<0.001). The 7-year diseasefree survival rate for oropharyngeal squamous cell carcinoma was 88.6% (90.1% for HPV-positive cases and 85.9% for HPV-negative cases). Among HPV-positive cases, patients with metastasis had an 11.75-fold higher risk of recurrence than those without (p<0.001); among HPV-negative cases, patients with metastasis had a 4.62-fold higher risk than those without (p=0.004). Conclusion: Patients with HPV-positive oropharyngeal squamous cell carcinoma had higher overall survival and increased recurrence rates within the first 3 years but lower recurrence rates beyond 5 years than patients with HPV-negative disease. More frequent follow-ups after 5 years are recommended for patients with HPV-positive disease. Tobacco and alcohol consumption negatively affect the overall survival of patients with HPV-positive oropharyngeal squamous cell carcinoma.
Challenges and opportunities in head and neck cancer research in developing countries: insights from a fireside chat
(2025) Chaves, Aline Lauda Freitas; Kowalski, Luiz Paulo; Marta, Gustavo Nader; Silva, Alan Roger dos Santos; Muniz, Luciana Vieira; Mak, Milena Perez; Gössling, Gustavo Cartaxo de Lima; Guimarães, Vítor Souza; Castro Júnior, Dálvaro Oliveira de; Curado, Maria Paula
Head and neck squamous cell carcinoma (HNSCC) represents a significant public health burden in developing countries, where access to early diagnosis, comprehensive care, and research infrastructure is limited. This article synthesizes the insights generated during a Fireside Chat convened by members of the Latin American Cooperative Oncology Group (LACOG)—Head and Neck and the Brazilian Group of Head and Neck Cancer (GBCP), with the participation of international expert Professor Hisham Mehanna. The discussion addressed key challenges and opportunities in clinical and translational research within resource-constrained settings. Major themes included the unmet needs of patients with HNSCC, particularly regarding treatment-related toxicities and the need for biomarker-driven, personalized approaches. Barriers to research in low- and middle-income countries were explored, including patient comorbidities, late-stage presentation, and regulatory hurdles. The group emphasized the importance of pragmatic, context-sensitive research that reflects local disease burden, health care structures, and cultural factors. Capacity building, multidisciplinary teamwork, and in- tegration of translational science into clinical care were highlighted as essential for advancing outcomes. The manuscript also outlines the preparedness of Brazilian centers for early-phase trials, strategies to enhance patient recruitment, and mechanisms to strengthen collaboration among researchers, governmental agencies, and industry. Successful models from LACOG and GBCP were presented to illustrate local leadership in advancing HNSCC research. Ultimately, the authors advocate for a coordinated national research agenda that positions Brazil and similar nations as meaningful contributors to the global head and neck cancer research landscape, fostering innovation while addressing the realities of under-represented populations.

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