Background: Current evidence suggests an inverse association between socioeconomic status and stroke incidence. Our aim was to measure the variation in incidence among different city districts (CD) and their association with socioeconomic variables. Methods: We prospectively ascertained all possible stroke cases occurring in the city of Joinville during the period 2005-2007. We determined the incidence for each of the 38 CD, age-adjusted to the population of Joinville. By linear regression analysis, we correlated incidence data with mean years of education (MYE) and mean income per month (MIPM). Results: Of the 1,734 stroke cases registered, 1,034 were first-ever strokes. In the study period, the crude incidence in Joinville was 69.5 per 100,000 (95% confidence interval, 65.3-73.9). The stroke incidence among CD ranged from 37.5 (22.2-64.6) to 151.0 per 100,000 (69.0-286.6). The stroke incidence was inversely correlated with years of education (r = -0.532; p<0.001). MYE and MIPM were strongly related (R = 0.958), resulting in exclusion of MIPM by collinearity. Conclusions: Years of education can explain a wide incidence variation among CD. These results may be useful to guide the allocation of resources in primary prevention policies. Copyright (C) 2011 S. Karger AG...

Introdução. O câncer de boca em 1998 foi a décima-primeira localização mais comum das neoplasias malignas, exceto pele, no sexo masculino, em São Paulo, com 1,6% dos casos. Dados do Registro de Câncer de São Paulo mostram que a incidência não diminuiu em anos recentes. A região é de alta incidência para esse tipo de câncer, em comparação às demais regiões brasileiras e mesmo em termos mundiais. Julgou-se de interesse de Saúde Pública verificar a incidência do câncer de boca no Município de São Paulo, segundo sexo e idade, em anos selecionados. Objetivos. Descrever os coeficientes de incidência de câncer de boca no Município de São Paulo em 1969, 1973, 1978 e 1998, segundo sexo, idade e localização topográfica do tumor, comparando-os; calcular a probabilidade de incidência de câncer de boca em intervalos selecionados de idade segundo sexo e localização topográfica do tumor. Métodos. Partindo-se de dados secundários (Registro de Câncer de SP), obtiveram-se as taxas de incidência e calcularam-se as taxas de incidência acumulada segundo sexo e localização topográfica em intervalos de 5 anos. Os riscos acumulados para até as idades de 20,30,...,70 anos, em porcentagem, foram calculados e apresentados em gráficos seguindo o modelo de Zdeb modificado por Souza; para análise estatística foram construídos intervalos de confiança para os riscos...

A ramulose, causada por Colletotrichum gossypii var. cephalosporioides, é uma das mais importantes doenças do algodoeiro no Brasil. O fungo é transportado e transmitido pela semente, que se constitui fonte de inóculo inicial. Os objetivos do presente trabalho foram i) estudar o efeito de inibidores de germinação sobre a germinação, comprimento da radícula e incidência do patógeno nas sementes; ii) avaliar o efeito de níveis de incidência na semente e do controle químico da parte aérea sobre o progresso da ramulose; iii) estudar a transmissão do patógeno planta-semente em função da incidência da doença. Com base nos resultados observou-se que os solutos Manitol e NaCl no potencial osmótico de -0,8 MPa reduziram a germinação, o comprimento da radícula e não interferiram na detecção do patógeno. A área abaixo da curva de progresso da incidência e severidade da ramulose foi maior, quanto maior foi o nível de incidência nas sementes, independente do número de pulverizações no ano de 2006. No ano de 2007, a área abaixo da curva de progresso da ramulose foi dependente do número de pulverizações, sendo maior, quanto maior foi o nível de incidência nas sementes, mas sendo reduzida de acordo com o número crescente de pulverizações. Não houve efeito da quantidade de doença sobre a produção nos anos estudados...

Introdução: Apesar do AVC persistir como a primeira causa de óbito no Brasil, estudos de mortalidade têm demonstrado queda de taxas pela doença nas últimas décadas. Comparamos a evolução das taxas de morbi-mortalidade de primeiro evento de AVC em uma mesma base populacional em quase dez anos de intervalo. Além disso, no período de 2005-6, também obtivemos a incidência de primeiro evento de subtipos de AVC, a prevalência dos fatores de risco cardiovasculares e o prognóstico funcional após seis meses do evento. Métodos: Em 2005 e 2006, utilizando metodologia proposta por Sudlow e Warlow, foram coletados prospectivamente informações sobre todos os casos de AVC, o uso de medicações pré-mórbidas e a presença de fatores de risco tradicionais. Obtivemos as taxas de incidência e de mortalidade de primeiro evento de AVC, ajustadas por idade para a população mundial e a letalidade em até 30 dias. Comparamos estes resultados com os obtidos na cidade de Joinville em 1995. As taxas de incidência e mortalidade anual foram ajustadas por idade pelo método direto. Resultados: Entre 1323 casos de AVC registrados em 2005-6, 759 foram primeiros eventos da doença. A incidência ajustada por idade por 100.000 habitantes foi de 143...

Introdução - Estudos sobre o câncer de cólon mostram que a sua incidência, no mundo, tem aumentado de maneira significativa no último século. Acredita-se que este resultado esteja relacionado, entre outros aspectos, com a industrialização, a urbanização ocorridas neste período e mudanças no estilo de vida. A morbimortalidade associada ao câncer de cólon observada em países desenvolvidos é maior do que em países em desenvolvimento e o que se tem observado é que, embora a tendência da incidência seja crescente para ambos os sexos, a mortalidade permanece estável. Objetivo - Analisar as tendências da incidência e da mortalidade de pacientes com câncer de cólon, registrados no Registro de Câncer de Base Populacional (RCBP) do Município de São Paulo. Métodos - Foram analisadas as tendências temporais da incidência no período de 1997 a 2005 e da mortalidade no período de 1980 a 2007. As análises foram feitas separadamente por sexo e faixa etária e os efeitos da idade, do período e da coorte foram estimados através do modelo de regressão de Poisson. Resultados - Houve aumento na incidência por câncer de cólon no município de São Paulo, em quase todas as faixas etárias estudadas. O aumento da mortalidade foi menor do que o aumento da incidência e parece coincidir com um efeito de coorte presente durante todo o período do estudo. Tanto na incidência quanto na mortalidade...

Introdução: A cada ano, são diagnosticados mais de um milhão de novos casos de câncer de mama em mulheres no mundo. Os países mais desenvolvidos apresentam as maiores incidências, enquanto a mortalidade é maior nos países em desenvolvimento. No Brasil, as incidências mais elevadas se localizam nas regiões Sul e Sudeste. Nos últimos cinco anos, a incidência de câncer de mama aumentou cerca de 30 por cento nos países do ocidente, porém, a partir do ano 2000, observa-se ligeiro decréscimo na mortalidade. A investigação simultânea sobre a incidência e a mortalidade pode fornecer informações sobre a etiologia da doença, e a análise dos efeitos da idade, período e da coorte facilita a compreensão dos mecanismos responsáveis pela variação nas tendências. Objetivos: Analisar as tendências da incidência e da mortalidade por câncer de mama feminino no município de São Paulo, segundo os efeitos da idade, período e coorte. Métodos: Foram analisadas a incidência no período de 1997 a 2005, e a mortalidade no período de 1982 a 2005. Os dados foram obtidos no Registro de Câncer de Base Populacional de São Paulo, no Sistema de Mortalidade do Ministério da Saúde (SIM-MS) e no Instituto Brasileiro Geografia e Estatística (IBGE). Os efeitos da idade...

A infecção pelo vírus da imunodeficiência humana na Amazônia tem-se mostrado como um dos mais recentes desafios para o enfrentamento da epidemia de HIV/aids no Brasil. Estudos epidemiológicos baseados em dados de incidência mostram tendência de crescimento da epidemia na região Norte do país. O Serviço de Assistência Especializada de Santarém é referência em assistência às pessoas com HIV/aids de 25 municípios das mesorregiões do baixo Amazonas e sudoeste do Pará. Os objetivos do presente trabalho consistem em descrever as características sociodemográficas, clínicas e laboratoriais de pessoas vivendo com HIV à admissão nesse serviço de referência, comparando-as entre os períodos: 1999 a 2002(P1), 2003 a 2006(P2) e 2007 a 2010(P3) e analisar as tendências de incidência de aids em Santarém entre 1999 e 2010. As informações referentes às variáveis de interesse foram obtidas em revisão de prontuários. Foram calculados os coeficientes de incidência padronizados a partir dos casos notificados de aids em Santarém, obtidos em bases de dados nacionais e locais. A análise de tendência de incidência foi realizada por modelos de regressão polinomial. A maioria dos 527 sujeitos (62,4%) foi admitida em P3...

INTRODUÇÃO: o câncer de estômago já foi, mundialmente, a neoplasia com maior ocorrência na população. Ao longo das décadas, a incidência deste câncer apresenta tendência de decréscimo significativo, sendo que, atualmente, é o quinto tumor maligno mais frequente no mundo. A mortalidade não acompanhou a tendência de decréscimo na mesma velocidade e ainda é considerada a terceira principal causa de morte por câncer. O Brasil acompanhou a tendência mundial, registrando o declínio significativo da incidência e da mortalidade. O município de São Paulo apresenta as mais altas taxas de incidência e mortalidade do país. Apesar disso, existem poucos estudos de tendências de incidência dessa neoplasia para São Paulo e este é o primeiro estudo que investiga as tendências de incidência e mortalidade por sexo, por faixas etárias e por tipo histológico. OBJETIVO: analisar as tendências dos coeficientes de incidência e mortalidade do câncer de estômago, segundo sexo, faixa etária e tipo histológico pela classificação de Lauren. MÉTODOS: estudo ecológico de séries temporais. Foram analisados os novos casos de câncer de estômago, diagnosticados no período de 1997 a 2011, no município de São Paulo, cadastrados no Registro de Câncer de Base Populacional de São Paulo...

Background: Scarce information is available about the variation in the incidence of Type 1 diabetes in the Brazilian population in the last decades. Aim: The objective of this study was to assess the long-term trends (1986-2006) in the incidence of Type 1 diabetes in Bauru, São Paulo State, Brazil. Subjects and methods: The annual incidence of Type 1 diabetes (per 100,000 per yr) from 1986 to 2006 was determined in children yr of age, using the capture and recapture method. Results: A total of 176 cases were diagnosed in the study population. The overall incidence was 10.4/100,000 with a range of 2.82/100,000 in 1987 to 18.49/100,000 in 2002 representing a 6.56-fold increase within the same population. The estimated incidence, using the capture and recapture method varied from 2.82/100,000 per yr in 1987 to 27.20/100,000 per yr in 2002, representing a 9.6-fold variation. The global pattern of incidence variation was categorized as high (10-19.99/100,000 per yr), and very high (20/100,000 per yr) in 71.43% of the study-years. Incidence was slightly higher among females, Caucasians, children in the 5-9 yr of age range and belonging to lower socio-economic classes. Most diagnoses were established during the colder months and/or with higher pluviometric indexes. Conclusions: The incidence of Type 1 diabetes in children is increasing in Bauru...

OBJECTIVE: As in Brazil cancer registries are mostly based on large cities, there are no estimates per state or per region and information on the disease incidence in the vast in-land areas is very scarce. An incidence survey was conducted in 18 major cities of the state of São Paulo, excluding the capital, aiming to collect information about cancer incidence in the state of São Paulo. METHODS: Of the 18 cities in state of São Paulo included in the survey, all had available resources for cancer management. Data from the year of 1991 were collected by the personnel of the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Statistics), who were especially trained by the study coordinators at the Fundação Oncocentro de São Paulo (Cancer Center of São Paulo). The collected data were processed and analyzed at the Oncocentro. Data collection, processing, and analyses were performed according to the recommendations of the International Agency for Research on Cancer. RESULTS: Although some discrepancies were observed in cancer incidence rates between the cities, results obtained for all 18 cities combined were remarkably close to those recently found for the city of São Paulo in the year 1993. One remarkable finding was the relatively high cancer incidence rates in both sexes in the city of Santos. CONCLUSIONS: The very similar all-sites cancer incidence rates found in the year 1991...

OBJECTIVE: In an admixed population of older Cubans, the incidence and association of APOE and socio demographic risk factors with dementia incidence was estimated. METHODS: A single-phase survey (baseline) of all over 65-year-olds residing in seven catchment areas in Cuba (n=2944) was conducted between 2003 and 2007. Dementia diagnosis was established according to DSM-IV and 10/66 criteria. APOE genotype was determined in 2520 participants. An incidence wave was conducted 4.5 years after cohort inception in order to estimate incidence and associations with sociodemographic risk factors of the APOE ε4 genotype. RESULTS: The incidence rate of DSM IV dementia was 9.0 per 1000 person-years (95% CI 7.2-11.3) and of 10/66 dementia was 20.5 per 1000 person-years (95% CI, 17.6-23.5). Older age, a family history of dementia and APOE ε4 genotype were independent risk factors for incident 10/66 dementia. APOE genotype was associated cross-sectionally with dementia prevalence, but the effect on the incidence of dementia was attenuated, and only apparent among those in the youngest age group. CONCLUSION: The incidence of dementia in the older Cuban population is relatively high and similar to levels reported in Europe and North-America. The study showed that the relationship between APOE ε4 and incident dementia is stronger in the younger-old than the older-old and that this change must be taken into account in models of dementia.

OBJECTIVE: To study the behavior of breast cancer incidence in the city of Goiania/Goias, during the specified period of years, according to the age group and geospatial distribution. METHODS: In order to achieve our objectives, we conducted three distinctive studies, as described below: Study I: This study sought to verify the Average Annual Percentage Change (AAPC) of breast cancer incidence in Goiania, per decade of life. It used the database of the Population Based Cancer Registries of Goiania (RCBPGo), between 1988 and 2003. During this period, it was registered 3,310 new cases of female breast cancer. The incidence of both crude and standardized rates, this is adjusted by Segi’s World population, were calculated per age groups at each 10 years. Poisson Regression was used to calculate the AAPC for these age groups. Study II: Studied breast cancer incidence trends in young women, in Goiania, during the same period of time (1988 to 2003). The women were divided in three age groups: young women, younger than 39 years old;; women between 40 and 59 years old;; and women above 60 years old. To conduct this study, the annual incidence was calculated by the respective age groups. It was calculated the AAPC and the linear regression. The latter was used to obtain the correlation coefficient and the determination coefficient. Study III: The database of the Population Based Cancer Registries of Goiania (RCBPGo) was updated in this study until 2006;; therefore...

Existing evidence forms a body of "conventional wisdom" on the redistributive impact of fiscal policies that has been recently questioned by more disaggregated analyses. This paper proposes an additional extension to the traditional benefit incidence analysis to explore further the extent to which the conventional wisdom holds, as well as to provide effective guidance in fiscal decision making. The benefit incidence analysis extension includes linking fiscal policies with the concept of equality of opportunities. The paper describes this approach and showcases the application of the proposed "opportunity incidence analysis" to six pilot countries: Liberia, Cote d Ivoire, Zambia, Tajikistan, Thailand, and Paraguay. Three main contributions stand out: first, opportunity incidence analysis complements traditional benefit incidence analysis by applying its mechanics to a more forward looking concept of equal opportunity. Second, opportunities can be used to target public spending with higher precision. Third...

Benefit incidence analysis has become a popular tool over the past decade, especially for researchers at the World Bank. Despite or perhaps because of the popularity of this method, recent research has pointed out many of its limitations. One of the most common criticisms of benefit incidence analysis is that its description of average participation rates is not necessarily useful in guiding marginal changes in public spending policies. This article considers a variety of methods for analyzing the marginal benefit incidence of policy changes. A key conceptual point is that despite the fact that the various methods measure marginal incidence, they do not measure the same thing nor are they intended to do so. There are many possible policy changes and thus many margins of interest. Each method captures one of these and so is of interest for some analyses and inappropriate for others. Empirically, the precision of the methods differs substantially, with those relying on differenced data or aggregations of households yielding standard errors that are quite large relative to the estimated shares.

OBJECTIVES: To update the analysis of the cohort mortality and cancer incidence study of employees in the Australian petroleum industry. METHODS: Employees of Australian Institute of Petroleum member companies were enrolled in the cohort in four industry-wide surveys between 1981 and 1999. Mortality of 16 547 males and 1356 females was determined up to 31 December 2001 and cancer incidence to 31 December 2000. Cause specific mortality and cancer incidence were compared with those of the Australian population by means of standardised mortality ratios (SMRs) and standardised incidence ratios (SIRs). Associations between increased incidence of specific cancers and employment in the petroleum industry were tested by trends according to period of first employment, duration of employment, latency, and hydrocarbon exposure, adjusting for personal smoking history where appropriate. RESULTS: There was a significant elevation of the incidence of mesothelioma (SIR 1.77, 95% CI 1.05 to 2.79), melanoma (SIR 1.37, 95% CI 1.19 to 1.58), and prostate cancer (SIR 1.18, 95% CI 1.04 to 1.34). The SIRs of all leukaemias and of acute non-lymphocytic leukaemia (ANLL) were not significantly different from unity, but all 11 ANLL cases were clustered in the middle to high hydrocarbon exposure categories. Tanker drivers had a significantly elevated incidence of kidney cancer (12 cases v 5.84 expected...

Objective: To assess data quality of cancer registrations for Indigenous Australians and produce reliable national Indigenous cancer incidence statistics. Methods: Completeness of Indigenous identification was assessed for the eight Australian cancer registries using an innovative indirect assessment method based on registry-specific registration rates for smoking-related cancers. National age-standardised incidence rates and rate ratios (Indigenous:non-Indigenous) were calculated for all cancers combined and 26 individual cancer sites. Multivariate regression analysis was used to investigate trends in Indigenous cancer incidence by time or remoteness of residence, and whether the incidence rate ratio (Indigenous:non-Indigenous) was different in younger than older age-groups. Results: Four registries covering 84% of the Indigenous population had sufficiently complete Indigenous identification to be included in analysis. Compared to other Australians, Indigenous Australians had much higher incidence of lung and other smoking-related cancers, cervix, uterus and liver cancer, but much lower incidence of breast, prostate, testis, colorectal and brain cancer, melanoma of skin, lymphoma and leukaemia. Incidence was higher in remote areas for some cancers (including several smoking-related cancers) but lower for others. The incidence rate ratios (IRRs) for smoking-related cancers were higher in younger than older people. Conclusions: Indigenous Australians have a different pattern of incidence of specific cancers than other Australians and large geographical variations for several cancers. Implications: All cancer registries need to further improve Indigenous identification...

Objectives: To determine the cancer incidence in Gipuzkoa (Spain) from 1998 to 2002 and describe time trends since 1986. Methods: The annual incidence of cancer in Gipuzkoa from 1998 to 2002 was estimated as a rate per 100,000 inhabitants. Incidence trends for the period 1986-2002 were studied for all cancers and for the main cancer sites using Poisson regression and Joinpoint regression for prostate tumours. Results: On average, one in 3 men and one in 5 women would probably be diagnosed with cancer at some time during their life (0-74 years). Among men, prostate surpassed lung as the most frequent cancer site. Among women, breast cancer represented approximately 30% of all cases of cancer (excluding non-melanoma skin cancers). There was an annual increase in the incidence of cancer of 1.5% (95% CI, 1.1-1.8) in men and 0.9% (95% CI, 0.5-1.3) in women. The incidence of prostate cancer in men increased over the study period, and especially between 1996 and 1999, with an annual increase of 34.7% (95% CI, 5.9-71.5). The incidence of lung cancer in women presented an annual increase of 5.2% (95% CI, 3.4-7.1). In contrast, the incidence of stomach cancer decreased during the study period. Conclusions: Cancer incidence in Gipuzkoa increased during the study period. This increase was particularly marked in lung cancer and skin melanoma...

BACKGROUND: The Government of Trinidad and Tobago is in the process of developing a comprehensive National Oncology Programme. Regarding Paediatric Oncology, it is necessary to characterize this population to adequately direct its development. This report describes the incidence of childhood cancer in Trinidad and Tobago. PROCEDURE: The data were extracted from the National Cancer Registry of Trinidad and Tobago and the Eric Williams Medical Sciences Complex. Malignancies were coded with the International Classification of Childhood Cancer, 3rd edition. Incidence rates were calculated for the period 2001-2006, age 0-14 years and by county. RESULTS: The crude incidence rate of childhood cancer was 1.9 per 100 000 patient years (pyrs). One hundred and forty-five cases were reviewed for the six-year period with an incidence rate of 7.5 per 100 000 pyrs. The highest incidence was in children < 5 years: 14 per 100 000pyrs for males and 11.4 per 100 000 pyrs for females. Leukaemias and central nervous system tumours formed the majority of the cancers (58.6%), however nephroblastoma was more common than neuroblastoma especially in females < 5 years: 2.7 per 100 000 pyrs compared with 1.2 per 100 000 pyrs for neuroblastoma. The incidence of all childhood cancers did not vary across counties...

OBJECTIVES: To summarize incidence and risk factors for each main cause of visual loss in an African-Caribbean population and discuss the implications of these data from a public health perspective. METHODS: A nationally representative cohort (n = 4 709; ages 40-84 years at baseline) had ophthalmic and other examinations over 9 years. Incidence rates were estimated by the product-limit approach. Risk factors were evaluated from Cox regression models. RESULTS: Average incidence was ~ 0.1% per year for blindness (< 6/120) and 0.7% per year for low vision (< 6/18 to 6/120), increasing steeply with age (P < 0.05) and affecting related quality of life (P < 0.05). Age-related cataract and open-angle glaucoma (OAG) accounted for 73.2% of blindness and diabetic retinopathy (DR) for 8.9%; cataract caused two-thirds of low vision. Average incidence was 5.1% per year for all lens changes (gradable/ungradable opacities or aphakia) and 0.4% per year for cataract surgery. Incidence of definite OAG was 0.5% per year (0.9% for suspect or probable); 53% of the affected were unaware. Persons with diabetes mellitus (DM) had a DR incidence of 4.4% per year. Age-related macular degeneration was rare (0.08% per year). Main cataract risk factors were age and DM. OAG incidence increased with age...

Objectives: To determine the cancer incidence in Gipuzkoa (Spain) from 1998 to 2002 and describe time trends since 1986. Methods: The annual incidence of cancer in Gipuzkoa from 1998 to 2002 was estimated as a rate per 100,000 inhabitants. Incidence trends for the period 1986-2002 were studied for all cancers and for the main cancer sites using Poisson regression and Joinpoint regression for prostate tumours. Results: On average, one in 3 men and one in 5 women would probably be diagnosed with cancer at some time during their life (0-74 years). Among men, prostate surpassed lung as the most frequent cancer site. Among women, breast cancer represented approximately 30% of all cases of cancer (excluding non-melanoma skin cancers). There was an annual increase in the incidence of cancer of 1.5% (95% CI, 1.1-1.8) in men and 0.9% (95% CI, 0.5-1.3) in women. The incidence of prostate cancer in men increased over the study period, and especially between 1996 and 1999, with an annual increase of 34.7% (95% CI, 5.9-71.5). The incidence of lung cancer in women presented an annual increase of 5.2% (95% CI, 3.4-7.1). In contrast, the incidence of stomach cancer decreased during the study period. Conclusions: Cancer incidence in Gipuzkoa increased during the study period. This increase was particularly marked in lung cancer and skin melanoma...