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Objective To identify reasons among Brazilian women for never having a Pap test. Design We designed a cross-sectional study that used data from the National Health Survey. Sample Two thousand four hundred and two women 25-64 years old who never had a pap test. Measures Variables were age, race, education, marital status, housing condition, primary health care access, health insurance, self-perceived health, and social support network. We calculated the prevalence of different reasons and odds ratios for each. Results The most frequent reason for never having a test were linked to women thinking the test was unnecessary (42.3%) which had a significant association with marital status (OR = 1.52; 95% CI = 1.07-1.91), age (OR = 1.56; 95% CI = 1.21-1.99), area of residence (OR = 1.15; 95% CI = 1.02-1.39), having a health insurance (OR = 1.18; 95% CI = 1.01-1.36), and self-perceived health (OR = 1.42; 95% CI = 1.28-1.56). The second most frequent reason was not knowing they needed a test (22.9%) which was associated with age (OR = 1.95; 95% CI = 1.74-2.16) and self-perceived health (OR = 1.56; 95% CI = 1.33-1.80). Conclusions The findings suggest lack of knowledge about cervical cancer and its prevention among Brazilian women. We consider it essential that the health service can provide the test, as well as the necessary guidelines for raising the awareness of the target audience.

This study aims to estimate the prevalence of the primary occupational exposures, considered risk factors for Cancer in Brazil. We elaborated two exposure scenarios considering the agents' classification and the intensity of exposure, stratified by Brazilian regions and sex. Two pairs of specialists performed the classification of economic activities and occupations due to exposure. There was an excellent overall agreement (94%) and acceptable overall reliability (kappa 0.92, 95% CI 0.89-0.95). There is a notable difference (595%) in occupational exposure between the north (with a higher concentration of rural areas and extractivism) and southeast (with a higher level of industrial activities). There is a difference in prevalence from 833% for solvents to 1170% for inorganic dust between the two scenarios. There is a heterogeneity of exposures according to location, sex, circumstance, and sensitiveness of classification.

OBJECTIVE To describe the cross-cultural adaptation and psychometric properties of the Brazilian version of the IN-PATSAT32 questionnaire. METHODS The questionnaire was applied to 328 patients in a public hospital, and the retest was performed with 86 patients, approximately 1 week after the test. Psychometric analyses were performed to evaluate the structure, reliability, and internal consistency of the questionnaire. RESULTS The adapted questionnaire presented high sensitivity and the intraclass correlation coefficient (ICC > 8) indicated strong convergent validity and discriminant properties of the instrument, as well as high internal consistency (Cronbach's α > 0.8). Exploratory factor analysis divided the questionnaire into five dimensions: satisfaction with a multidisciplinary team (α = 0.953, kp = 0.61, ICC = 0.953), doctors (α = 0.993, kp = 0.817, ICC = 0.966), therapeutic (α = 0.946, kp = 0.869, ICC = 0.972), hospital structure (α = 0.97, kp = 0.87, ICC = 0.947), and hospital discharge. CONCLUSION The results indicated that the Brazilian version maintained its psychometric properties when used in a heterogeneous population and with different diagnoses and stages of treatment for cancer. PRACTICE IMPLICATIONS This questionnaire can be used in the Brazilian hospital routine to gauge the satisfaction of patients with hospitalization.

Objective To assess the test-retest reliability of the Memorial Symptom Assessment Scale translated and culturally adapted into Brazilian Portuguese. Methods The scale was applied in an interview format for 190 patients with various cancers type hospitalized in clinical and surgical sectors of the Instituto Nacional de Câncer José de Alencar Gomes da Silva and reapplied in 58 patients. Data from the test-retest were double typed into a Microsoft Excel spreadsheet and analyzed by the weighted Kappa. Results The reliability of the scale was satisfactory in test-retest. The weighted Kappa values obtained for each scale item had to be adequate, the largest item was 0.96 and the lowest was 0.69. The Kappa subscale was also evaluated and values were 0.84 for high frequency physic symptoms, 0.81 for low frequency physical symptoms, 0.81 for psychological symptoms, and 0.78 for Global Distress Index. Conclusion High level of reliability estimated suggests that the process of measurement of Memorial Symptom Assessment Scale aspects was adequate. RESUMO Objetivo Avaliar a confiabilidade teste-reteste da versão traduzida e adaptada culturalmente para o português do Brasil do Memorial Symptom Assessment Scale. Métodos A escala foi aplicada em forma de entrevista em 190 pacientes com diversos tipos de câncer internados nos setores clínicos e cirúrgicos do Instituto Nacional de Câncer José de Alencar Gomes da Silva e reaplicada em 58 pacientes. Os dados dos testes-retestes foram inseridos num banco de dados por dupla digitação independente em Excel e analisados pelo Kappa ponderado. Resultados A confiabilidade da escala mostrou-se satisfatória nos testes-retestes. Os valores do Kappa ponderado obtidos para cada item da escala apresentaram-se adequados, sendo o maior item de 0,96 e o menor de 0,69. Também se avaliou o Kappa das subescalas, sendo de 0,84 para sintomas físicos de alta frequência, de 0,81 para sintomas físicos de baixa frequência, de 0,81 também para sintomas psicológicos, e de 0,78 para Índice Geral de Sofrimento. Conclusão Altos níveis de confiabilidade estimados permitem concluir que o processo de aferição dos itens do Memorial Symptom Assessment Scale foi adequado.

BACKGROUND: Colorectal cancer is the third most common type of cancer in the world and the increased survival of the colorectal cancer population is very significant. Thus, it becomes relevant to study the symptoms associated with the progression of the disease and treatment, for proper clinical management. OBJECTIVE: To describe the clinical and epidemiological profile of colorectal cancer patients and to identify the most prevalent signs and symptoms patterns. METHODS: Cross-sectional study evaluating the prevalence of symptoms in 348 colorectal cancer patients admitted to a referral oncology hospital. We applied MSAS-BR scale and, through factor analysis with principal componente analysys, we performed the grouping of symptoms. RESULTS: There was a predominance of men, aged 60 years or older, married, white, with high school, moderately differentiated tumor, stage III/IV disease, colon cancer and no distant metastasis. The most prevalent symptoms were weight loss (67.53%) and the least prevalent were mouth sores (2.01%). The groupings of symptoms established were “fatigue and psychic symptoms”, “gastrointestinal symptoms”, “self-perceptive symptoms” and “general symptoms”, which described 80% of the symptoms presented. CONCLUSION: We evidenced the importance of identifying these symptoms clusters in order to improve strategies for clinical management in patients with colorectal cancer. RESUMO CONTEXTO: O câncer colorretal é o terceiro tipo de câncer mais comum no mundo e o aumento de sobrevida da população com câncer colorretal é muito significativo. Com isso, torna-se relevante o estudo dos sintomas associados à progressão da doença e do tratamento, para um manejo clínico adequado. OBJETIVO: Descrever o perfil clínico e epidemiológico de pacientes com câncer colorretal e identificar padrões de sinais e sintomas mais prevalentes. MÉTODOS: Estudo transversal que avaliou prevalência de sintomas em 348 pacientes com câncer colorretal internados em hospital de referência em oncologia. Foi aplicada a escala MSAS-BR e, através da análise fatorial com análise dos componentes principais, realizou-se o agrupamento de sintomas. RESULTADOS: Houve predomínio de homens, com 60 anos ou mais, casados, de cor branca, com o ensino médio, com tumor moderadamente diferenciado, doença com estágio III/IV, com câncer de cólon e sem metástase à distância. O sintoma mais prevalente foi perda de peso (67,53%) e o menos prevalente foi ferida na boca (2,01%). Os agrupamentos de sintomas formados foram “fadiga e sintomas psíquicos”, “sintomas gastrointestinais”, “sintomas autoperceptivos” e “sintomas gerais”, que descreveram 80% dos sintomas apresentados. CONCLUSÃO: Evidenciou-se a importância da identificação desses sintomas para criação de estratégias de manejo clínico de pacientes com câncer colorretal.

Resumo Objetivo: avaliar os sintomas mais frequentes apresentados pelos pacientes com câncer de cabeça e pescoço e fatores associados. Metodologia: trata-se de um estudo transversal realizado com 77 pacientes do serviço de cirurgia de cabeça e pescoço do Instituto Nacional de Câncer (Brasil). Foi utilizado o Memorial Symptom Assessment Scale (MSAS), adaptado ao Brasil. Foi avaliada a prevalência dos sintomas, bem como sua associação com variáveis demográficas e clínicas por meio dos testes de qui- quadrado e de ANOVA. Resultados: os sintomas mais prevalentes foram boca seca (62,5 %), tristeza (60 %), preocupações (53,75 %), nervosismo (48,75 %) e tosse (46,25 %). Quanto à faixa etária, identificou-se diferença nos sintomas físicos de baixa frequência (PHYS-L), com maior queixa entre os jovens (p < 0,01). Na escala global (TMSAS) houve queixa maior dos pacientes ambulatoriais comparados aos internados (p = 0,05). Houve, ainda, queixa maior de sintomas de baixa frequência entre pacientes sem metás-tase (p = 0,05). Conclusão: considerando-se a ocorrência de múltiplos sintomas no paciente oncológico, é necessário ter métodos que sejam capazes de avaliar, de forma mais ampla, os sintomas. Dessa forma, o enfermeiro terá melhor compreensão da complexidade dos grupos de sintomas, permitindo aperfeiçoar as intervenções clínicas no processo de enfermagem. Resumen Objetivo: evaluar los síntomas más frecuentes presentados por los pacientes con cáncer de cabeza y cuello y factores asociados. Metodología: estudio transversal realizado con 77 pacientes del servicio de cirugía de cabeza y cuello del Instituto Nacional de Cáncer (Brasil). Se utilizó el Memorial Symptom Assessment Scale (MSAS) adaptado a Brasil. Se estimó la prevalencia de los síntomas, así como su asociación con variables demográficas y clínicas, evaluada a través de las pruebas de chi cuadrado y de ANOVA. Resultados: los síntomas más prevalentes fueron boca seca (625 %), tristeza (60 %), preocupaciones (5375 %), nerviosismo (48,75 %) y tos (46,25 %). Para la franja etaria se identificó diferencia en los síntomas físicos de baja frecuencia (PHYS-L), con mayor queja entre los jóvenes (p < 0,01). En la escala global (TMSAS) hubo mayor queja de los pacientes ambulatorios que de los internados (p = 0,05). Se produjo, incluso, mayor queja de síntomas de baja frecuencia entre pacientes sin metástasis (p = 0,05). Conclusión: si se tiene en cuenta la aparición de múltiples síntomas en el paciente oncológico, es necesario tener métodos que sean capaces de evaluar, de forma más amplia, los síntomas. De esa forma, el enfermero tendrá una mejor comprensión de la complejidad de los grupos de síntomas y podrá perfeccionar las intervenciones clínicas en el proceso de enfermería. Abstract Objective: to evaluate the most frequent symptoms showed by patients with cancer of head and neck, and associated factors. Methodology: cross-sectional study conducted with 77 patients of service of head and neck surgery of the National Institute of Cancer (Brazil). It was used the Memorial Symptom Assessment Scale (MSAS), adapted to Brazil. It was estimated the prevalence of symptoms, as well as its association with demographic and clinical variables, assessed through Chi-squared and ANOVA tests. Results: the most prevalent symptoms were: dry mouth (62.5 %), sadness (60 %), concerns (53.75 %), nervousness (48.75 %) and cough (46.25 %). Difference in the physical symptoms of low frequency (PHYS-L) was identified for the age group, with greater complaint among young people (p < 0.01). On the global scale (TMSAS) there was greater complaint of outpatients than that of hospitalized patients (p = 0.05). There was greater complaint of symptoms of low frequency among patients without metastasis (p = 0.05). Conclusion: if it is taken into account the appearance of multiple symptoms in cancer patients, forms able to assess these in a broader way are necessary, which allow the nurse to get a better understanding of the complexity of the groups of symptoms and improve clinical interventions in the nursing process.

Objective: To evaluate symptoms among patients with abdominal cancer and associated factors. Materials and methods: A cross-sectional study with 100 patients. The prevalence of symptoms was evaluated through the Memorial Symptom Assessment Scale (MSAS) and its association with demographic and clinical variables using chi-square and ANOVA tests. Results: The most prevalent symptoms were weight loss (64.0 %), pain (56.0 %), dry mouth (50.0 %), “I do not look more myself” (48.0 %) and lack of energy (45.0 %). There was a significant difference between sex and high-frequency (PHYS-H) (p = 0.001) and low-frequency (PHYS-L) physical symptoms (p = 0.004), and for general scale (TMSAS) (p = 0.002); (p = 0.001), general range (p = 0.027) and borderline significance for the global scale (GDI) (p = 0.051); high-frequency physical symptoms (p = 0.022), low-frequency physical symptoms (p = 0.034) and the overall scale (p = 0.034). There was one major complaint regarding the severity of high-frequency physical symptoms in patients with liver cancer (p = 0.018). Conclusion: Symptoms of physical and psychological aspects in cancer patients were associated with gender, race, marital status and tumor location. There is a need for tools to assess symptoms and enable health professionals to intervene more effectively. RESUMEN Objetivo: evaluar los síntomas entre los pacientes con cáncer abdominal y factores asociados. Materiales y método: estudio transversal realizado con 100 pacientes. Se evaluó la prevalencia de los síntomas, a través de la Memorial Symptom Assessment Scale (MSAS), y su asociación con variables demográficas y clínicas, por medio de pruebas de chi cuadrado y ANOVA. Resultados: los síntomas más prevalentes fueron pérdida de peso (64,0 %), dolor (56,0 %), boca seca (50,0 %), “No me siento yo mismo” (48,0 %) y falta de energía (45,0 %). Hay una diferencia significativa entre el sexo y los síntomas físicos de alta frecuencia (PHYS-H) (p = 0,001) y de baja frecuencia (PHYS-L) (p = 0,004), y para escala general (TMSAS) (p = 0,002); entre la raza y los síntomas físicos de alta frecuencia (p = 0,008), la escala general (p = 0,027) y la significancia limítrofe para la escala global (GDI) (p = 0,051); el estado civil y los síntomas físicos de alta frecuencia (p = 0,022), los síntomas físicos de baja frecuencia (p = 0,034) y la escala general (p = 0,034). Hubo una queja mayor en relación a la gravedad de los síntomas físicos de alta frecuencia en pacientes con cáncer de hígado (p = 0,018). Conclusión: síntomas de aspectos físicos y psicológicos en pacientes oncológicos se han asociado al sexo, la raza, el estado civil y la localización del tumor. Existe la necesidad de instrumentos para que los síntomas sean evaluados y permitan que los profesionales de la salud puedan intervenir de manera más eficaz. RESUMO Objetivo: avaliar sintomas entre pacientes com câncer abdominal e fatores associados. Materiais e método: estudo transversal realizado com 100 pacientes. Foi avaliada a prevalência dos sintomas, através do Memorial Symptom Assessment Scale (MSAS), e sua associação com variáveis demográficas e clínicas, por meio de testes de qui quadrado e ANOVA. Resultados: os sintomas mais prevalentes foram perda de peso (64,0 %), dor (56,0 %), boca seca (50,0 %), “Eu não pareço mais eu mesmo” (48,0 %) e falta de energia (45,0 %). Há diferença significativa entre sexo e sintomas físicos de alta frequência (PHYS-H) (p = 0,001) e de baixa frequência (PHYS-L) (p = 0,004), e para escala geral (TMSAS) (p = 0,002); entre raça e sintomas físicos de alta frequência (p = 0,008), escala geral (p = 0,027) e significância limítrofe para a escala global (GDI) (p = 0,051); estado civil e sintomas físicos de alta frequência (p = 0,022), sintomas físicos de baixa frequência (p = 0,034) e a escala geral (p = 0,034). Houve uma queixa maior em relação à gravidade de sintomas físicos de alta frequência em pacientes com câncer de fígado (p = 0,018). Conclusão: sintomas de aspectos físico e psicológico em pacientes oncológicos foram associados a sexo, raça, estado civil e localização do tumor. Há necessidade de instrumentos para que os sintomas sejam avaliados e permitam que profissionais de saúde possam intervir de maneira mais eficaz.

Objective. To evaluate the need for information in patients with abdominal neoplasms. Methods. The sample consisted of 100 patients hospitalized in a surgical ward for patients with abdominal neoplasms at the National Institute of Cancer Jose de Alencar Gomes da Silva / INCA, in the period between June and December 2016. To collect the data, the Brazilian Portuguese version of the European Organization for Research and Treatment of Cancer (EORTC) information module questionnaire (QLQ-INFO25) was used. Results. In general, for most items, the patients showed satisfaction with the amount of information received. The items referring to the disease, examinations, treatment and general information stand out, with an average score of more than 80%. For some items, however, there is dissatisfaction with the amount of information received, especially those related to the cause of the disease, aspects of out-of-hospital and home care, different places of care and aspects of self-help, with a satisfaction level of less than 40%. Conclusion. Despite the high level of satisfaction with the information received, it was observed that almost all patients would like more information, which makes us recommend that, as part of the care, the information offered to these patients about the treatment and the evolutionary process of the disease should be enhanced. Descriptors: abdominal neoplasms; oncology nursing; patient satisfaction. How to cite this article : Silva DGF, de Souza ALLP, Martins TSF, Pedrosa TM, Muzi CD, Guimaraes RM. Quality of information given to surgical patients with abdominal cancer. Invest. Educ. Enferm. 2017; 35(2):221-231.

Objective: to describe the process of semantic equivalence, the first stage in the validation of the EORTC QLQ-ELD14 instrument for Brazilian Portuguese. Method: Direct and independent translations of the instrument into Portuguese were carried out and validated by a meeting of experts to generate a synthesis version. The version chosen was submitted to reverse translations into English, and the form was pre-tested with patients. At the conclusion of the process, a summary version was presented. The pre-test and the final version of the instrument were applied to a total of 28 patients at a high complexity oncology treatment center. Result: after completion of the first round of pretesting, some adjustments for the next phase of the study were necessary by the expert committee. After these adjustments, in the second phase of pre-testing, the instrument was well-accepted by the population. Conclusion: the Portuguese summary version of the EORTC QLQ-ELD14 instrument for assessing the quality of life of elderly cancer patients is ready to be submitted to the next stages of the evaluation of its psychometric properties.

Introduction: Smoking is currently a public health problem, considering its high prevalence and mortality due to tobacco-related diseases. The degree of urbanization has been associated with smokin...

OBJECTIVE: To assess the trend of thyroid cancer mortality in Brazil between 1980 and 2010. MATERIALS AND METHODS: An ecological study of time series. Mortality rates for thyroid cancer adjusted by age according to gender were calculated between 1980 and 2010. Data were analyzed by three distinct strategies: polynomial regression, joinpoint analysis, and moving averages. RESULTS: Over 70% of deaths occur in the elderly, regardless of sex. Among young adults, the mortality rate is low, with no difference between men and women. Among mature adults and elderly, mortality is increasing, and significantly, for women. There is a trend of decreasing mortality in all female adults and overall population, and in males and 40-59 years and overall population, both excluding the elderly, with statistical significance. CONCLUSION: Knowledge about trends allows setting priorities and allocating resources toward positive changes in this scenario in the Brazilian population. OBJETIVO: Avaliar a tendência da mortalidade por câncer de tireoide no Brasil entre 1980 e 2010. MATERIAIS E MÉTODOS: Estudo ecológico, de séries temporais. As taxas de mortalidade por câncer de tireoide ajustadas por idade segundo sexo foram calculadas entre 1980 e 2010. Os dados foram analisados por três estratégias distintas: regressão polinomial, joinpoint analysis e médias móveis. RESULTADOS: Mais de 70% das mortes ocorrem nos idosos, independente do sexo. Entre adultos jovens, a mortalidade é baixa, sem diferença entre homens e mulheres. Entre adultos maduros e idosos a mortalidade é crescente e com aumento expressivo para mulheres. Há uma tendência de mortalidade decrescente no sexo feminino para adultos e global; e no sexo masculino para 40-59 anos e global, ambos excluindo os idosos, com significância estatística. CONCLUSÃO: O conhecimento sobre a tendência permite estabelecer prioridades e alocar recursos de forma direcionada para a modificação positiva desse cenário na população brasileira.

Este artigo tem por objetivo descrever a evolução da transição da mortalidade por cânceres de mama e colo do útero no Brasil em relação ao desenvolvimento socioeconômico. Foram obtidos dados de mortalidade por câncer de mama e de colo do útero no Brasil para um período de 20 anos, correspondente a um intervalo bicensitário. Os óbitos foram corrigidos e as taxas padronizadas. Além disso, indicadores sociais foram mensurados para os três anos censitários incluídos na série temporal. Observa que os estados brasileiros possuem muita heterogeneidade com relação aos indicadores sociais e à mortalidade pelos dois cânceres, e parece haver um padrão entre a condição socioeconômica e a mortalidade por câncer de mama e de colo do útero. Conclui que é necessário, portanto, realizar a avaliação e o planejamento das ações, considerando cenários de desenvolvimento, para garantir o acesso universal e equitativo das mulheres às políticas públicas de saúde.Palavras-chave: Demografia, Mortalidade, Desenvolvimento, Câncer, Políticas públicas, Políticas de saúde.CANCER'S TRANSITION IN BRAZIL AND STRATEGICAL DECISION-MAKING IN WOMEN´S PUBLIC HEALTH POLICIES Abstract: This article aims to describe the evolution of the transition in mortality from breast and cervix cancers in Brazil in relation to socioeconomic development. There were data obtained of mortality from breast cancer and cervical cancer in Brazil for a period of 20 years, corresponding to a censitary range. Deaths were corrected and rates standardized. In addition, social indicators were measured for all three census years included in the time series. It was observed that the Brazilian states have a lot of heterogeneity with respect to social indicators and mortality for both cancers, and there seems to be a pattern between socioeconomic status and mortality from breast and cervix cancer. It is therefore necessary to carry out the assessment and planning of actions, considering development scenarios, to ensure universal and equal access of women to public health policies. Key words: Demographics, Mortality, Development, Cancer, Public policies, Health policies.

CONTEXT: The most recent global estimate revealed the presence of about one million new cases of stomach cancer for the year 2008, setting itself as the fourth most common cause of cancer. OBJECTIVE: The present study aims to assess the trend of mortality from stomach cancer in Brazil according to regions between 1980 and 2009. METHODS: Data on deaths from stomach cancer were obtained from the Mortality Information System, and the demographic data, from the Brazilian Institute of Geography and Statistics. The rates of mortality were standardized by age according to world population. The trend curves were calculated for Brazilian regions by sex. The technique used was polynomial regression and joinpoint. RESULTS: The tendency for males and females is similar in all regions, although the magnitude is higher among men in all places. Regions Midwest, South, Southeast tended to decline, while the Northern region showed no significant trend, and the Northeast tended to increase. CONCLUSION: It is therefore a need to evaluate public health policies for gastric cancer aimed at the demographic transition (change of urbanization and lifestyle) that is occurring throughout the country.