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Gallbladder cancer (GBC) mortality in Chile is among the highest worldwide. In 2006, the Chilean government launched a programme guaranteeing access to gallbladder surgery (cholecystectomy) for patients aged 35-49 years. We evaluated the impact of this programme on digestive cancer mortality. After conducting an interrupted time series analysis of hospitalisation and mortality data from 2002 to 2018 publicly available from the Chilean Department of Health Statistics and Information, we calculated the change in the proportion of individuals without gallbladder since 10 years. We then estimated age, gender, region, and calendar-year standardised mortality ratios (SMRs) as a function of the change in the proportion of individuals without gallbladder. The cholecystectomy rate increased by 45 operations per 100,000 persons per year (95%CI 19-72) after the introduction of the health programme. Each 1% increase in the proportion of individuals without gallbladder since 10 years was associated with a 0.73% decrease in GBC mortality (95% CI -1.05% to -0.38%), but the negative correlation was limited to women, southern Chile and age over 60. We also found decreasing mortality rates for extrahepatic bile duct, liver, oesophageal and stomach cancer with increasing proportions of individuals without gallbladder. To conclude, 12 years after its inception, the Chilean cholecystectomy programme has markedly and heterogeneously changed cholecystectomy rates. Results based on aggregate data indicate a negative correlation between the proportion of individuals without gallbladder and mortality due to gallbladder and other digestive cancers, which requires validation using individual-level longitudinal data to reduce the potential impact of ecological bias.

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Background: Persons living with HIV (PLWH) have a higher risk of persistent infection with human papillomavirus (HPV) and anal cancer. We evaluated knowledge and awareness of HPV infection and risk factors for anal cancer among PLWH in Puerto Rico (PR). Methods: Data from a cross-sectional study (2020-2021) were analyzed (n=212). Inclusion criteria included PLWH, aged ≥ 26 years, and living in PR. Telephone interviews collected information on sociodemographic, lifestyle and clinical characteristics. Two 13-item scales were used to assess knowledge of HPV and anal cancer risk factors; adequate knowledge for both scales were defined as scoring >70%. Logistic regression models using generalized linear models were used to determine the association between 1) HPV infection awareness, 2) HPV infection knowledge, and 3) Anal cancer risk factors knowledge. Results: The median age was 54 years (IQR: 46,58), 67.5% were male, 71.7% reported having an income <$20,000, and 54.3% had an education level of more than high school. HPV awareness was high (82.1%), but only 40.2% and 3.8% had adequate knowledge of HPV and anal cancer risk factors, respectively. In adjusted logistic regression models, men who have sex with men (OR: 1.26, 95%CI: 1.07-1.47) and women (OR: 1.35, 95%CI: 1.15-1.59) aged ≥50 years had higher odds of HPV awareness than heterosexual men in that age group. Moreover, those with history of anal Pap test aged <50 years had more HPV awareness (OR 1.34, 95%CI: 1.08-1.66) than their counterparts. Adequate HPV knowledge was higher among participants with an education level of more than high-school (OR:1.28, 95%CI: 1.10-1.50) and with a history of HPV diagnosis (OR:1.33, 95%CI: 1.08-1.65) than their counterparts. In addition, people with good/very good/excellent health perception had higher odds of HPV knowledge (OR:1.23, 95%CI: 1.03-1.47) than those who reported poor/regular health perception. For anal cancer risk factors, PLWH for ≥15 years had increased odds of having adequate knowledge (OR:1.07, 95%CI: 1.02-1.14) than their counterparts. Conclusions: Despite high awareness of HPV, limited knowledge about HPV and anal cancer risk factors was observed among PLWH. Results from our study highlight the need for educational efforts within this population as an anal cancer prevention strategy.

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OBJECTIVE: To describe the implementation of an oral cancer screening program at the Barretos Cancer Hospital (BCH) and present the outcome based on data obtained from 2014 to 2020. MATERIALS AND METHODS: The residents of the Regional Health District of Barretos (DRS-V) were personally invited by community health agents or nurses, and among 13,973 people, 15,222 oral examinations were carried out over the years in 18 of its municipalities. Oral examinations were performed at the Mobile Dental Unit and at the Prevention Department of the BCH. Inclusion criteria were being 35 years of age or older, having a personal history of tobacco or alcohol consumption, or having a lesion in the oral cavity found by community health agent or self-reported, regardless of age or risk factors. RESULTS AND CONCLUSION: The main result of our study was the stages of oral cancer among screen detected cases were smaller compared to cases in the hospital registry, in the state and in Brazil. Oral cancer detection rate per 1,000 oral examinations was 10.7.The early stages of oral cancer found by screening in primary care facilities or using mobile units suggest that, when organized, screening may improve the prognosis of oral cancer.

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PURPOSE: The relationship between engaging in two domains of cancer-preventive behaviors, lifestyle behaviors and colonoscopy screening, is unknown in Hispanic adults. Accordingly, the study examined the association between lifestyle and colonoscopy screening in Hispanic adults along the Texas-Mexico border, where there is suboptimal colorectal cancer prevention. METHODS: Lifestyle behavior adherence and compliance with colonoscopy screening schedules were assessed using 2013-2023 data from the Cameron County Hispanic Cohorta population-based sample of Hispanic adults living along the Texas-Mexico border. The 2018 World Cancer Research Fund scoring system characterized healthy lifestyle engagement. Multivariable logistic regression quantified the association between lifestyle behaviors and colonoscopy screening. RESULTS: Among 914 Hispanic adults, there was a mean adherence score of 2.5 out of 7 for recommended behaviors. Only 33.0% (95% CI 25.64-41.39%) were up-to-date with colonoscopy. Complete adherence to fruit and vegetable (AOR [adjusted odds ratio] 5.2, 95% CI 1.68-16.30; p = 0.004), fiber (AOR 2.2, 95% CI 1.06-4.37; p = 0.04), and ultra-processed foods (AOR 2.8, 95% CI 1.30-6.21; p = 0.01) consumption recommendations were associated with up-to-date colonoscopy screening. Having insurance versus being uninsured (AOR 10.8, 95% CI 3.83-30.62; p < 0.001) and having local medical care versus in Mexico (AOR 7.0, 95% CI 2.26-21.43; p < 0.001) were associated with up-to-date colonoscopy. CONCLUSIONS: Adherence to dietary lifestyle recommendations was associated with being up-to-date with colonoscopy screenings. Those with poor dietary behavior are at risk for low-colonoscopy use. Improving lifestyle behaviors may complement colonoscopy promotion interventions. Healthcare accessibility influences up-to-date colonoscopy prevalence. Our findings can inform cancer prevention strategies for the Hispanic population.

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This study aimed to assess the use of colorectal cancer (CRC) tests for prevention and early detection, alongside exploring the associated barriers to these tests. A stratified national survey was conducted in Chile, involving 1893 respondents (with a 2.3% error margin and 95% confidence interval). Logistic and multinomial regression analyses were employed to examine variations in test utilization likelihood and barrier. We found that the key determinants for undergoing CRC tests included age, health status, possession of private health insurance, and attainment of postgraduate education. Notably, 18% and 29% of respondents covered by public and private insurance, respectively, cited personal prevention as the primary motivation for test uptake. The principal obstacle identified was lack of knowledge, mentioned by 65% of respondents, while 29% and 19% of the publicly and privately insured respectively highlighted lack of access as a barrier. The results of this study provide valuable insights into factors influencing CRC screening, aiming to inform public health policies for expanding national coverage beyond diagnosis and treatment to encompass preventive measures.

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The development of antiprogestins was initially a gynecological purpose. However, since mifepristone was developed, its application for breast cancer treatment was immediately proposed. Later, new compounds with lower antiglucocorticoid and antiandrogenic effects were developed to be applied to different pathologies, including breast cancer. We describe herein the studies performed in the breast cancer field with special focus on those reported in recent years, ranging from preclinical biological models to those carried out in patients. We highlight the potential use of antiprogestins in breast cancer prevention in women with BRCA1 mutations, and their use for breast cancer treatment, emphasizing the need to elucidate which patients will respond. In this sense, the PR isoform ratio has emerged as a possible tool to predict antiprogestin responsiveness. The effects of combined treatments of antiprogestins together with other drugs currently used in the clinic, such as tamoxifen, CDK4/CDK6 inhibitors or pembrolizumab in preclinical models is discussed since it is in this scenario that antiprogestins will be probably introduced. Finally, we explain how transcriptomic or proteomic studies, that were carried out in different luminal breast cancer models and in breast cancer samples that responded or were predicted to respond to the antiprogestin therapy, show a decrease in proliferative pathways. Deregulated pathways intrinsic of each model are discussed, as well as how these analyses may contribute to a better understanding of the mechanisms involved.

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O câncer de colo de útero é uma neoplasia comum e letal para mulheres no Brasil, com uma estimativa de 17 mil novos casos entre 2023 e 2025. A região Norte apresenta as maiores taxas de incidência e mortalidade, refletindo desigualdades no acesso a serviços de saúde. A detecção precoce e a vacinação são essenciais para a prevenção, mas a cobertura é insuficiente quando se trata de povos indígenas. Trata-se de um estudo descritivo que busca analisar a proporção de exames citopatológicos em mulheres indígenas de 25 a 64 anos, considerando dois triênios, de acordo com as recomendações da Organização Mundial de Saúde (OMS), com base nos dados do Sistema de Informação do Câncer. Os dados foram obtidos a partir de dados populacionais do Distrito Especial de Saúde Indígena do Amapá e Norte do Pará. No primeiro triênio (2018-2020), a proporção de exames foi de 3,37% no DSEI AMP e 0% em Pedra Branca do Amapari, município de referência do povo wajãpi. No segundo triênio (2021-2023), essas proporções aumentaram para 21,95% e 52,38%, respectivamente. A melhora significativa nos indicadores de realização de exames junto aos Wajãpi, é atribuída ao Projeto de Rastreamento de Câncer do Colo do Útero, realizado pelo Instituto de Pesquisa e Formação Indígena (Iepé) em cooperação com o DSEI AMP. Ainda que a colaboração entre as comunidades wajãpi, Iepé e DSEI AMP tenha produzido uma melhoria nos índices, os desafios permanecem, especialmente em relação à cobertura e à qualidade da assistência à saúde fornecida aos povos indígenas.

Cervical cancer is a common and lethal neoplasm for women in Brazil, with an estimated 17 thousand new cases between 2023 and 2025. The North region has the highest incidence and mortality rates, reflecting inequalities in access to health services . Early detection and vaccination are essential for prevention, but coverage is insufficient when it comes to indigenous peoples. This is a descriptive study that seeks to analyze the proportion of cytopathological exams in indigenous women aged 25 to 64 years, considering two three-year periods, in accordance with the recommendations of the World Health Organization (WHO), based on data from the Information System of Cancer. The data were obtained from population data from the Special Indigenous Health District of Amapá and Norte do Pará. In the first three years (2018-2020), the proportion of exams was 3.37% in DSEI AMP and 0% in Pedra Branca do Amapari, a reference municipality for the Wajãpi people. In the second three-year period (2021-2023), these proportions increased to 21.95% and 52.38%, respectively. The significant improvement in indicators for testing among the Wajãpi is attributed to the Cervical Cancer Tracking Project, carried out by the Institute of Indigenous Research and Training (Iepé) in cooperation with the DSEI AMP. Although the collaboration between the Wajãpi, Iepé and DSEI AMP communities has produced an improvement in rates, challenges remain, especially in relation to the coverage and quality of health care provided to indigenous peoples.

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In Chile, the cancer has become the main cause of death; the Northern Regions of Chile do not escape to this rea- lity. Both nationally and in the North of Chile, digestives cancers constitute the main cause of death over cancers of other organs. There is currently a National Cancer Law and a National Cancer Plan that provide the legal and technical framework for the implementation of preventive strategies that include the establishment of screening tests according to the local reality of each health service, however, there is still a limitation in the resources avai- lable for its implementation. Local experiences, such as the one carried out in the Region of Antofagasta , have shown in Colorectal Cancer (CRC) that by using a quantitative fecal immunochemcal test for occult blood in stools (FIT) as a screening method, asymptomatic patients carrying CRC can be detected in early stages of their disease, it also allows us to detect patients with CRC precursor lesions (adenomas with high and/or low grade dysplasias). It is important to continue advancing for the moment with the support of Regional Governments in obtaining fi- nancial resources to implement the different screening tests with clinical evidence for the main digestive cancers that affect the population of the Northern Macrozone of Chile.

En Chile el cáncer se ha convertido en la principal causa de muerte, las Regiones del Norte de Chile no escapan a esta realidad. Tanto a nivel Nacional como en el Norte de Chile, los cánceres digestivos en grupo constituyen la principal causa de muerte por sobre los cánceres de otros órganos. Existe actualmente una Ley Nacional del Cáncer y un Plan Nacional del Cáncer que dan el marco legal y técnico para la implementación de estrategias preventivas que incluyen la instauración de test de tamizajes o cribados según la realidad local de cada servicio de salud, sin embargo, aún existe limitación en los recursos disponibles para su implementación. Experiencias locales como la realizada en la Región de Antofagasta, han demostrado que en Cáncer Colorrectal (CCR), mediante el uso de un test inmunoquímico de sangre oculta en deposiciones cuantitativo (TSODi) como método de tamizaje, se pueden detectar pacientes asintomáticos portadores de CCR en etapas precoces de su enfermedad, además, permite detectar pacientes portadores de lesiones precursoras del CCR (adenomas con displasias de alto y/o bajo grado). Es importante seguir avanzando por el momento con apoyo de Gobiernos Regionales en la obtención de los recursos financieros para implementar los distintos test de tamizajes con evidencia clínica para los principales cánceres digestivos que afectan a la población de la Macrozona Norte de Chile

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Objetivo: identificar, na literatura científica, as estratégias utilizadas por enfermeiros da Atenção Primária para a prevenção do câncer de colo do útero. Métodos: revisão integrativa nas bases de dados EMBASE, LILACS (BVS), SCOPUS e Web of Science, entre março e abril de 2023. Após a busca, seguiu-se com leitura na íntegra dos artigos selecionados e extração dos dados para análise. A amostra final foi constituída por 5 estudos. Resultados: as principais estratégias utilizadas foram intervenções educativas, com predominância de palestras e posterior convite ou coleta de material para a realização do exame preventivo. Também foram utilizadas rodas de conversa (círculo de cultura), orientações por contato telefônico e oferta de ficha clínica auto preenchível na consulta de enfermagem. Conclusões: os estudos possibilitaram identificar estratégias positivas na prevenção do câncer de colo do útero, podendo direcionar enfermeiros a investir cada vez mais em metodologias voltadas a uma maior autonomia das mulheres

Objective: to identify, in the scientific literature, the strategies used by primary care nurses to prevent cervical cancer. Methods: An integrative review of the EMBASE, LILACS (BVS), SCOPUS, and Web of Science databases between March and April 2023. After the search, the selected articles were read in full, and the data were extracted for analysis. The final sample consisted of 5 studies. Results: the main strategies used were educational interventions, with a predominance of lectures and subsequent invitations or collection of material to carry out the preventive exam. Conversation circles (culture circles), telephone guidance, and the provision of a self-completed clinical form during the nursing consultation were also used. Conclusions: the studies made it possible to identify positive strategies for preventing cervical cancer, which could direct nurses to increasingly invest in methodologies aimed at increasing women's autonomy

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Objective: To explore factors associated with communication and information-seeking after receipt of skin cancer prevention information among Hispanic individuals. Methods: Multivariable logistic regression was used to analyze existing data on demographics, personal experience, salience, and beliefs variables collected from Hispanic individuals to determine independent associations with sharing and seeking information about skin cancer prevention. Results: Of 578 participants, 53% reported any communication about skin cancer prevention behaviors or skin cancer genetic risk; and 31% and 21% sought additional information about preventive behaviors or genetic risk, respectively. Female sex, greater perceived severity, higher comparative chance of getting skin cancer, and lower health literacy were associated with greater communication, while having no idea of one's own skin cancer risk was related to less communication. Greater health numeracy and higher cancer worry were associated with information-seeking about prevention behaviors and genetic risk. Conclusion: Up to half of participants reported communication or information-seeking, although factors associated with specific activities differed. Future studies should evaluate how to promote communication behaviors in the Hispanic community and how sharing and seeking information influence an individual's network prevention practices. Innovation: Several factors related to communication behaviors among Hispanic people after obtaining skin cancer prevention information were identified.Trial registration: This trial was registered on clinicaltrials.gov (NCT03509467).