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V Wünsch-Filho

Publications and source records attributed to V Wünsch-Filho.

6 recordsLinked to original sources
PubMed2006

Epidemiological studies in the information and genomics era: experience of the Clinical Genome of Cancer Project in São Paulo, Brazil.

Genomics is expanding the horizons of epidemiology, providing a new dimension for classical epidemiological studies and inspiring the development of large-scale multicenter studies with the statistical power necessary for the assessment of gene-gene and gene-environment interactions in cancer etiology and prognosis. This paper describes the methodology of the Clinical Genome of Cancer Project in São Paulo, Brazil (CGCP), which includes patients with nine types of tumors and controls. Three major epidemiological designs were used to reach specific objectives: cross-sectional studies to examine gene expression, case-control studies to evaluate etiological factors, and follow-up studies to analyze genetic profiles in prognosis. The clinical groups included patients' data in the electronic database through the Internet. Two approaches were used for data quality control: continuous data evaluation and data entry consistency. A total of 1749 cases and 1509 controls were entered into the CGCP database from the first trimester of 2002 to the end of 2004. Continuous evaluation showed that, for all tumors taken together, only 0.5% of the general form fields still included potential inconsistencies by the end of 2004. Regarding data entry consistency, the highest percentage of errors (11.8%) was observed for the follow-up form, followed by 6.7% for the clinical form, 4.0% for the general form, and only 1.1% for the pathology form. Good data quality is required for their transformation into useful information for clinical application and for preventive measures. The use of the Internet for communication among researchers and for data entry is perhaps the most innovative feature of the CGCP. The monitoring of patients' data guaranteed their quality.

Adult↗
PubMed2006

The effect of performing corrections on reported uterine cancer mortality data in the city of São Paulo.

Reports of uterine cancer deaths that do not specify the subsite of the tumor threaten the quality of the epidemiologic appraisal of corpus and cervix uteri cancer mortality. The present study assessed the impact of correcting the estimated corpus and cervix uteri cancer mortality in the city of São Paulo, Brazil. The epidemiologic assessment of death rates comprised the estimation of magnitudes, trends (1980-2003), and area-level distribution based on three strategies: i) using uncorrected death certificate information; ii) correcting estimates of corpus and cervix uteri mortality by fully reallocating unspecified deaths to either one of these categories, and iii) partially correcting specified estimates by maintaining as unspecified a fraction of deaths certified as due to cancer of "uterus not otherwise specified". The proportion of uterine cancer deaths without subsite specification decreased from 42.9% in 1984 to 20.8% in 2003. Partial and full corrections resulted in considerable increases of cervix (31.3 and 48.8%, respectively) and corpus uteri (34.4 and 55.2%) cancer mortality. Partial correction did not change trends for subsite-specific uterine cancer mortality, whereas full correction did, thus representing an early indication of decrease for cervical neoplasms and stability for tumors of the corpus uteri in this population. Ecologic correlations between mortality and socioeconomic indices were unchanged for both strategies of correcting estimates. Reallocating unspecified uterine cancer mortality in contexts with a high proportion of these deaths has a considerable impact on the epidemiologic profile of mortality and provides more reliable estimates of cervix and corpus uteri cancer death rates and trends.

Adult↗
PubMed2001

The burden of mouth cancer in Latin America and the Caribbean: epidemiologic issues.

The incidence rates of mouth cancer vary from low to high among the countries of Latin America and the Caribbean. This review will examine incidence and mortality rates according to risk factors for the disease. Studies of local populations are reviewed and common patterns established. Although the incidence rate of mouth cancer is decreasing in some countries, a large increase is observed in southern South America. This trend will probably be maintained over the next few decades. Specific risk factors have been identified: high tobacco smoking and alcohol drinking prevalence, high intake of charcoal-grilled red meat, and mate drinking. The increase in tobacco smoking among females will have a strong impact on the incidence of mouth cancer in the future. In some Latin American and Caribbean countries, lay educational information on cancer is scant. The importance of improving information systems on cancer and the development of tobacco smoking and alcohol control programs are stressed. The training of health practitioners in the early detection and treatment of mouth lesions is a public health goal that could improve survival, but the difficulties encountered by people from the lowest socioeconomic strata in obtaining access to primary health care could hinder this objective. Semin Oncol 28:158-168.

Caribbean Region↗
PubMed1998

Occupational risk factors of lung cancer in São Paulo, Brazil.

OBJECTIVES: This study estimated the risk of occupational exposure for lung cancer in the metropolitan region of São Paulo, the largest urbanized and industrialized area in Brazil. METHODS: In this hospital-based case-referent study of 398 cases and 860 referents, the cases were matched to referents according to age, gender, and hospital and personally interviewed for information on lifetime job history, smoking habits, passive smoking exposure, cancer in relatives, socioeconomic status, and migratory history. The analysis concerned industrial titles and occupational categories. With the use of a job-exposure matrix, exposure to asbestos, polynuclear aromatic hydrocarbons, arsenic, dust, nickel and chromium was assessed. RESULTS: For the men in the 56 industrial and 122 occupational categories examined, an excess risk of lung cancer was found in the machinery industry [odds ratio (OR) 1.62, 95% confidence interval (95% CI) 1.02-2.55). In pottery manufacturing the risk (OR 2.21, 95% CI 1.00-4.87) was increased for workers exposed > or = 10 years (OR 6.43, 95% CI 1.12-37.01). Textile workers employed for > or = 10 years with a latency of > or = 40 years had an elevated risk (OR 21.93, 95% CI 1.96-245.0). In the analysis using the job-exposure matrix no risk was detected for the specific lung cancer carcinogens examined. For the women, no significantly elevated risk was observed. CONCLUSIONS: The results of this study revealed risks of lung cancer for men in the machinery industry and for pottery and textile workers with long-term exposure.

Adult↗
PubMed1993

Methodological considerations in case-control studies to evaluate BCG vaccine effectiveness.

Several case-control studies evaluating the effectiveness of BCG vaccine in the last decade have presented contradictory results like previous prospective studies. Methodological differences could explain some of the case-control study results. This study explores the possibility that contradictory results could be imputed to the choice of different series of controls. Three controls were compared for each case of tuberculous meningitis: neighbourhood, hospital and household. BCG effectiveness estimates were 86.8%, 92.0% and 29.5%, respectively. The data indicated an interaction between BCG vaccine status and tuberculous focus. This could have influenced the lower effectiveness estimates found when cases were compared with household controls. The paper discusses aspects related to case-control studies applied to evaluate BCG effectiveness such as: incubation period and sufficient time since vaccination to allow development of an immune response; the presence of a tuberculous focus among the groups of cases and controls and the interaction between focus and BCG vaccination; recall bias; and optimum selection of controls in case-control studies in the context of infectious diseases.

BCG Vaccine↗