JOSE ELUF NETO
Projetos de Pesquisa
Unidades Organizacionais
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
86 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 86
- Fração de câncer de cabeça e pescoço atribuível ao tabaco e ao álcool em cidades de três regiões brasileiras(2018) KFOURI, Suely Aparecida; ELUF NETO, José; KOIFMAN, Sérgio; CURADO, Maria Paula; MENEZES, Ana; DAUDT, Alexander Welaussen; WüNSCH FILHO, VictorABSTRACT: Objectives: To estimate the fraction of head and neck cancer (HNC) attributable to tobacco and alcohol in cities in the Midwest, Southeast and South regions of Brazil. Methods: Case-control study including 1,594 cases of HNC and 1,292 hospital controls. The association of HNC with tobacco and alcohol was estimated by the odds ratio and respective 95% confidence intervals through non-conditional logistic regression, adjusted for age, sex, schooling, consumption of fruits and vegetables, alcohol drinking (to examine the tobacco effect), and tobacco smoking (to examine the alcohol effect). The proportions of HNC attributable to tobacco and alcohol were estimated through the attributable fraction (AF) calculation. Separate estimates were made for Goiânia (Midwest), Rio de Janeiro and São Paulo (Southeast) and Pelotas and Porto Alegre (South). Results: The HNC fraction attributable to smoking was slightly higher in Goiânia (AF = 90%) than in cities in the Southeast (AF = 87%) and South (AF = 86%). The HNC fraction attributable to the consumption of alcoholic beverages presented similar and higher results in the cities of Southeast (AF = 78%) and South (AF = 77%) than in Goiânia (AF = 62%). Conclusion: The HNC fractions attributable to smoking were more expressive than for alcohol consumption. Although with discrete distinctions between them, the AFs to tobacco smoking and alcohol consumption in HNC observed in the cities of these three Brazilian regions were similar to those obtained in Latin America studies, but they were higher than in other parts in the world.
- Follow-up of women screened for cervical cancer in S & atilde;o Paulo, Brazil: An analysis of the times to diagnostic investigation and treatment(2021) RIBEIRO, Caroline Madalena; SILVA, Isabel dos Santos; NETO, Jose Eluf; CURY, Lise Cristina Pereira Baltar; SILVA, Gulnar Azevedo eBackground: Cervical cancer incidence and mortality rates are higher in Brazil than in western countries. Access to cytology-based screening has increased in the country in recent decades, but few studies have assessed the quality of the follow-up care of women with abnormal screening tests that require further investigation. Methods: A record-linkage cohort study was conducted in Sa & tilde;o Paulo state. Women aged 25+ years, who were screened in 2010, and whose test revealed a high-grade, or more severe, lesion were eligible. Follow-up information on diagnostic investigations, treatments and mortality was obtained through record-linkage of health databases. The Kaplan-Meier method was used to estimate median times between screening and diagnostic investigation, and diagnosis and treatment initiation. Cox survival models were used to identify correlates of the length of these time intervals. Results: 4300 women had a high-grade, or more severe, test result. Of these, 2788 (64.8 %) had a diagnostic investigation record, 1763 (41 %) a confirmed diagnosis of a precursor lesion or cancer, and 1247 (70.7 %) a treatment record. The median time to diagnosis was 190 days, with the probability of undergoing a diagnostic investigation within 30 days of the abnormal screening test being 7%. The median time to treatment was 81 days, with the probability of undergoing treatment within 60 days of a confirmed diagnosis being 44 %. Delays in diagnosis and treatment were associated with area-based healthcare indicators. Conclusion: Times to diagnosis and treatment were long, well above recommendations. Strategies to improve follow-up care must be prioritized to ensure screening reduces cervical cancer incidence and mortality.
- Factors influencing HPV vaccine delivery by healthcare professionals at public health posts in Sao Paulo, Brazil(2017) FIGUEROA-DOWNING, Daniella; BAGGIO, Maria Luiza; BAKER, Misha L.; CHIANG, Ellen Dias De Oliveira; VILLA, Luisa L.; NETO, Jose Eluf; EVANS, Dabney P.; BEDNARCZYK, Robert A.Objective: To assess the association between Brazilian healthcare providers' characteristics and their knowledge, perceptions, and practices regarding the HPV vaccine. Methods: An observational cross-sectional study was conducted at five public health posts in Sao Paulo between July 28 and August 8, 2014. Healthcare professionals directly involved in patient care were asked to complete a written survey. Factors associated with routine verification of HPV vaccination status were evaluated using Poisson regression. Results: Among 200 participants included, 74 (38.5%) reported never and 70 (36.5%) reported always asking about HPV immunization status. Doctors were significantly less likely to report always asking than were community health agents (5/39 [12.8%] vs 32/60 [53.3%]; adjusted prevalence ratio [aPR] 0.25 [95% confidence interval (CI) 0.07-0.91]). Knowledge about the correct dosing schedule was associated with-always rather than never verifying vaccination status (aPR 2.46 [95% CI 1.06-5.70]). Conclusion: Knowledge and attitude played secondary roles in influencing HPV vaccine verification. Community health agents were crucial for vaccine promotion; continued education and support of this group is essential for the sustained success of HPV immunization efforts in Brazil.
- Critical Analyses of the Introduction of Liquid-Based Cytology in a Public Health Service of the State of Sao Paulo, Brazil(2015) LONGATTO-FILHO, Adhemar; LEVI, Jose Eduardo; MARTINS, Toni Ricardo; COHEN, Diane; CURY, Lise; VILLA, Luisa Lina; ELUF-NETO, JoseObjective: The aim of this study was to compare the performance of the current conventional Pap smear with liquidbased cytology (LBC) preparations. Study Design: Women routinely undergoing their cytopathological and histopathological examinations at Fundacao Oncocentro de Sao Paulo (FOSP) were recruited for LBC. Conventional smears were analyzed from women from other areas of the State of Sao Paulo with similar sociodemographic characteristics. Results: A total of 218,594 cases were analyzed, consisting of 206,999 conventional smears and 11,595 LBC. Among the conventional smears, 3.0% were of unsatisfactory preparation; conversely, unsatisfactory LBC preparations accounted for 0.3%. The ASC-H (atypical squamous cells -cannot exclude high-grade squamous intraepithelial lesion) frequency did not demonstrate any differences between the twomethods. In contrast, the incidence of ASC-US (atypical squamous cells of undetermined significance) was almost twice as frequent between LBC and conventional smears, at 2.9 versus 1.6%, respectively. An equal percentage of highgrade squamous intraepithelial lesions were observed for the two methods, but not for low-grade squamous intraepithelial lesions, which were more significantly observed in LBC preparations than in conventional smears (2.2 vs. 0.7%). The index of positivity was importantly enhanced from 3.0% (conventional smears) to 5.7% (LBC). Conclusions : LBC performed better than conventional smears, and we are truly confident that LBC can improve public health strategies aimed at reducing cervical lesions through prevention programs. (C) 2015 S. Karger AG, Basel
- Vaccination coverage rates and predictors of HPV vaccination among eligible and non-eligible female adolescents at the Brazilian HPV vaccination public program(2020) FAISAL-CURY, Alexandre; LEVY, Renata Bertazzi; TOURINHO, Maria Fernanda; GRANGEIRO, Alexandre; ELUF-NETO, JoseBackground Since March 2014, the quadrivalent HPV vaccine has been incorporated into the Brazilian Unified Health Care System and began to be offered, without direct costs, for girls from 9 to 13 years of age. Older female adolescents would have the option to be vaccinated at private health care system being responsible for the payment of HPV vaccine. The present study aimed to evaluate the coverage rates and predictors of HPV vaccination in Brazil among two groups of female adolescents: eligible and non-eligible for the HPV vaccination public program. Methods We used data from the 2015 Brazilian National Adolescent School-Based Health Survey, which involved a probabilistic sample of 5404 female adolescents students at public and private schools. Using a questionnaire, we gathered information on sociodemographic characteristics, sexual behavior, and respondent perception of parental supervision and have been vaccinated for HPV. Age-specific vaccination rates were analyzed in girls aged 9 to 13 at the time of public vaccination (eligible for public policy), as well among those 14 to 17 years old not eligible by the Ministry of Health for vaccination. We used Poisson regression models to investigate associated factors. Results HPV vaccine coverage was 83.5 and 21.8% among eligible and non-eligible populations, respectively. In both populations, the chance of being vaccinated decreased with older age. In the eligible population there is a greater chance of being vaccinated among ethnic group ""pardas"" but not with other indicators of socioeconomic status. In the non-eligible population, there was a clear association between higher vaccine coverage and greater maternal education and living with the mother. Conclusion Our findings highlight the importance of public policies to minimize inequities in access to cancer prevention measures in vulnerable adolescents. A public policy of HPV vaccination for older female adolescents would increase coverage with possible reduction of HPV-related diseases in this group of women.
- Preventable fractions of colon and breast cancers by increasing physical activity in Brazil: perspectives from plausible counterfactual scenarios(2018) REZENDE, Leandro Fornias Machado de; GARCIA, Leandro Martin Totaro; MIELKE, Gregore Iven; LEE, Dong Hoon; WU, Kana; GIOVANNUCCI, Edward; ELUF-NETO, JoseBackground: Physical activity is associated with lower risk of colon and breast cancers. Herein we estimated preventable fractions of colon and breast cancers in Brazil by increasing population-wide physical activity to different counterfactual scenarios. Methods: We used data from a representative national survey in Brazil and corresponding relative risks of colon and postmenopausal breast cancers from a meta-analysis. Estimated cancer incidence was retrieved from GLOBOCAN and Brazilian National Cancer Institute. Five counterfactual scenarios for physical activity were considered: (i) theoretical minimum risk exposure level (>= 8,000 metabolic equivalent of tasks-minute/week-MET-min/week); (ii) physical activity recommendation (>= 600 MET-min/week); (iii) a 10% reduction in prevalence of insufficient physical inactivity (< 600 MET-min/week); (iv) physical activity level in each state equals the most active state in Brazil; (v) closing the gender differences in physical activity. Results: About 19% (3,630 cases) of colon cancers and 12% (6,712 cases) of postmenopausal breast cancers could be prevented by increasing physical activity to >= 8,000 MET-min/week. Plausible counterfactual scenarios suggested the following impact on cancer prevention: reaching physical activity recommendation: 1.7% (1,113 cases) of breast and 6% (1,137 cases) of colon; 10% reduction in physical inactivity prevalence: 0.2% (111 cases) of breast and 0.6% (114 cases) of colon; most active state scenario: 0.3% (168 cases) of breast and 1% (189 cases) of colon; reducing gender differences in physical activity: 1.1% (384 cases) of breast and 0.6% (122 cases) of colon. Conclusions: High levels of physical activity are required to achieve a sizable impact on breast and colon cancer prevention in Brazil.
- Cigarette, Cigar, and Pipe Smoking and the Risk of Head and Neck Cancers: Pooled Analysis in the International Head and Neck Cancer Epidemiology Consortium(2013) WYSS, Annah; HASHIBE, Mia; CHUANG, Shu-Chun; LEE, Yuan-Chin Amy; ZHANG, Zuo-Feng; YU, Guo-Pei; WINN, Deborah M.; WEI, Qingyi; TALAMINI, Renato; SZESZENIA-DABROWSKA, Neonila; STURGIS, Erich M.; SMITH, Elaine; SHANGINA, Oxana; SCHWARTZ, Stephen M.; SCHANTZ, Stimson; RUDNAI, Peter; PURDUE, Mark P.; ELUF-NETO, Jose; MUSCAT, Joshua; MORGENSTERN, Hal; MICHALUART JR., Pedro; MENEZES, Ana; MATOS, Elena; MATES, Ioan Nicolae; LISSOWSKA, Jolanta; LEVI, Fabio; LAZARUS, Philip; VECCHIA, Carlo La; KOIFMAN, Sergio; HERRERO, Rolando; HAYES, Richard B.; FRANCESCHI, Silvia; WUENSCH-FILHO, Victor; FERNANDEZ, Leticia; FABIANOVA, Eleonora; DAUDT, Alexander W.; MASO, Luigino Dal; CURADO, Maria Paula; CHEN, Chu; CASTELLSAGUE, Xavier; CARVALHO, Marcos Brasilino de; CADONI, Gabriella; BOCCIA, Stefania; BRENNAN, Paul; BOFFETTA, Paolo; OLSHAN, Andrew F.Cigar and pipe smoking are considered risk factors for head and neck cancers, but the magnitude of effect estimates for these products has been imprecisely estimated. By using pooled data from the International Head and Neck Cancer Epidemiology (INHANCE) Consortium (comprising 13,935 cases and 18,691 controls in 19 studies from 1981 to 2007), we applied hierarchical logistic regression to more precisely estimate odds ratios and 95% confidence intervals for cigarette, cigar, and pipe smoking separately, compared with reference groups of those who had never smoked each single product. Odds ratios for cigar and pipe smoking were stratified by ever cigarette smoking. We also considered effect estimates of smoking a single product exclusively versus never having smoked any product (reference group). Among never cigarette smokers, the odds ratio for ever cigar smoking was 2.54 (95% confidence interval (CI): 1.93, 3.34), and the odds ratio for ever pipe smoking was 2.08 (95% CI: 1.55, 2.81). These odds ratios increased with increasing frequency and duration of smoking (P-trend <= 0.0001). Odds ratios for cigar and pipe smoking were not elevated among ever cigarette smokers. Head and neck cancer risk was elevated for those who reported exclusive cigar smoking (odds ratio = 3.49, 95% CI: 2.58, 4.73) or exclusive pipe smoking (odds ratio = 3.71, 95% CI: 2.59, 5.33). These results suggest that cigar and pipe smoking are independently associated with increased risk of head and neck cancers.
- European ancestry and polymorphisms in DNA repair genes modify the risk of melanoma: A case-control study in a high UV index region in Brazil(2011) GONCALVES, Fernanda T.; FRANCISCO, Guilherme; SOUZA, Sonia P. de; LUIZ, Olinda C.; FESTA-NETO, Cyro; SANCHES, Jose A.; CHAMMAS, Roger; GATTAS, Gilka J. F.; ELUF-NETO, JoseBackground: UV radiation is the major environmental factor related to development of cutaneous melanoma. Besides sun exposure and the influence of latitude, some host characteristics such as skin phototype and hair and eye color are also risk factors for melanoma. Polymorphisms in DNA repair genes could be good candidates for susceptibility genes, mainly in geographical regions exposed to high solar radiation. Objective: Evaluate the role of host characteristic.; and DNA repair polymorphism in melanoma risk in Brazil. Methods: We carried out a hospital-based case-control study in Brazil to evaluate the contribution of host factors and polymorphisms in DNA repair to melanoma risk. A total of 412 patients (202 with melanoma and 210 controls) were analyzed regarding host characteristics for melanoma risk as well as for 11 polymorphisms in DNA repair genes. Results: We found an association of host characteristics with melanoma development, such as eye and hair color, fair skin, history of pigmented lesions removed, sunburns in childhood and adolescence, and also European ancestry. Regarding DNA repair gene polymorphisms, we found protection for the XPG 1104 His/His genotype (OR 0.32; 95% CI 0.13-0.75), and increased risk for three polymorphisms in the XPC gene (PAT+; IV-6A and 939Gln), which represent a haplotype for XPC. Melanoma risk was higher in individuals carrying the complete XPC haplotype than each individual polymorphism (OR 3.64; 95% CI 1.77-7.48). Conclusions: Our data indicate that the host factors European ancestry and XPC polymorphisms contributed to melanoma risk in a region exposed to high sun radiation.
- Risk factors for head and neck cancer in young adults: a pooled analysis in the INHANCE consortium(2015) TOPORCOV, Tatiana Natasha; ZNAOR, Ariana; ZHANG, Zuo-Feng; YU, Guo-Pei; WINN, Deborah M.; WEI, Qingyi; VILENSKY, Marta; VAUGHAN, Thomas; THOMSON, Peter; TALAMINI, Renato; SZESZENIA-DABROWSKA, Neonila; STURGIS, Erich M.; SMITH, Elaine; SHANGINA, Oxana; SCHWARTZ, Stephen M.; SCHANTZ, Stimson; RUDNAI, Peter; RICHIARDI, Lorenzo; RAMROTH, Heribert; PURDUE, Mark P.; OLSHAN, Andrew F.; ELUF-NETO, Jose; MUSCAT, Joshua; MOYSES, Raquel Ajub; MORGENSTERN, Hal; MENEZES, Ana; MCCLEAN, Michael; MATSUO, Keitaro; MATES, Dana; MACFARLANE, Tatiana V.; LISSOWSKA, Jolanta; LEVI, Fabio; LAZARUS, Philip; VECCHIA, Carlo La; LAGIOU, Pagona; KOIFMAN, Sergio; KJAERHEIM, Kristina; KELSEY, Karl; HOLCATOVA, Ivana; HERRERO, Rolando; HEALY, Claire; HAYES, Richard B.; FRANCESCHI, Silvia; FERNANDEZ, Leticia; FABIANOVA, Eleonora; DAUDT, Alexander W.; CURIONI, Otavio Alberto; MASO, Luigino Dal; CURADO, Maria Paula; CONWAY, David I.; CHEN, Chu; CASTELLSAGUE, Xavier; CANOVA, Cristina; CADONI, Gabriella; BRENNAN, Paul; BOCCIA, Stefania; ANTUNES, Jose Leopoldo Ferreira; AHRENS, Wolfgang; AGUDO, Antonio; BOFFETTA, Paolo; HASHIBE, Mia; LEE, Yuan-Chin Amy; WUENSCH FILHO, VictorBackground: Increasing incidence of head and neck cancer (HNC) in young adults has been reported. We aimed to compare the role of major risk factors and family history of cancer in HNC in young adults and older patients. Methods: We pooled data from 25 case-control studies and conducted separate analyses for adults <= 45 years old ('young adults', 2010 cases and 4042 controls) and > 45 years old ('older adults', 17 700 cases and 22 704 controls). Using logistic regression with studies treated as random effects, we estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: The young group of cases had a higher proportion of oral tongue cancer (16.0% in women; 11.0% in men) and unspecified oral cavity / oropharynx cancer (16.2%; 11.1%) and a lower proportion of larynx cancer (12.1%; 16.6%) than older adult cases. The proportions of never smokers or never drinkers among female cases were higher than among male cases in both age groups. Positive associations with HNC and duration or pack-years of smoking and drinking were similar across age groups. However, the attributable fractions (AFs) for smoking and drinking were lower in young when compared with older adults (AFs for smoking in young women, older women, young men and older men, respectively, =19.9% (95% CI = 9.8%, 27.9%), 48.9% (46.6%, 50.8%), 46.2% (38.5%, 52.5%), 64.3% (62.2%, 66.4%); AFs for drinking = 5.3% (-11.2%, 18.0%), 20.0% (14.5%, 25.0%), 21.5% (5.0%, 34.9%) and 50.4% (46.1%, 54.3%). A family history of early-onset cancer was associated with HNC risk in the young [OR = 2.27 (95% CI = 1.26, 4.10)], but not in the older adults [OR = 1.10 (0.91, 1.31)]. The attributable fraction for family history of early-onset cancer was 23.2% (8.60% to 31.4%) in young compared with 2.20% (-2 .41%, 5.80%) in older adults. Conclusions: Differences in HNC aetiology according to age group may exist. The lower AF of cigarette smoking and alcohol drinking in young adults may be due to the reduced length of exposure due to the lower age. Other characteristics, such as those that are inherited, may play a more important role in HNC in young adults compared with older adults.
- Genome-wide association study of HPV seropositivity(2011) CHEN, Dan; MCKAY, James D.; CLIFFORD, Gary; GABORIEAU, Valerie; CHABRIER, Amelie; WATERBOER, Tim; ZARIDZE, David; LISSOWSKA, Jolanta; RUDNAI, Peter; FABIANOVA, Eleonora; BENCKO, Vladimir; JANOUT, Vladimir; FORETOVA, Lenka; MATES, Ioan Nicolae; SZESZENIA-DABROWSKA, Neonila; CURADO, Maria Paula; KOIFMAN, Sergio; MENEZES, Ana; WUENSCH-FILHO, Victor; ELUF-NETO, Jose; GARROTE, Leticia Fernandez; MATOS, Elena; ZELENIKA, Diana; BOLAND, Anne; BOFFETTA, Paolo; PAWLITA, Michael; LATHROP, Mark; BRENNAN, PaulHigh-risk alpha mucosal types of human papillomavirus (HPV) cause anogenital and oropharyngeal cancers, whereas beta cutaneous HPV types (e.g. HPV8) have been implicated in non-melanoma skin cancer. Although antibodies against the capsid protein L1 of HPV are considered as markers of cumulative exposure, not all infected persons seroconvert. To identify common genetic variants that influence HPV seroconversion, we performed a two-stage genome-wide association study. Genome-wide genotyping of 316 015 single nucleotide polymorphisms was carried out using the Illumina HumanHap300 BeadChip in 4811 subjects from a central European case-control study of lung, head and neck and kidney cancer that had serology data available on 13 HPV types. Only one association met genome-wide significance criteria, namely that between HPV8 seropositivity and rs9357152 [odds ratio (OR) = 1.37, 95% confidence interval (CI) = 1.24-1.50 for the minor allele G; P = 1.2 x 10(-10)], a common genetic variant (minor allele frequency = 0.33) located within the major histocompatibility complex (MHC) II region at 6p21.32. This association was subsequently replicated in an independent set of 2344 subjects from a Latin American case-control study of head and neck cancer (OR = 1.35, 95% CI = 1.18-1.56, P = 2.2 x 10(-5)), yielding P = 1.3 x 10(-14) in the combined analysis (P-heterogeneity = 0.87). No heterogeneity was noted by cancer status (controls/lung cancer cases/head and neck cancer cases/kidney cancer cases). This study provides a proof of principle that genetic variation plays a role in antibody reactivity to HPV infection.