Cancer risk factors and screening tests in the Pantanal population, a rural area in Brazil.
Authors: Figueiredo Jose Marcio Barros , Rode Jessica , Mendez Roberto Della Rosa , Godoy Antonio Carlos , Melão Rodrigo , Almeida Rita de Cassia Lira de , Albaneze Waldir Staut , Barbosa Marcio Barbosa Cruz Ribeiro , Pereira Jose Luiz Mikimba , Barros Fernando Giordano de , Rosa Rodolpho Costa Marques Pereira da , Zucca Luis Eduardo Rosa 
Published: June 2023

e18526 Background: Cancer is a severe public health problem in Brazil, and prevention and screening measures are uneven throughout the country, despite universal guidelines of the NCI/Sistema Único de Saúde (SUS). The non-governmental and multidisciplinary expedition “Alma Pantaneira” is one of the few health programs in the Pantanal region, state of Mato Grosso do Sul, inland Brazil, with a rural population of 45,000 inhabitants. The expedition takes place regularly for over ten years on a pre-established route. Methods: This is a observational study involving data collection through questionnaires from the Alma Pantaneira Expedition, previously submitted and approved by the Local Ethics Committee. The questionnaire was distributed to six physicians who volunteered to apply. Patients of both sexes and over 18 years old were included. The study sample was defined by convenience, including all patients treated by the program in the period established between 11/18/21 to 11/30/21. Results: The collection involved 156 patients, with a mean age of 41.25 ± 13.95 years of which 63.5% were men and 36.5% were women. We observed that among the study population, 70.5% declared themselves brown, 10.9% black, and 15.4% white. More than half of the population, 25.6%, and 32.1%, were classified as overweight and having grade 1 obesity, respectively. The most prevalent comorbidity was systemic arterial hypertension (SAH) at 23.7%, followed by diabetes mellitus (DM) at 3.2%. When we analyze other risk factors, 38.5% of the population are active smokers, 3.2% are former smokers, and 51.3% are frequent alcohol consumers. When it comes to population screening for cancer, 65.9% of women over 25 years of age underwent the Papanicolaou Test in the last two years; 42.9% of men over 45 years old had performed a PSA test, and only 5.8% of the population underwent a colonoscopy over 45 years of age. Regarding the family history of cancer, it was identified that 12.3% of the population had a first- and second-degree relative with a positive history of cancer; 7.7% of the population had a first- or second-degree relative with a history of breast cancer before age 50, and 5.1% with a history of bowel cancer before age 50. In addition, 4.5% of the population had three or more first- or second-degree relatives with a history of cancer before age 50. Conclusions: The present study generated epidemiological data hitherto unavailable in the Pantanal region, inland Brazil, on the prevalence of the main risk factors for the development of malignant neoplasms, as well as secondary prevention measures. Population screening for cancer is below the target set by the WHO for the most prevalent types of cancer. Risk factors such as smoking, alcohol consumption, and being overweight are above the average for the Brazilian population. The need to adopt public policies in the study population and increase access to prevention, screening, diagnosis and early cancer treatment is urgent.