Câncer colorretal : análise de sobrevida e fatores de estilo de vida associados

Abstract

Objectives - To describe the dietary intake and nutritional status of patients with colorectal cancer (CRC) in the state of Mato Grosso, from 2019 to 2021; to verify the association between CRC and smoking, alcohol consumption, sedentary lifestyle, obesity, and consumption of red meat and vegetables; to analyze the five-year disease-specific survival of CRC diagnosed between 2008 and 2013, according to sex and age group, in Greater Cuiabá, Mato Grosso, Brazil. Methods - For the description of dietary intake and nutritional status, patients with CRC (codes C18-C21 in ICD-10) were selected from two high-complexity hospitals in Mato Grosso, who answered a questionnaire on frequency of consumption. Foods considered markers of healthy and unhealthy diets, as well as animal proteins, were included. Body mass index (BMI) was calculated using self-reported weight and height. For the study of associations, systematic reviews with meta-analyses were adopted, including case-control studies. Random-effects meta-analyses were used to combine effect estimates from the studies. For survival analysis, data from the Population-Based Cancer Registry (PBCR) of Greater Cuiabá and the Mortality Information System (MIS) were used, with probabilistic linkage between them through record linkage. The five-year disease-specific survival probabilities, by sex and age group, were estimated using the Kaplan-Meier method and the log-rank test. Results - Of the 95 patients with CRC, the majority reported consuming natural fruit juice 1 to 4 days/week (43.2%), fruits (40.4%), cooked vegetables (56.4%), processed meats (55.8%), and soft drinks/artificial juices (41.1%). The "never/almost never" category was most frequently cited for alcohol consumption (83.2%), instant noodles (74.7%), packaged snacks (82.1%), sweets (43.2%), and filled cookies (74.7%). Among animal proteins, milk (52.6%) and red meat (68.1%) were consumed 5 to 7 days/week by the majority. Most of the population analyzed was overweight (56%). Systematic reviews with meta-analyses showed an association between CRC and smoking (OR = 1.18; 95% CI: 1.05-1.33), sedentary lifestyle (OR = 1.37; 95% CI: 1.09-1.72), obesity (OR = 1.17; 95% CI: 1.03-1.34), regular consumption of red meat (OR = 1.74; 95% CI: 1.07-2.82), and regular consumption of vegetables (OR = 0.34; 95% CI: 0.19-0.66). From 2008 to 2013, 683 new cases and 193 deaths from CRC were recorded in the PBCR and MIS, respectively. The median time between diagnosis and death from CRC was 44.8 months (95% CI: 42.4–47.3) for women, and 46.1 months (95% CI: 43.4–48.6) for men. The five-year survival probability was 83.5% (95% CI: 79.9–87.2%) for women and 89.6% (95% CI: 86.4–93.0%) for men. Conclusion - Natural fruit juice, fruits, cooked vegetables, processed meats, and soft drinks/artificial juices had the highest consumption frequencies. Smoking, sedentary lifestyle, obesity, and red meat consumption were identified as factors associated with CRC, while regular vegetable consumption acted as a protective factor. The survival analysis showed that women had a shorter time between diagnosis and death from the disease, and a lower five-year survival probability.