EPIDEMIOLOGICAL ANALYSIS OF THE INCIDENCE OF MALIGNANT NEOPLASMS OF THE ESOPHAGUS IN PIAUÍ: DATA FROM THE LAST 5 YEARS

Abstract

Esophageal cancer is a neoplasm with high incidence and mortality, affecting more men than women in Brazil, with about 10,990 new cases annually. The most frequent type is squamous cell carcinoma, while adenocarcinoma has increased due to obesity and gastroesophageal reflux disease. Risk factors include tobacco, alcohol, and eating hot foods. Treatment varies according to staging and may involve chemotherapy, radiotherapy, and surgery, with neoadjuvant approaches being effective in increasing surgical success. This pathology is related to regions with low human development indexes, and in Brazil, Piauí stands out for having one of the lowest rates, which negatively impacts access to prevention, early diagnosis and treatment, reflecting on the evolution of the disease and survival rates. Therefore, the analysis of this study is essential to develop more equitable and effective public health policies in the state of Piauí. OBJECTIVE: To analyze the number and variables of esophageal cancer cases in Piauí in the last 5 years. METHODOLOGY: This is an epidemiological, retrospective and descriptive research, with a quantitative approach, based on data obtained from the Department of Informatics of the Unified Health System (DATASUS), carried out through data on notifications of esophageal cancer cases in Piauí in the last 5 years. RESULTS AND DISCUSSIONS: Between 2019 and 2023, 381 cases of esophageal neoplasia were analyzed in Piauí, with a predominance of males (72%, n = 274) compared to females (28%, n = 107). The disease mainly affects older adults, with the incidence increasing from the age of 50, with the groups of 60 to 64 years (16.8%, n = 64) and 65 to 69 years (14.4%, n = 55) being the most affected. Only 2.9% of the cases occurred in individuals under 40 years of age. Staging indicated that 51.4% (n = 196) of the patients were diagnosed in stages 2 and 3, evidencing delays in diagnosis; Only 0.5% (n = 2) were in stage 0 and 7.6% (n = 29) in stage 1. Chemotherapy was the main therapeutic modality used (57.2%, n = 218), followed by radiotherapy (11.5%, n = 44) and surgery (5.5%, n = 21). In addition, 2.9% (n = 11) received combined chemotherapy and radiotherapy, while 22.8% (n = 87) had no information about the recorded treatment. The high percentage of cases without staging and treatment data indicates deficiencies in information collection. CONCLUSION: Between 2019 and 2023, esophageal cancer in Piauí showed a predominance in men and individuals over 50 years of age, with diagnoses mostly in advanced stages. Chemotherapy was the main form of treatment. The variation in cases, including a drop in 2020, was possibly influenced by the COVID-19 pandemic. The lack of complete information on treatment and staging highlights the need to improve registries to optimize treatment and prevention strategies.