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Original article • Hematol., Transfus. Cell Ther. 44 (1) • Jan-Mar 2022 • https://doi.org/10.1016/j.htct.2020.08.017 copy

Overview of lymphoma diagnosis in Brazilian public health system patients: Open data analysis for health care planning

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Knowing the information regarding the panorama of lymphoma diagnosis in patients treated in the Brazilian Public Unified Health System from the last 10 years is a challenge for Strategic Health Planning.

Objective

To characterize the Brazilian population with lymphoma treated in the Brazilian Public Unified Health System between 2008 and 2017 regarding staging, sex, residence site and mortality.

Material and methods

A descriptive, retrospective, and longitudinal trial with secondary data from DataSUS (SIA/SUS and SIM/SUS) obtained from patients with ICD-10 C81-85.

Results

There were 70,850 lymphoma cases between 2008 and 2017, of which 55% were male, the median age was 51 years, and 27% had Hodgkin Lymphoma. Most patients (56%) were treated outside the residence city. São Paulo State accounted for 25% of patients. Treatment initiation took more than 60 days in 27% of cases. A total of 45,601 deaths were due to lymphoma (12% Hodgkin Lymphoma and 88% Non-Hodgkin Lymphoma), with a median age 63 years, and were mainly males (55%). Staging data were inadequate in 23% of patients, and analysis was performed only on the valid records. Advanced disease was diagnosed in 58% of patients (60% male; 57% female) and was more common in Non-Hodgkin Lymphoma (62%) versus Hodgkin Lymphoma (49%).

Discussion

Late diagnosis interferes with mortality rates. Health promotion and cancer prevention campaigns, especially targeting the male public, and training for early diagnosis and early treatment are needed.

Conclusion

Effective measures for early diagnosis and treatment are urgently needed for lymphoma control.

Keywords
Lymphoma; Neoplasms; Neoplasm staging; Delayed diagnosis; Mortality

	Sex	Total	(%)	Type of lymphoma
				HL	(%)	NHL	(%)
SUS patients	Male	39,081	55%	10,461		28,620
	Female	31,769	45%	8824		22,945
	Total	70,850	100%	19,285	27%	51,565	73%
Number of deaths	Male	25,276	55%	2972		22,304
	Female	20,323	45%	2295		18,028
	NI	2	0%	1		1
	Total	45,601	100%	5268	12%	40,333	88%

Age (years)	Patients		Type of lymphoma
			Hodgkin lymphoma		Non-Hodgkin lymphoma
	Number	(%)	Number of patients	(%)	Number of patients	(%)
0-19	8659	12%	4882	25%	3777	7%
20-24	4414	6%	2989	16%	1425	3%
25-29	4292	6%	2576	14%	1716	3%
30-34	4095	6%	2003	11%	2092	4%
35-39	3888	6%	1422	7%	2466	5%
40-44	3931	6%	1010	5%	2921	6%
45-49	4600	7%	845	4%	3755	7%
50-54	5523	8%	818	4%	4705	9%
55-59	6288	9%	776	4%	5512	11%
60-64	6605	9%	669	3%	5936	12%
64-69	6184	9%	538	3%	5646	11%
70-74	5217	7%	327	2%	4890	9%
75-79	3867	5%	249	1%	3618	7%
80-84	2187	3%	115	1%	2072	4%
85-89	843	1%	48	0%	795	2%
≥ 90	257	0%	18	0%	239	0%
Total	70,850	100%	19,285	100%	51,565	100%

Year	Patients		Type of lymphoma
			Hodgkin lymphoma		Non-Hodgkin lymphoma
	Number	%	Number	%	Number	%
2008	7023	10%	1921	10%	5102	10%
2009	6781	10%	1892	10%	4889	9%
2010	6997	10%	1868	10%	5129	10%
2011	7175	10%	1963	10%	5212	10%
2012	7076	10%	1955	10%	5121	10%
2013	7241	10%	1967	10%	5274	10%
2014	7212	10%	1908	10%	5304	10%
2015	7306	10%	1985	10%	5321	10%
2016	7520	11%	2039	11%	5481	11%
2017	6519	9%	1787	9%	4732	9%
Total	70,850	100%	19,285	100%	51,565	100%

Region	State	Patients		Type of lymphoma
				Hodgkin lymphoma		Non-Hodgkin lymphoma
		Number	%	Number	%	Number	%
North	AC	212	0%	63	0%	149	0%
	AM	772	1%	291	2%	481	1%
	AP	103	0%	31	0%	72	0%
	PA	940	1%	412	2%	528	1%
	RO	359	1%	113	1%	246	0%
	RR	72	0%	21	0%	51	0%
	TO	367	1%	131	1%	236	0%
	Total	2825	4%	1062	6%	1763	2%
Northeast	AL	810	1%	241	1%	569	1%
	BA	3341	5%	964	5%	2377	5%
	CE	3017	4%	850	4%	2167	4%
	MA	1201	2%	311	2%	890	2%
	PB	1305	2%	330	2%	975	2%
	PE	3044	4%	810	4%	2234	4%
	PI	1016	1%	274	1%	742	1%
	RN	1296	2%	367	2%	929	2%
	SE	555	1%	174	1%	381	1%
	Total	15,585	22%	4321	22%	11,264	22%
Midwest	DF	839	1%	254	1%	585	1%
	GO	1849	3%	557	3%	1292	3%
	MS	907	1%	266	1%	641	1%
	MT	862	1%	266	1%	596	1%
	Total	4457	6%	1343	6%	3114	6%
Southeast	ES	1319	2%	386	2%	933	2%
	MG	7852	11%	2162	12%	5690	11%
	RJ	5062	7%	1429	7%	3633	7%
	SP	17,451	25%	4703	25%	12,748	25%
	Total	31,684	45%	8.680	46%	23,004	45%
South	PR	5331	8%	1432	7%	3899	8%
	RS	6986	10%	1508	8%	5478	11%
	SC	3982	6%	939	5%	3043	6%
	Total	16,299	24%	3879	20%	12,420	25%
Total		70,850	100%	19,285	100%	51,565	100%

Region	State (UF)	Death		Type of lymphoma
				Hodgkin lymphoma		Non-Hodgkin lymphoma
		Number	%	Number	%	Number	%
North	AC	73	0%	8	0%	65	0%
	AM	456	1%	70	1%	386	1%
	AP	58	0%	10	0%	48	0%
	PA	727	2%	110	2%	617	2%
	RO	154	0%	25	0%	129	0%
	RR	45	0%	12	0%	33	0%
	TO	193	0%	25	0%	168	0%
	Total	1706	4%	260	5%	1446	4%
Northeast	AL	396	1%	38	1%	358	1%
	BA	2195	5%	248	5%	1947	5%
	CE	1586	3%	213	4%	1373	3%
	MA	631	1%	90	2%	541	1%
	PB	667	1%	52	1%	615	2%
	PE	1902	4%	227	4%	1675	4%
	PI	680	1%	79	2%	601	1%
	RN	685	2%	90	2%	595	1%
	SE	365	1%	44	1%	321	1%
	Total	9107	20%	1081	21%	8026	20%
Midwest	DF	830	2%	85	2%	745	2%
	GO	1116	2%	128	2%	988	2%
	MS	470	1%	64	1%	406	1%
	MT	444	1%	45	1%	399	1%
	Total	2860	6%	322	6%	2538	6%
Southeast	ES	878	2%	83	2%	795	2%
	MG	4422	10%	555	11%	3867	10%
	RJ	4622	10%	508	10%	4114	10%
	SP	12,810	28%	1.484	28%	11,326	28%
	Total	22,732	50%	2.630	50%	20,102	50%
South	PR	3026	7%	350	7%	2676	7%
	RS	4396	10%	440	8%	3956	10%
	SC	1774	4%	183	3%	1591	4%
	Total	9196	20%	973	18%	8223	20%
Total		45,601	100%	5.266	100%	40,335	100%

Year	Death		Type of lymphoma
			Hodgkin lymphoma		Non-Hodgkin lymphoma
	Number	%	Number	%	Number	%
2008	4052	9%	474	9%	3578	9%
2009	4197	9%	462	9%	3735	9%
2010	4217	9%	483	9%	3734	9%
2011	4425	10%	512	10%	3913	10%
2012	4698	10%	542	10%	4156	10%
2013	4569	10%	536	10%	4033	10%
2014	4729	10%	535	10%	4194	10%
2015	4822	11%	562	11%	4260	11%
2016	4964	11%	555	11%	4409	11%
2017	4928	11%	605	11%	4323	11%
Total	45,601	100%	5266	100%	40,335	100%

Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH) R. Dr. Diogo de Faria, 775 cj 133, 04037-002, São Paulo / SP - Brasil - São Paulo - SP - Brazil
E-mail: htct@abhh.org.br

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