quinta-feira, 11 de dezembro de 2008

Porque o câncer não superará as doenças cardiovasculares no Brasil em 2020

A imprensa repercutiu essa apresentação o IARC afirmando que as mortes por câncer superarão as por doenças cardiovasculares em 2020. Não há um único estudo sobre o tema, trata-se de mera especulação , a não ser que na China e India, o hábito tabágico se espalha. Mas, o tabagismo também aumenta o número de mortes por doença cardiovascular.
No Brasil, esse quadro não acontecerá porque a prevalência:
1.de hipertensão é muito elevada quando comparada aos países europeus e EUA.
2. do tabagismo nunca foi elevada como na Europa, EUA e Ásia.
3. da obesidade e do diabetes está em elevação e, terá impacto na mortalidade cardiovascular como já se observa no EUA.
O mais grave da afirmativa do IARC é desconhecer que o espectro das doenças cardiovasculares naõ se restringem à sindrome coronariana aguda e à doença cerebrovascular. Essas duas entidades clínicas são manifestações do fenômeno aterosclerótico-hipertensivo que evoluirá para acometer outros órgãos (rins, retina, córtex cerebral) e funções (renal, visual, cognitiva, auditiva).

Cancer set to overtake heart disease as top global killer December 11, 2008 Lisa Nainggolan and Nick Mulcahy
Aarhus, Denmark - Cancer is set to overtake cardiovascular disease to become the leading cause of death worldwide by 2010, according to a new report [
1] from the International Agency for Research on Cancer (IARC), a division of the World Health Organization (WHO). President of the American Heart Association (AHA), Dr Tim Gardner, told heartwire he applauds the new report and looks forward to working with cancer organizations to tackle risk factors that increase the likelihood of both cancer and cardiovascular disease.
According to the IARC report—which is a call to action asking governments to help fund cancer-prevention and research initiatives and international tobacco-control policies—the burden of cancer doubled globally between 1975 and 2000 and is set to double again by 2020 and nearly triple by 2030.
The report—which was discussed at an event in Atlanta this week called Conquering Cancer: A Global Effort—says that low- and middle-income countries will experience the impact of higher cancer incidence and death rates more sharply than industrialized countries.
The factors they have identified as predictive of an increase in cancer deaths are the very same factors that are going to result in more cardiovascular deaths, too.
This is also true of heart disease—just last week, as reported by heartwire, researchers predicted that 85% of cardiovascular deaths worldwide would occur in low- and middle-income countries by 2030. However, the authors of this article stressed that there still exists "a window of opportunity" to prevent the epidemic from reaching its full potential and magnitude.
Among the reasons stated by the IARC for the growing cancer burden is the adoption in less well-developed countries of "Western" habits, such as tobacco use and high-calorie, high-fat, and trans-fat diets.
"Obviously, this new cancer report is an important prediction," Gardner told heartwire. "The risk and demographic factors they have identified as predictive of an increase in cancer deaths are the very same factors that are going to result in more cardiovascular deaths, too, so we are on the same track." US deaths from cancer and heart disease currently declining
The news on cancer in developing countries is in contrast with another recent report that shows cancer incidence and death rates for men and women in the US continuing to decline [
The number-one and number-three killers in the US currently are coronary heart disease and stroke, respectively, says the AHA [
And while the nation has already made progress in reducing death rates from these two conditions, Gardner says that without a concerted effort to reduce some key risk factors, such as obesity and physical inactivity, "the momentum of reducing heart disease and stroke deaths will be lost. We will see our children developing heart disease earlier. This could reverse the progress in cardiovascular death rates that we have seen over the past decade."
We are not jealous about our position in terms of heart disease being the number-one killer.
"We are not jealous about our position in terms of heart disease being the number-one killer; it's a distinction none of us want to have," he added. "The AHA has been working for decades to move out of that 'top spot' of being the number-one killer. But unless we can do better in reducing some of these risk factors in the US, it may be a long time before we can shed the title of number one."Smoking is the easiest target
Cigarette smoking accounts for nearly 440 000 of the more than 2.4 million annual deaths in the US, and there are catastrophic predictions for the number of deaths that will occur due to smoking in developing countries. In India, for example, new research published earlier this year forecasts that by 2010 around one million deaths per year there will be attributable to smoking.
"Tobacco use is an enormous health burden across the globe and makes a significant contribution to deaths from both cancer and cardiovascular disease," Gardner adds.
"We applaud the findings of the IARC report. We're very concerned about smoking rates in the US and newly developed countries, and we are really working very hard on trying to deal with that—the one risk factor that can most easily be targeted."
Leading US cancer organizations unite against the growing global cancer burden [press release]. December 9, 2008. Available at: http://www.eurekalert.org/pub_releases/2008-12/acs-luc120908.php.
Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin 2008; 58:71-96.
American Heart Association. American Heart Association comment on the International Agency for Research on Cancer, World Cancer Report [press release]. December 11, 2008. Available at: http://americanheart.mediaroom.com/index.php?s=43&item=625.

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