Background: Phenolic compound consumption may have a protective effect against gastric cancer (GC). Most GC studies focus on the flavonoids class, but results are conflicting and knowledge gaps remain for other classes and total polyphenol intake. This study aimed to assess the association between polyphenol intake (total, flavonoids, and other classes) and GC. Methods: In this systematic review and meta-analysis, the PubMed, Embase, Scopus, LILACS, Web of Science, and OpenGrey databases were searched for studies published up to 20 March 2022. Case–control and cohort studies analyzing the association between polyphenol intake and GC were included. For the meta-analysis, pooled summary estimates were calculated using a random-effects model, and the estimates extracted adjusted for most variables. Subgroup analyses were performed for subclass (e.g., flavonoids and other classes), sex, geographical area, study design, anatomical subtype, histological subtype, family history of GC and fruit and/or vegetable intake. The study was registered with PROSPERO (#CRD42022306014). Findings: The search identified 2752 records, of which 19 studies published during the period 1999–2021 including a total of 1,197,857 subjects were eligible. Polyphenol consumption reduced GC risk by 29% (RR = 0.71; 95% CI: 0.62–0.81; I² = 60.5%); while flavonoid intake decreased GC risk by 28% (RR = 0.72; 95% CI: 0.61–0.85; I² = 64.3%), similar to the reduction fort other classes (RR = 0.65; 95% CI: 0.54–0.79; I² = 72.0%). Protective effects against GC were observed in both sexes (male, RR = 0.79; 95% CI: 0.67–0.94, I² = 31.6%; female, RR = 0.65; 95% CI: 0.48–0.87, I² = 49.7%) and for intestinal subtype (RR = 0.65; 95% CI: 0.52–0.82, I² = 0.0%). By continent, polyphenol consumption reduced GC risk in both Europe (RR = 0.67; 95% CI: 0.57–0.79, I² = 44.2%) and Asia (RR = 0.67; 95% CI: 0.51–0.89, I² = 60.7%). Conclusions: Dietary polyphenol intake decreased GC risk. The reduction was greatest in females. Most previous studies were carried out in Europe and Asia. Further studies investigating polyphenol consumption and GC in Latin American populations are warranted.

The oral cavity is a link between of external environment with gastrointestinal tract. Studies are controversial on the presence of Periodontal Disease (PD) and its association with Gastric Adenocarcinoma (GAC). The authors performed a systematic review and meta-analysis to verify the association between PD and GAC. Six electronic databases were evaluated between 1961 and 2022. Titles and abstracts were reviewed independently according to the eligibility criteria, assessing full texts of selected studies. The quality of the included research was verified using the Newcastle-Ottawa Scale for case-control and cohort studies. Statistical analyses were performed based on fixed and/or random effects models to calculate the summarized Relative Risk (RR) and its 95 % Confidence Interval (95 % CI). There were 639 studies, of which nine articles were included (3 case-controls and 6 cohorts). Overall, the authors identified 1,253 cases of GAC 2,501 controls in case-control studies, and 1,631 patients with GAC enrolled in cohort studies. Patients presenting PD increased the risk of developing GAC by 17 % (RR=1.17; 95 % CI 1.03‒1.32), which remained regardless of the diagnostic method for PD, i.e., clinical examination (RR = 1.19; 95 % CI 1.14‒1.24) and self-report (RR = 1.34; 95 % CI 1.06‒1.69). Moreover, Asian patients (RR=1.17; 95 % CI 1.00‒1.36) with PD had a higher risk of having GAC than American and European patients (RR = 1.18; 95 % CI 0.84‒1.66). The presence of PD the risk of GAC suggesting that its infectious-inflammatory process of PD may be related to GAC development. Further investigations on the oral-gastric microbiota and its role in the carcinogenesis of gastric cancer should be carried out, and the screening of patients with potential risk for GAC should be considered in the clinical practice of dentists.

Objective: This study aimed to analyze the prognosis of women with breast cancer by molecular subtypes, sociodemographic variables, and clinical and treatment characteristics. Methods: This hospital-based retrospective cohort study analyzed 1,654 women over 18 years of age diagnosed with invasive breast cancer from 2000 to 2018. Data were extracted from Brazil’s Oncocenter Foundation of São Paulo. The variables analyzed were age, histology, molecular subtypes, clinical staging, treatment type, and diagnosis-to-treatment time. Cox regression analysis was applied to estimate death risk. Results: Women with HER-2-positive (nonluminal) and triple-negative molecular subtypes were more than twice more likely to be at risk of death, with adjusted hazard ratio — HRadj=2.30 (95% confidence interval — 95%CI 1.34–3.94) and HRadj=2.51 (95%CI 1.61–3.92), respectively. A delayed treatment associated with an advanced clinical stage at diagnosis increased fourfold the risk of death (HRadj=4.20 (95%CI 2.36–7.49). Conclusion: In summary, besides that interaction between advanced clinical stage and longer time between diagnosis and treatment, HER-2-positive (nonluminal) and triple-negative phenotypes were associated with a worse prognosis. Therefore, actions to reduce barriers in diagnosis and treatment can provide better outcome, even in aggressive phenotypes.

OBJETIVO: Avaliar o impacto das Redes Regionais de Atenção à Saúde (RRAS) e da Regulação de Oncologia na acessibilidade geográfica ao tratamento oncológico dos principais tipos de câncer no estado de São Paulo. MÉTODOS: Estudo antes-depois, comparando os triênios anterior (2007–2009) e posterior (2017–2019) à implementação das políticas. Utilizaram-se dados do Registro Hospitalar de Câncer de São Paulo para analisar indicadores de deslocamento e atração de pacientes para cirurgia, radioterapia ou quimioterapia em seis tipos de câncer: estômago, colorretal, pulmão, mama feminina, colo do útero e próstata. As RRAS foram adotadas como unidades geográficas de análise, e os deslocamentos inter-RRAS foram categorizados em quartis (< 25%, 25%–49%, 50%–74% e ≥ 75%). Análise temporal foi realizada por mapas temáticos (QGIS, versão 3.28) e teste de qui-quadrado (α = 5%). RESULTADOS: Aproximadamente 25% dos pacientes se deslocaram para tratamento. As RRAS 6 (Capital), 9 (Bauru) e 13 (Ribeirão Preto) mantiveram-se como polos de atração. No Norte e Noroeste, as RRAS 11 e 12 apresentaram redução nos deslocamentos para todos os tipos de câncer; na RRAS 10, a queda ocorreu para tumores colorretal e pulmão. No Sudeste, as RRAS 3 e 5 não possuem serviços habilitados, exigindo deslocamentos, enquanto as RRAS 1, 2 e 4 mantiveram elevados percentuais. No Leste, as RRAS 14 a 17 registraram redução dos deslocamentos, exceto para câncer de pulmão. No Sul, os deslocamentos aumentaram nas RRAS 7 e 8. No geral, houve redução nos deslocamentos para câncer de colo do útero e próstata, e aumento para pulmão, especialmente cirurgia. CONCLUSÃO: A implementação das RRAS e da Regulação de Oncologia alterou a acessibilidade geográfica de forma heterogênea: houve melhora no Norte e Noroeste, piora no Sul, e estabilidade dos polos de referência. Destaca-se a necessidade de aperfeiçoamentos no planejamento regional, com atenção às desigualdades territoriais, ao tipo de tumor e à modalidade terapêutica.