Profile of antineoplastic medication among indigenous people treated in the Brazilian Unified National Health System

Abstract: Brazil has an estimated 900,000 indigenous people (0.4% of the country’s population), belonging to more than 300 different ethnic groups. However, information is scarce on cancer epidemiology and the antineoplastic drugs used in treatment of these individuals. The study’s objectives are to identify the antineoplastic drugs used and to describe the profile of use of these drugs in the indigenous population treated in Brazil, as well as to describe the patients’ epidemiological profile. An ecological study was performed involving outpatient chemotherapy care from January 2014 to December 2018 throughout Brazil. The data source was the Outpatient Information System of the Brazilian Health Informatics Department, considering only Authorizations for High-Complexity Chemotherapy Procedures. We identified 2,425 authorizations for chemotherapy procedures for treatment of indigenous patients. Of these, 2,292 authorizations for a total of 210 individuals were analyzed. We found an increase in the number of authorizations and of indigenous persons receiving chemotherapy over the period, with a higher concentration of individuals living in and receiving treatment in the South of Brazil, plus a wide diversity in the types of diagnosed tumors (n = 63) and of treatment regimen used during the treatment (n = 107). The current study provided a new overview of the epidemiological profile of indigenous patients receiving chemotherapy in the Brazilian Unified National Health System. The findings help fill a current knowledge gap on indigenous people’s health in Brazil.

摘要：巴西现有约90万原住民人口，占全国总人口的0.4%，分属300余个不同族群。然而，针对该群体的癌症流行病学特征及治疗所用抗肿瘤药物（antineoplastic drugs）的相关信息仍较为匮乏。本研究旨在明确巴西接受诊疗的原住民群体所使用的抗肿瘤药物种类，并描述此类药物的使用概况，同时阐述患者的流行病学特征。本研究为生态学研究（ecological study），纳入2014年1月至2018年12月巴西全国范围内的门诊化疗诊疗服务数据。数据来源于巴西卫生信息部（Brazilian Health Informatics Department）的门诊信息系统，仅纳入高级别化疗程序的诊疗授权数据。研究共识别出2425份针对原住民患者化疗治疗程序的授权书，其中2292份授权书涉及210名个体，最终纳入分析。研究期间，化疗授权数量及接受化疗的原住民人数均呈增长态势；多数患者居住于巴西南部并在当地接受诊疗；确诊肿瘤类型共计63种，治疗期间使用的治疗方案共计107种，二者均存在较高多样性。本研究为巴西统一国家卫生系统（Brazilian Unified National Health System）内接受化疗的原住民患者的流行病学特征提供了全新的全景式梳理，研究结果填补了巴西原住民健康领域当前的知识空白。