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        "titulo" => "Evolu&#231;&#227;o da mortalidade por cancro do pulm&#227;o em Portugal &#40;1955&#8211;2005&#41;"
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            0 => "Lung cancer"
            1 => "mortality"
            2 => "trends"
            3 => "epidemiology"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">While the rate of smoking and lung cancer mortality has been decreasing in western Europe&#44; there was no decline in lung cancer mortality in Portugal until 1998&#46;</p> <span class="elsevierStyleSectionTitle">Aim</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To describe lung cancer mortality trends in Portugal&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Lung cancer mortality rates &#40;International Disease Classification 10&#58; C33-34&#41; in Portugal 1955&#8211;2005 by gender and 5-year age groupings were provided by the World Health Organization and the National Institute of Statistics&#46; Standard mortality rates &#40;direct method&#44; world population&#41; were calculated for the 35&#8211;74&#44; 35&#8211;44&#44; 45&#8211;54&#44; 55&#8211;64 and 65&#8211;74 year-old age groups&#46; Joinpoint regression was used to calculate the annual percent change &#40;APC&#41; in mortality and to identify any inflection points&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Between 1955 and 2005 we observed a stabilisation in lung cancer mortality in men aged 35&#8211;74 years old&#44; varying 3&#46;77&#37;&#47;year &#40;95&#37; confidence interval &#91;95&#37;CI&#93;&#58; 3&#46;53&#8211;4&#46;01&#41; in 1955&#8211;1986 and &#8722;0&#46;15&#37;&#47;year &#40;95&#37;CI&#58; &#8722;0&#46;99&#8211;0&#46;69&#41; in 1996&#8211;2005&#46; We observed negative APC point estimates &#40;with none significantly below zero&#41; in the most recent trends except for the 45&#8211;54 age group&#44; where we only noted an APC deceleration since 1981&#46; The mortality increased 1&#46;60&#37;&#47;year &#40;95&#37;CI&#58; 1&#46;40&#8211;1&#46;77&#41; in women aged 35&#8211;74 years old 1955&#8211;2005&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">In the last two decades we observed a lung cancer mortality stabilisation in males&#44; whereas mortality in females increased continuously&#46; These results place Portugal at the end of the third stage of the smoking epidemic&#46;</p>"
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      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introdu&#231;&#227;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A preval&#234;ncia de fumadores tem diminu&#237;do na Europa Ocidental&#44; observando-se j&#225; o decl&#237;nio da mortalidade por cancro do pulm&#227;o&#46; Contudo&#44; at&#233; 1998 n&#227;o se observava ainda um decr&#233;scimo da frequ&#234;ncia deste cancro em Portugal&#46;</p> <span class="elsevierStyleSectionTitle">Objectivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Descrever a tend&#234;ncia secular da mortalidade por cancro do pulm&#227;o em Portugal&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">As taxas de mortalidade por cancro do pulm&#227;o &#40;ICD10&#58;C33-34&#41; em Portugal&#44; entre 1955 e 2005&#44; por sexo e grupo et&#225;rio &#40;5 anos de amplitude&#41;&#44; obtiveram-se atrav&#233;s da Organiza&#231;&#227;o Mundial de Sa&#250;de e do Instituto Nacional de Estat&#237;stica&#46; Calcularam-se taxas de mortalidade padronizadas &#40;m&#233;todo directo&#44; popula&#231;&#227;o mundial&#41;&#44; para os grupos et&#225;rios 35&#8211;74&#47;35&#8211;44&#47;45&#8211;54&#47;55&#8211;64&#47;65&#8211;74 anos&#46; Realizou-se uma regress&#227;o <span class="elsevierStyleItalic">joinpoint</span> para calcular a varia&#231;&#227;o anual percentual &#40;VA&#37;&#41; da mortalidade e identificar eventuais pontos de inflex&#227;o&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Entre 1955 e 2005&#44; em homens dos 35 aos 74 anos&#44; observou-se uma estabiliza&#231;&#227;o da mortalidade por cancro do pulm&#227;o&#44; variando 3&#44;77&#37;&#47;ano &#40;intervalo de confian&#231;a a 95&#37; &#91;IC95&#37;&#93;&#58; 3&#44;53&#59; 4&#44;01&#41; entre 1955 e 1986 e &#8722;0&#44;15&#37;&#47;ano &#40;IC95&#37;&#58; &#8722;0&#44;99&#59; 0&#44;69&#41; entre 1996 e 2005&#46; Observaram-se estimativas pontuais da VA&#37; negativas &#40;n&#227;o significativamente inferiores a zero&#41; nas tend&#234;ncias mais recentes de todos os grupos et&#225;rios&#44; excepto no grupo 45-54 anos&#44; onde apenas se verificou uma desacelera&#231;&#227;o da VA&#37; desde 1981&#46; Em mulheres entre 35 e 74 anos&#44; a mortalidade aumentou 1&#44;60&#37;&#47;ano &#40;IC95&#37;&#58; 1&#44;40&#59; 1&#44;77&#41; entre 1955 e 2005&#46;</p> <span class="elsevierStyleSectionTitle">Conclus&#227;o</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Observou-se uma estabiliza&#231;&#227;o das taxas de mortalidade por cancro do pulm&#227;o nos homens&#44; enquanto nas mulheres esta aumentou de forma constante&#46; Estes resultados colocam Portugal no final do terceiro est&#225;dio da epidemia tab&#225;gica&#46;</p>"
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Trends in lung cancer mortality in Portugal (1955–2005)
Evolução da mortalidade por cancro do pulmão em Portugal (1955–2005)
Luís Alves1,2,3,
Corresponding author
lalves@med.up.pt

Correspondence to/Correspondência: Serviço de Higiene e Epidemiologia, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal. Telefone: +351225513652, Fax: +351225513653.
, Joana Bastos1,3, Nuno Lunet1,3
1 Serviço de Higiene e Epidemiologia, Faculdade de Medicina da Universidade do Porto, Portugal/Hygiene and Epidemiology Unit, Faculty of Medicine, Universidade do Porto, Portugal
2 Unidade de Saúde Familiar Santo André de Canidelo, Vila Nova de Gaia, Portugal/Santo André de Canidelo Family Health Unit, Vila Nova de Gaia, Portugal
3 Instituto de Saúde Publica da Universidade do Porto (ISPUP), Portugal/Institute of Public Health, Universidade do Porto (ISPUP), Portugal
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      "pt" => array:1 [
        "titulo" => "Evolu&#231;&#227;o da mortalidade por cancro do pulm&#227;o em Portugal &#40;1955&#8211;2005&#41;"
      ]
    ]
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    "fechaRecibido" => "2009-01-20"
    "fechaAceptado" => "2009-02-17"
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          "clase" => "keyword"
          "titulo" => "Key-words"
          "identificador" => "xpalclavsec160172"
          "palabras" => array:7 [
            0 => "Lung cancer"
            1 => "mortality"
            2 => "trends"
            3 => "epidemiology"
            4 => "smoking"
            5 => "tobacco epidemics"
            6 => "Portugal"
          ]
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          "clase" => "keyword"
          "titulo" => "Palavras-chave"
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          "palabras" => array:7 [
            0 => "Cancro do pulm&#227;o"
            1 => "mortalidade"
            2 => "tend&#234;ncia"
            3 => "epidemiologia"
            4 => "tabagismo"
            5 => "epidemia tab&#225;gica"
            6 => "Portugal"
          ]
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    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">While the rate of smoking and lung cancer mortality has been decreasing in western Europe&#44; there was no decline in lung cancer mortality in Portugal until 1998&#46;</p> <span class="elsevierStyleSectionTitle">Aim</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To describe lung cancer mortality trends in Portugal&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Lung cancer mortality rates &#40;International Disease Classification 10&#58; C33-34&#41; in Portugal 1955&#8211;2005 by gender and 5-year age groupings were provided by the World Health Organization and the National Institute of Statistics&#46; Standard mortality rates &#40;direct method&#44; world population&#41; were calculated for the 35&#8211;74&#44; 35&#8211;44&#44; 45&#8211;54&#44; 55&#8211;64 and 65&#8211;74 year-old age groups&#46; Joinpoint regression was used to calculate the annual percent change &#40;APC&#41; in mortality and to identify any inflection points&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Between 1955 and 2005 we observed a stabilisation in lung cancer mortality in men aged 35&#8211;74 years old&#44; varying 3&#46;77&#37;&#47;year &#40;95&#37; confidence interval &#91;95&#37;CI&#93;&#58; 3&#46;53&#8211;4&#46;01&#41; in 1955&#8211;1986 and &#8722;0&#46;15&#37;&#47;year &#40;95&#37;CI&#58; &#8722;0&#46;99&#8211;0&#46;69&#41; in 1996&#8211;2005&#46; We observed negative APC point estimates &#40;with none significantly below zero&#41; in the most recent trends except for the 45&#8211;54 age group&#44; where we only noted an APC deceleration since 1981&#46; The mortality increased 1&#46;60&#37;&#47;year &#40;95&#37;CI&#58; 1&#46;40&#8211;1&#46;77&#41; in women aged 35&#8211;74 years old 1955&#8211;2005&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">In the last two decades we observed a lung cancer mortality stabilisation in males&#44; whereas mortality in females increased continuously&#46; These results place Portugal at the end of the third stage of the smoking epidemic&#46;</p>"
      ]
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introdu&#231;&#227;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A preval&#234;ncia de fumadores tem diminu&#237;do na Europa Ocidental&#44; observando-se j&#225; o decl&#237;nio da mortalidade por cancro do pulm&#227;o&#46; Contudo&#44; at&#233; 1998 n&#227;o se observava ainda um decr&#233;scimo da frequ&#234;ncia deste cancro em Portugal&#46;</p> <span class="elsevierStyleSectionTitle">Objectivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Descrever a tend&#234;ncia secular da mortalidade por cancro do pulm&#227;o em Portugal&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">As taxas de mortalidade por cancro do pulm&#227;o &#40;ICD10&#58;C33-34&#41; em Portugal&#44; entre 1955 e 2005&#44; por sexo e grupo et&#225;rio &#40;5 anos de amplitude&#41;&#44; obtiveram-se atrav&#233;s da Organiza&#231;&#227;o Mundial de Sa&#250;de e do Instituto Nacional de Estat&#237;stica&#46; Calcularam-se taxas de mortalidade padronizadas &#40;m&#233;todo directo&#44; popula&#231;&#227;o mundial&#41;&#44; para os grupos et&#225;rios 35&#8211;74&#47;35&#8211;44&#47;45&#8211;54&#47;55&#8211;64&#47;65&#8211;74 anos&#46; Realizou-se uma regress&#227;o <span class="elsevierStyleItalic">joinpoint</span> para calcular a varia&#231;&#227;o anual percentual &#40;VA&#37;&#41; da mortalidade e identificar eventuais pontos de inflex&#227;o&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Entre 1955 e 2005&#44; em homens dos 35 aos 74 anos&#44; observou-se uma estabiliza&#231;&#227;o da mortalidade por cancro do pulm&#227;o&#44; variando 3&#44;77&#37;&#47;ano &#40;intervalo de confian&#231;a a 95&#37; &#91;IC95&#37;&#93;&#58; 3&#44;53&#59; 4&#44;01&#41; entre 1955 e 1986 e &#8722;0&#44;15&#37;&#47;ano &#40;IC95&#37;&#58; &#8722;0&#44;99&#59; 0&#44;69&#41; entre 1996 e 2005&#46; Observaram-se estimativas pontuais da VA&#37; negativas &#40;n&#227;o significativamente inferiores a zero&#41; nas tend&#234;ncias mais recentes de todos os grupos et&#225;rios&#44; excepto no grupo 45-54 anos&#44; onde apenas se verificou uma desacelera&#231;&#227;o da VA&#37; desde 1981&#46; Em mulheres entre 35 e 74 anos&#44; a mortalidade aumentou 1&#44;60&#37;&#47;ano &#40;IC95&#37;&#58; 1&#44;40&#59; 1&#44;77&#41; entre 1955 e 2005&#46;</p> <span class="elsevierStyleSectionTitle">Conclus&#227;o</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Observou-se uma estabiliza&#231;&#227;o das taxas de mortalidade por cancro do pulm&#227;o nos homens&#44; enquanto nas mulheres esta aumentou de forma constante&#46; Estes resultados colocam Portugal no final do terceiro est&#225;dio da epidemia tab&#225;gica&#46;</p>"
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