The mortality of children and adolescents with cancer is larger among indigenous people, according to the new edition of the Pediatric Oncology Panorama, from the Desiderata Institute. The cut of data obtained with the Ministry of Health and the National Cancer Institute (INCA) show a rate of 76 deaths every 1 million indigenous per year. Already among children and white adolescents this rate is 42.6/million, falling to 38.9/million among blacks and 38.9/million among those identified as yellows, which have oriental origin.
According to the last census, almost 45% of indigenous people in Brazil live in the North region, followed by the Northeast region, where 31.22% of this population lives. These are the regions that have the lowest incidence of new cases: 111.1 every 1 million children and adolescents in the North and 138.1 in the Northeast. But they are also both with the highest mortality rates: 47.5 and 44.5/million, respectively.
The coordinator of the Oncopediatric Service of the Octávio Lobo Children’s Oncological Hospital, in Belém, Pará, Alayde Vieira, does not rule out that the number of cases may be higher and that there is underground. According to her, multiple factors may be contributing to this high mortality in the northern region, starting with geographical issues that make it difficult to access health services:
“We have a lot of difficulty in moving. In the state of Pará, for example, we have 144 municipalities, and sometimes, in the municipality itself, as is the example of Altamira, to move from an indigenous riverside community to the city of Altamira, I take 1,000 km of travel. And this can not be done on foot, only by aircraft or by boat, “the coordinator details.
Service
The services themselves exist in a smaller quantity in the region. Currently, Brazil has 77 hospitals qualified in pediatric oncology. More than half of them – 36 – are in the southeast, only 3 of them are in the north. As a result, more than 40% of patients up to 19 need to be treated in a hospital without specialized service and more than 20% have to move to cities other than those who live to get treatment.
And these difficulties still join an unfavorable socioeconomic scenario “we have a higher treatment abandonment than is found in the Northeast, South and Southeast, because we have a child who lives in a riverside region, in a quilombo, in a village. And that mother who has a low income, which father needs to work, with who will leave the other children? His son is for the socioeconomic condition, “adds Alayde Vieira.
The oncologist also explains that the care of indigenous children requires a special approach because some patients, for genetic reasons, metabolize medications differently:
“We used the same medication, the same volume, the same dose, and our children evolved with toxicities. And that caught our attention. So we did a study of over 10 years, and we started to observe That our indigenous population, or the mixed population, which is the majority of our state, when it had genetically indigenous ancestry above a certain value, it began to have larger side effects. For serious and severe infections than other children, “explains the expert.
The solution was to create a differentiated protocol, with greater hydration, and administration of antigens to protect the organs from side effects, for example, which according to the doctor increases the challenge of treating this population.
The Panorama of Pediatric Oncology is Available on the website for public consultation and experts.
