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Conhecimentos e fatores de risco para o desenvolvimento do cancro da boca, faringe e laringe em estudantes universitários da Guiné-Bissau
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Os cancros da boca, laringe e faringe são neoplasias com fatores de risco semelhantes, que incluem o contacto com o fumo do tabaco, o álcool das bebidas alcoólicas ou agentes infeciosos como o vírus do papiloma humano (HPV). O consumo de alimentos antioxidantes, uma boa higiene oral, hábitos de atividade física e controlo do peso são considerados fatores protetores destes cancros. O conhecimento destes fatores, protetores e de risco, são importantes para a prevenção destas neoplasias.
Esta dissertação tem como o objetivo identificar os conhecimentos e os fatores de risco para o desenvolvimento destas patologias em estudantes universitários da Guiné-Bissau, bem como propor uma escala de pontuação teórica para sensibilizar para o risco de cancro da boca, laringe e faringe e estudar as associações da escala do risco com os conhecimentos.
Para atingir os objetivos propostos, foi realizado um estudo observacional-transversal, descritivo, quantitativo e analítico, por meio de um questionário online junto dos estudantes inscritos na Universidade Lusófona da Guiné-Bissau, em Bissau.
Um total de 288 estudantes integraram a amostra, com uma idade média de 24,7 anos e a maioria (99,7%) de nacionalidade guineense. A maior parte dos estudantes referiu espontaneamente que hábitos tabágicos (52,4%) e hábitos alcoólicos (41%) são fatores de risco para o cancro da boca, laringe e faringe. Numa questão fechada, os estudantes disseram que “Sim, tenho a certeza” que hábitos tabágicos (62,5%), hábitos alcoólicos (56,6%), hábitos de higiene oral (37,2%) e hábitos alimentares não saudáveis (34,7%) são fatores de risco para estas patologias.
O principal fator de risco de desenvolverem cancro da boca, laringe e faringe nestes estudantes são o elevado risco de contágio com vírus do papiloma humano (HPV), uma vez que 90,6% não tomaram a vacina contra o HPV, a maioria pratica sexo oral sem preservativo (67,4%) e muito têm múltiplos parceiros para esta prática (38,5%). Outros fatores de risco elevados nesta amostra é não realizar visitas anuais ao dentista (65,6%), não cumprir as recomendações de atividade física moderada a vigorosa da Organização Mundial de Saúde (47,8%), não consumir alimentos protetores diariamente, como hortícolas (22,9%), frutas (21,2%), frutas cítricas (31,3%) e café (5,2%).
Uma escala teórica para a sensibilização dos fatores de risco de cancro da boca, laringe e faringe com 7 dimensões e pontuação máxima de 70 pontos foi proposta. A mediana do risco calculada foi de 20,5 pontos. A maioria dos estudantes (77,4%) foi categorizado com um risco baixo (0 a 23,6 pontos), no entanto 22,6% dos alunos tiveram um risco intermédio. Os estudantes que relatam mais conhecimentos espontâneos também são os que apresentam um menor risco, avaliada através da pontuação da escala teórica total (Rho=-0,268, p<0,001) e parciais para hábitos tabágicos (Rho=-0,221, p<0,001) e hábitos alimentares saudáveis (Rho=-0,200, p<0,001).
A maior parte dos estudantes universitários da Guiné-Bissau desta amostra têm conhecimentos limitados dos fatores de risco para o cancro da boca, laringe e faringe. Os principais fatores de risco são o elevado risco de contágio com o HPV. Estes estudantes ainda podem melhorar os seus hábitos de higiene oral, alimentares e de atividade física. Aqueles estudantes que demonstraram ter maiores conhecimentos espontâneos, tiveram menores pontuações na escala do risco proposta, tanto para o total quanto para os parciais de hábitos tabágicos e de hábitos alimentares saudáveis. Medidas de Saúde Pública que promovam melhores hábitos de higiene oral e alimentares, bem como que reduzam o risco de contágio com o HPV são necessárias nesta população para potenciar um menor risco de desenvolver a doença. Ainda, mais estudos para a escala de avaliação do risco de cancro da boca, laringe e faringe seria importante, de forma a implementar como medida de sensibilização para o risco.
Mouth, larynx and pharynx cancers are neoplasms with similar risk factors, which include contact with tobacco smoke, alcohol from alcoholic beverages or infectious agents such as the human papillomavirus (HPV). The consumption of antioxidant foods, good oral hygiene, physical activity habits and weight control are considered protective factors against these cancers. Knowledge of these risk and protective factors is important for the prevention of these cancers. This dissertation aims to identify the knowledge and risk factors for the development of these pathologies in university students in Guinea-Bissau, as well as to propose a theoretical scoring scale to raise awareness of the risk of mouth, larynx and pharynx cancers and to study the associations of the risk scale with knowledge. To achieve the proposed objectives, an observational, cross-sectional, descriptive, quantitative, and analytical study was carried out, through an online questionnaire with students enrolled at the Lusófona University of Guinea-Bissau, in Bissau. A total of 288 students were included in the sample, with an average age of 24.7 years and the majority (99.7%) of Guinean nationality. Most students spontaneously reported that smoking habits (52.4%) and alcohol habits (41%) are risk factors for cancer of the mouth, larynx and pharynx. In a closed question, students said “Yes, I am sure” that smoking habits (62.5%), alcohol habits (56.6%), oral hygiene habits (37.2%) and unhealthy eating habits (34.7%) are risk factors for these pathologies. The main risk factor for developing cancer of the mouth, larynx and pharynx in these students is the high risk of infection with the human papillomavirus (HPV), since 90.6% have not taken the HPV vaccine, most practice oral sex without a condom (67.4%), and many have multiple partners for this practice (38.5%). Other high-risk factors in this sample are not having annual dental visits (65.6%), not meeting the World Health Organization's recommendations for moderate to vigorous physical activity (47.8%), and not consuming protective foods daily, such as vegetables (22.9%), fruits (21.2%), citrus fruits (31.3%), or coffee (5.2%). A theoretical scale for awareness of risk factors for mouth, larynx and pharynx cancer with 7 dimensions and a maximum score of 70 points was proposed. The calculated median risk was 20.5 points. Most students (77.4%) were categorized as having low risk (0 to 23.6 points), but 22.6% of students had intermediate risk. Students who report more spontaneous knowledge are also those who present a lower risk, assessed through the overall scale score (Rho=-0.268, p<0.001) and partial scores for smoking habits (Rho=-0.221, p<0.001) and healthy eating habits (Rho=-0.200, p<0.001). Most university students from Guinea-Bissau in this sample have limited knowledge of the risk factors for cancer of the mouth, larynx and pharynx. The main risk factors are the high risk of HPV infection. These students can still improve their oral hygiene, eating and physical activity habits. Those students who demonstrated greater spontaneous knowledge had lower scores on the proposed overall risk scale and for following partial risk scale: smoking habits and healthy eating habits. Public health measures that promote better oral hygiene and eating habits, in addition to reducing the risk of HPV infection, are necessary in this population to potentially reduce the risk of developing the disease. Furthermore, further studies on the risk assessment scale for mouth, larynx and pharynx cancer would be important, in order to implement it as a risk awareness measure.
Mouth, larynx and pharynx cancers are neoplasms with similar risk factors, which include contact with tobacco smoke, alcohol from alcoholic beverages or infectious agents such as the human papillomavirus (HPV). The consumption of antioxidant foods, good oral hygiene, physical activity habits and weight control are considered protective factors against these cancers. Knowledge of these risk and protective factors is important for the prevention of these cancers. This dissertation aims to identify the knowledge and risk factors for the development of these pathologies in university students in Guinea-Bissau, as well as to propose a theoretical scoring scale to raise awareness of the risk of mouth, larynx and pharynx cancers and to study the associations of the risk scale with knowledge. To achieve the proposed objectives, an observational, cross-sectional, descriptive, quantitative, and analytical study was carried out, through an online questionnaire with students enrolled at the Lusófona University of Guinea-Bissau, in Bissau. A total of 288 students were included in the sample, with an average age of 24.7 years and the majority (99.7%) of Guinean nationality. Most students spontaneously reported that smoking habits (52.4%) and alcohol habits (41%) are risk factors for cancer of the mouth, larynx and pharynx. In a closed question, students said “Yes, I am sure” that smoking habits (62.5%), alcohol habits (56.6%), oral hygiene habits (37.2%) and unhealthy eating habits (34.7%) are risk factors for these pathologies. The main risk factor for developing cancer of the mouth, larynx and pharynx in these students is the high risk of infection with the human papillomavirus (HPV), since 90.6% have not taken the HPV vaccine, most practice oral sex without a condom (67.4%), and many have multiple partners for this practice (38.5%). Other high-risk factors in this sample are not having annual dental visits (65.6%), not meeting the World Health Organization's recommendations for moderate to vigorous physical activity (47.8%), and not consuming protective foods daily, such as vegetables (22.9%), fruits (21.2%), citrus fruits (31.3%), or coffee (5.2%). A theoretical scale for awareness of risk factors for mouth, larynx and pharynx cancer with 7 dimensions and a maximum score of 70 points was proposed. The calculated median risk was 20.5 points. Most students (77.4%) were categorized as having low risk (0 to 23.6 points), but 22.6% of students had intermediate risk. Students who report more spontaneous knowledge are also those who present a lower risk, assessed through the overall scale score (Rho=-0.268, p<0.001) and partial scores for smoking habits (Rho=-0.221, p<0.001) and healthy eating habits (Rho=-0.200, p<0.001). Most university students from Guinea-Bissau in this sample have limited knowledge of the risk factors for cancer of the mouth, larynx and pharynx. The main risk factors are the high risk of HPV infection. These students can still improve their oral hygiene, eating and physical activity habits. Those students who demonstrated greater spontaneous knowledge had lower scores on the proposed overall risk scale and for following partial risk scale: smoking habits and healthy eating habits. Public health measures that promote better oral hygiene and eating habits, in addition to reducing the risk of HPV infection, are necessary in this population to potentially reduce the risk of developing the disease. Furthermore, further studies on the risk assessment scale for mouth, larynx and pharynx cancer would be important, in order to implement it as a risk awareness measure.
Descrição
Mestrado em parceria com a Escola Superior de Saúde do Instituto Politécnico da Guarda
Palavras-chave
Cancro da cabeça Cancro do pescoço Adultos jovens Guineenses Literacia Score