Do the Indian Women Have Gynecological Cancer?

Research made in Xanxerê Reservation - state of Santa Catarina

Acculturated group: 150 Caingangue women living on the sides of Xanxerê river, with socially drinking and smoking habits.

Feeding comes from hunting and agriculture. 

The tribe has a paternalistic regime; they came to the examination by imposition of the chief for the first time; spontaneously for the second time.

AGE:

116 women with less than 40 years

41 women with more than 40 years

From 15 to 20 years - 19

From 20 to 25 - 40

From 25 to 30 - 17

From 30 to 35 - 15

From 35 to 40 - 25

From 40 to 45 - 13

From 45 to 50 - 11

From 50 to 55 - 4

From 55 to 60 - 6

More than 60 - 7

CYTOLOGY’S PRESENTED:

2 class III cases (40 and 45 years old), one with positive biopsy.

2 class IV cases (48 and 75 years old)

1 class V case (42 years old)

4 positive cases among 159 - percentage of 2.5%

A) Risc by Age:

- 116 women examined 15-40 years old - positive O

- 24 women examined 40-50 years old - positive 3 - percentage of 12.5%

- 10 women examined 50-60 years - positive O

- 7 women examined + than 60 years old - positive 1 - percentage 14.3%.

B) Risc by Pregnancies: 

- 4 patients with no children with 0 positive case

- 97 patients up to 6 children with 0 positive case

- 58 patients with more than 6 children with 4 positive cases - 6.8%

C) Risc by the Date of the First Menstruation:

26 blanc, 2 positives (2 one with 15 years, the other with 12 years)

Not conclusive about the risk.

D) Risc by the Age of the First Sexual Relationship:

- 17 women had it between 10 and 15 years: 12 years - positive 1 - percentage of 6%

- 14 women had it between 15 and 20 years: 2 positives with 20 and 18 years - percentage of 2%

- 18 women had it between 20 and 25 years: 1 positive - 22 years - percentage 6%

- 1 woman between 25 and 30 years: no positive case

- 9 white women: no positive case

Coincident with marriage and having as consequence the first pregnancy

E) In Relation to Menopause:

20 women examined were in the menopause: 2 positive cases - percentage of 10%.

139 women with regular periods: 2 positive cases - percentage of 1,4%.

That data must be associated with age; one positive case had 42 years and was in the menopause.

All the positive cases had more than 40 years and more than 6 pregnancies, not showing any macroscopic lesions, making us consider an immunitarian balance of illness-ill person.

We have found no nodules on clinical examination of breast. All were breast-feeding.

In relation to the first relationship or menstruation is no correlation of risk.

In comparison with other statistical data, incidence of cervix cancer is 10 times more, and breast cancer is less.

Although this Symposium has been very well organized, there has been a mistake in the printing of the title of this work, probably due to the general belief that the Indians don't have cancer due to their habitat.  The title was originally published as "Indian women don't have gynecological cancer", but it was really meant to be a question.

DON'T THE INDIAN WOMEN HAVE GYNECOLOGICAL CANCER?

When we conducted a program of cancer prevention in the State of Santa Catarina, in the Xanxere Reservation, we examined 159 Caingangue women.

They live close to the Chapecozinho River, practicing agriculture, living in "ocas" (Indian huts) or wooden houses, which they accept if they have at least one room with earthen floor.

They drink cachaça (strong distilled drink from sugar cane) at Saturdays and smoke cigarettes made from strong raw tobacco ("fumo de corda"). They were examined in two phases.

The first group consisted of seventy women that came to the examinations by the insistence of the reservation's chief; the second group came spontaneously.

We have found 4 positive cases, distributed in the following manner:

- 2 class III – one of them positive biopsy

- 2 class IV

- 1 class V

We have divided the risk of cancer in relation to age, number of pregnancies, age of first menstruation, first sexual relationship, that was coincident with marriage and first pregnancy, and menopause.

AGE: 

116 had less than 40 years of age - no positive cases 0 (zero)

24 had between 40 and 50 years - 3 positive cases

7 had more than 60 years - 1 positive case

10 had between 50 and 60 years - 0(zero) positive case.

PREGNANCIES:

4 without children with 0 (zero) positive case

(three were pregnant and the fourth had less than 25 years, which meant a low index of sterility - almost zero)

97 women with up to 4 pregnancies and no positive cases + 58 women with more than 6 pregnancies and in this group were the 4 positive cases.

MENOPAUSE:

20 of the examined women were in the menopause; in this group we found two positive cases.

139 women had regular periods or were pregnant; between those with regular periods one was positive.

Between the other items, the age of the first sexual relationship varied (12, 18,20,22 years old) and age of the first menstruation (12.15 years old) we have found no clear relation. All the patients presented trichomoniasis.

We have dared to transform those numbers into percentages:

RISK OF CANCER ACCORDING TO THE AGE OF THE PATIENT:

Women less than 40 - 0%

Women from 40 to 50 years old - 12.5%

Women from 50 to 60 years old - 0%

Women more than 60 years old  - 14,3%

Resuming, women with more than 40 years - 9,1%

RISK OF CANCER ACCORDING TO THE NUMBER OF PREGNANCIES:

Less than 6 pregnancies 0%

More than 6 pregnancies 6,8%

RISK OF CANCER IN RELATION TO MENOPAUSE:

Women in the menopause 10%

Others 1,4%

We observe that 36% of the population studied had more than 6 children and 35% had more than 40 years of age; 50% of the population with more than 40 years is in the menopause.

RISK OF CANCER IN THE POPULATION IN GENERAL - 2.5%

Comparing with data obtained in the city of Xanxerê, a civilized group where the prevention campaign was made also for the first time, the incidence of cancer of the cervix is twice higher; in relation to the group in downtown Curitiba, the incidence is ten times higher.

In the examinations of the breast we have found no nodules.

In conclusion, the affirmative that Indian women don't have gynecological cancer is not true. That affirmative was due to the fact that they had not been properly examined before.