Cancer in Portugal

Cancer is an extremely heterogeneous disease in which cells lose the ability to repair DNA damage, giving rise to mutations that ultimately lead to abnormal cellular growth. Since cells become more susceptible to these damages as we age, the number of cancer cases has been rising over the years due to the increase in life expectancy.

Cancer represents a major health burden, being the second leading cause of death after cardiovascular diseases in Portugal. Regarding incidence, breast cancer is the most common type of cancer, followed by prostate, colorectal, lung, and thyroid.

Each year, 9000 new breast cancer cases are detected, and more than 2000 women die from this disease. The main risk factors associated with breast cancer are hormonal replacement therapy, genetic mutations, especially in BRCA genes, family history of breast or ovarian cancer, and reproductive history, namely pregnancy, menstruation, and menopause onset. In Portugal, all women between the ages of 50-69 are included in the national screening program consisting of biennial mammography. This allowed the detection of earlier stages in more than 30000 women, allowing a more efficient treatment.

Genetic factors, such as mutations in HOXB13 and BRCA2 genes, family history and diet increase the risk of prostate cancer development. Portugal reports around 7500 cases and 2000 deaths every year, making this disease the most common in men. Despite the lack of standard screening tests, rectal examination and PSA blood testing are the most used and effective tools to detect prostate cancer.

Colorectal cancer accounts for 10500 cases and more than 4500 deaths in Portugal. Risk factors include diet, family history, smoking, and alcohol intake.  Currently, there is no national screening program, therefore the detection of this disease relies on opportunistic screening in which people over the age of 50 perform the faecal immunochemical test (FIT). If it turns out positive, patients are required to perform a colonoscopy to confirm the presence of a lesion.

Over 6000 cases and 5000 deaths are associated with lung cancer in Portugal every year. Tobacco smoking is by far the leading cause of lung cancer development, with almost 80% of cases being attributed to smoking. Other risk factors include air pollution as well as exposure to asbestos and radon. Individuals who have a higher risk of developing this disease should consider a CT scan to enable the early detection of lung lesions.

Beatriz Santos

References

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Cancer Tomorrow. Who.int., https://gco.iarc.who.int/today/, February 4th 2024

Cancer Today. Who.int., https://gco.iarc.who.int/today/, February 4th 2024

Cancer Today. Who.int., https://gco.iarc.who.int/today/, February 4th 2024