Gestational trophoblastic disease : an analysis focused on social determinants of health

Abstract

Background: Cancer causes are varied and interrelated. It can be internal to the body, related to genetic aspects or external to the body which relates to the environment and living habits, as well as social disparities in which individuals are inserted. By realizing that social stratification exposes individuals to different risks, and therefore to a higher or lower vulnerability, which is directly related to the social context in which the individual is inserted, this study aims to understand the relationship between the social determinants of health and Gestational trophoblastic disease, according to the conceptual framework of Dahlgren and Whitehead. Methods: A descriptive study whose population was comprised of the medical records of women diagnosed with GTD. It was held in an obstetrical clinic of a Brazilian Northeast maternity of reference. The period was from June to August 2015. 119 medical records of women with GTD were identified between the years 2012-2013. To understand the relationship between the SDH and the factors related to GTD it was adopted the conceptual framework of Dahlgren and Whitehead. Findings: For each layer of the framework was made a correlation with the data found among the woman. About the first layer it was observed that the prevalence of GTD cases occurred among women aged between 13 and 19, corresponding to 49.9% (n = 59) of the women analysed. Related to the second layer, it was found that there was prevalence of oral contraceptive use with 32.8% (n = 39) of cases. The marital status that prevailed among women was single with 42% (n = 50). About the third layer it was not provided information related to social and community networks on the medical records. According to the fourth layer, the prevalent education level was less than 8 years of study (48.7%). Regarding to occupation, 38.7% (n = 46) of women were housewives. Related to the salary, 6.7% (n = 8) of women indicated have up to 1 minimum wage as income. Most women live on the countryside (60.5%). Related to the fifth layer it was found on the literature the need of intersectorial actions to solve the health inequities to promote an appropriate enviroment of health. Conclusion: It is understood that GTD has multifactorial etiology. Despite of the major influence of the genetic factor, the influence of social determinants on health outcomes of these women cannot be neglected. Therefore, it is essential for health professionals to understand the individuals in their entirety considering the various aspects that involve their lives.