Garau Mariela, Musetti Carina, Alonso Rafael, Barrios Enrique
Universidad de la República, Facultad de Medicina, Departamento de Métodos Cuantitativos. Montevideo, Uruguay.
Registro Nacional de Cáncer, Comisión Honoraria de Lucha contra el Cáncer. Montevideo, Uruguay.
Colomb Med (Cali). 2019 Dec 30;50(4):224-238. doi: 10.25100/cm.v50i4.4212.
Uruguay is the south American country which has the highest cancer incidence and mortality rates. The National Cancer Registry collects data on cancer cases nationwide since 1989 and has reached high quality standards in the last decades. This is the first report on incidence trends.
Data from the National Cancer Registry of all new cases of invasive cancer from twelve sites diagnosed in 2002-2015 was analyzed. Age-standardized rates were calculated. Trends of incidence rates were analyzed using joinpoint regression models.
For both, men and women, incidence rates trends for all cancer sites, colo-rectal and bladder cancer remained stable. Esophageal and gastric cancers descended while thyroid and kidney cancer incidence increased. In men lung cancer decreased; testicular cancer increased, and prostate cancer increased at the beginning of the period and decreased in the final years. In women, lung cancer increased, breast cancer remained stable and cervical cancer presented a significant decline from 2005 to 2010 and reached a plateau since then.
Cancer incidence dynamics are complex and affected not only by Public Health policies such as tobacco control, vaccination and screening programs, but also by environmental and life style changes and the attitude of the medical community towards the application of diagnostic and therapeutic tools. The aim of this paper is to analyze cancer incidence time trends in the country and provide possible explanations to them.
乌拉圭是南美洲癌症发病率和死亡率最高的国家。自1989年以来,国家癌症登记处收集全国癌症病例数据,在过去几十年中已达到高质量标准。这是关于发病率趋势的首份报告。
分析了国家癌症登记处2002年至2015年诊断出的12个部位侵袭性癌症所有新病例的数据。计算了年龄标准化率。使用连接点回归模型分析发病率趋势。
男性和女性所有癌症部位、结直肠癌和膀胱癌的发病率趋势均保持稳定。食管癌和胃癌发病率下降,而甲状腺癌和肾癌发病率上升。男性肺癌发病率下降;睾丸癌发病率上升,前列腺癌发病率在该时期开始时上升,最后几年下降。女性肺癌发病率上升,乳腺癌发病率保持稳定,宫颈癌在2005年至2010年显著下降,此后趋于平稳。
癌症发病率动态变化复杂,不仅受烟草控制、疫苗接种和筛查计划等公共卫生政策影响,还受环境和生活方式变化以及医学界对诊断和治疗工具应用态度的影响。本文旨在分析该国癌症发病率的时间趋势并给出可能的解释。