Tovar-Guzmán V, Flores-Aldana M, Salmerón-Castro J, Lazcano-Ponce E C
Center for Public Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
Dis Colon Rectum. 1998 Feb;41(2):225-31. doi: 10.1007/BF02238253.
Colorectal cancer is the third cause of cancer-related death in the world, with 468,000 estimated deaths in 1993. In some countries mortality rates have started to decline, and survival rates have increased. In this study performed in Mexico, information is presented on the increase in mortality from this form of cancer, especially in more economically developed areas.
The mortality trend for colorectal cancer was evaluated and standardized by five-year age groups in the period 1980 to 1993. Also, the standardized mortality ratio was calculated for Mexico's 32 states, as was the possible association between mortality and indicators of rurality level and fertility rates in the different regions of Mexico.
In the period studied, 18,962 deaths were officially reported. The average age of death was 66 years. The mortality rate among women (1.8) was significantly higher than among men (1.55 per 100,000 inhabitants). Mortality from colorectal cancer grew by 100 percent in both genders (beta = 0.089; P < 0.001), especially in the age group 34 and younger, in the 45 to 49 age group, and in the older than 75 age group (P < 0.05). The standardized mortality ratio was greater in the states in the north of Mexico. Finally, an inverse correlation was observed throughout Mexico between the rurality index (r = -0.60; P < 0.001) and the fertility rates (r = -0.43; P < 0.05) and mortality from colorectal cancer.
In this study, there is evidence that mortality from this cancer is higher in geographic areas with greater socioeconomic development, similar to regional patterns observed in other countries. In Mexico, the coming years will see a serious epidemic in mortality from this disease; therefore, immediate attention must be given to identifying the profile of high-risk subjects and implementing early cancer detection measures.
结直肠癌是全球癌症相关死亡的第三大原因，1993年估计有46.8万人死亡。在一些国家，死亡率已开始下降，生存率有所提高。在墨西哥进行的这项研究中，提供了有关这种癌症死亡率上升的信息，特别是在经济较发达地区。
评估并按五年年龄组对1980年至1993年期间结直肠癌的死亡率趋势进行标准化。此外，计算了墨西哥32个州的标准化死亡率，以及墨西哥不同地区死亡率与农村水平指标和生育率之间的可能关联。
在所研究的期间，官方报告了18962例死亡。平均死亡年龄为66岁。女性的死亡率（每10万居民中有1.8例）显著高于男性（每10万居民中有1.55例）。结直肠癌的死亡率在两性中均增长了100%（β=0.089；P<0.0）特别是在34岁及以下年龄组、45至49岁年龄组以及75岁以上年龄组（P<0.05）。墨西哥北部各州的标准化死亡率更高。最后，在墨西哥各地观察到农村指数（r=-0.60；P<0.001）和生育率（r=-0.43；P<0.05）与结直肠癌死亡率之间呈负相关。
在这项研究中，有证据表明，在社会经济发展程度较高的地理区域，这种癌症的死亡率更高，这与其他国家观察到的区域模式相似。在墨西哥，未来几年这种疾病的死亡率将出现严重流行；因此，必须立即关注确定高危人群的特征并实施早期癌症检测措施。
