María Milagros Bernal

Laryngeal cancer survival in Zaragoza (Spain): a population-based study

ObjectiveThis article aims to study larynx cancer survival from the Population-Based Cancer Registry of Zaragoza, Spain, for the period 1978–2002.MethodsThe survival rates were calculated using the Kaplan-Meier method. The automated calculation of the Catalan Institute of Oncology was utilised to obtain the relative survival.ResultsThe observed survival rate was 84.6% in the first year and 60.9% in the fifth year. The one-year relative survival in both genders was 86.8% (CI 95%: 85.3–88.4) and 70.1% (CI 95%: 67.8–72.4) after five years. Glottic cancer presented a better survival rate than supraglottic and subglottic cancers, and a better survival rate was also observed in younger ages. There were no statistical differences when comparing survival rates by gender and between the periods 1978–1986, 1987–1994 and 1995–2002.ConclusionsThe data suggest there were no significant changes in laryngeal cancer survival in the province of Zaragoza in the period 1978–2002 and that the tumours located in the glottis presented a better prognosis.

Mortality trends and prediction of HPV-related cancers in Brazil.

Estimation of the size of a cancer group, either through number of cases or extrapolation of past observed trends, is indispensable to the planning of effective assistance measures. The aim of this study was to analyze the mortality trends of human papillomavirus-related cancers in Brazil by sex, in the period 1996–2010, and make predictions until the year 2025. All deaths registered as being a result of cervical cancer (ICD-10 code: C53), as well as those caused by vulvar and vaginal (C51 and C52), anal (C21), penile (C60), and oropharyngeal (C02, C09, C10) cancers, were registered. Adjusted rate calculations for each year were used to study the trends through the regression program ‘Joinpoint’. Predictions were made using the Nordpred program, utilizing the age–period–cohort model. When analyzing separately by location, it was observed that penile and anal cancers in men presented an increasing trend for the entire period with a statistically significant annual percentage change of 4% for anal cancer and 1.4% for penile cancer. Predictions indicate a reduction in the risk of death due to oropharyngeal cancer in men and cervical, vulvar, and vaginal cancers in women. It was observed that the increase in the number of deaths occurs mainly because of population changes (size and age structure). In terms of risk, an increase is predicted for anal and penile cancers in men and consequently an increase in mortality rates is observed for these types of cancers, unlike what is expected for human papillomavirus-related cancers in women.

Predictions and estimations of colorectal cancer mortality, prevalence and incidence in Aragon, Spain, for the period 1998-2022

OBJECTIVE estimate colorectal cancer incidence and prevalence in, based on mortality and survival data from the period 1998-2007, and provide projections of incidence, prevalence and mortality until the year 2022. METHODS general and colorectal cancer mortality rates were obtained from the National Statistics Institute and survival data was obtained from the EUROCARE study. Estimations were carried out through the program MIAMOD. The joinpoint program was used to quantify the annual change expected in the projections. RESULTS in men, an increase in prevalence is expected, from 237.2 (Crude Rate - CR = 303.5) to 237.7 (CR = 412.7) per 100.000 inhabitants/year in 2022. Incidence rates would increase from 48.2 (CR = 61.6) in 2007 to 55.2 (CR = 83.1), and mortality would increase from 22.7 (CR = 29.4) to 26.0 (CR = 39.6) when comparing 2007 and women, a reduction in prevalence is expected from 181.5 (CR = 268.3) to 167.9 (CR = 286.2) cases per 100,000 inhabitants/year. Incidence would change from 25.0 (CR = 38.0) in 2007 to 22.7 (CR = 39.2), and for mortality there is also an expected decrease, from 11.3 (CR =18.0) to 10.3 (CR = 18.5). CONCLUSION the projections indicate that colorectal cancer in follows an increasing trend in incidence, mortality and prevalencein men, in opposition to corresponding decreasing trends in women.These projections must be considered in order to plan more effective prevention and treatment measures.

Cancer mortality in Brazil: Temporal Trends and Predictions for the Year 2030

AbstractCancer is currently in the spotlight due to their heavy responsibility as main cause of death in both developed and developing countries. Analysis of the epidemiological situation is required as a support tool for the planning of public health measures for the most vulnerable groups. We analyzed cancer mortality trends in Brazil and geographic regions in the period 1996 to 2010 and calculate mortality predictions for the period 2011 to 2030.This is an epidemiological, demographic-based study that utilized information from the Mortality Information System on all deaths due to cancer in Brazil. Mortality trends were analyzed by the Joinpoint regression, and Nordpred was utilized for the calculation of predictions.Stability was verified for the female (annual percentage change [APC] = 0.4%) and male (APC = 0.5%) sexes. The North and Northeast regions present significant increasing trends for mortality in both sexes. Until 2030, female mortality trends will not present considerable variations, but there will be a decrease in mortality trends for the male sex. There will be increases in mortality rates until 2030 for the North and Northeast regions, whereas reductions will be verified for the remaining geographic regions. This variation will be explained by the demographic structure of regions until 2030.There are pronounced regional and sex differences in cancer mortality in Brazil, and these discrepancies will continue to increase until the year 2030, when the Northeast region will present the highest cancer mortality rates in Brazil.

Desigualdades regionais na mortalidade por câncer de colo de útero no Brasil: tendências e projeções até o ano 2030

The scope of this article is to analyze the temporal trends of cervical cancer mortality in Brazil and calculate the projection of mortality through to the year 2030. Deaths that occurred within the 1996-2010 period were analyzed (Mortality Information System). Mortality trend analysis utilized the Joinpoint regression, while Nordpred was utilized for the calculation of projections. For Brazil, decreasing trends were identified (APC = 1.7% CI95%-2.2; −1.1 p < 0.05). The Midwest region presented a significant reduction trend (APC = −1.3% per year), along with the Southeast (APC = −3.3%) and South (APC = −3.9%) regions. The North and Northeast regions presented stable trends. The states of Acre (APC = −6.5%) and Rio Grande do Sul (APC = −4.1%) presented the most pronounced reduction trends. Analysis of the mortality projections revealed a reduction in mortality rates, starting from the first projected period, with a considerable reduction for the South region. Mortality rates through to the year 2030 are explained, principally, by reductions in the riskof the disease. Cervical cancer mortality presents reducing trends, however these are unequally distributed throughout the country, where the North and Northeast regions present the highest mortality rates.The scope of this article is to analyze the temporal trends of cervical cancer mortality in Brazil and calculate the projection of mortality through to the year 2030. Deaths that occurred within the 1996-2010 period were analyzed (Mortality Information System). Mortality trend analysis utilized the Joinpoint regression, while Nordpred was utilized for the calculation of projections. For Brazil, decreasing trends were identified (APC = 1.7% CI95%-2.2; -1.1 p < 0.05). The Midwest region presented a significant reduction trend (APC = -1.3% per year), along with the Southeast (APC = -3.3%) and South (APC = -3.9%) regions. The North and Northeast regions presented stable trends. The states of Acre (APC = -6.5%) and Rio Grande do Sul (APC = -4.1%) presented the most pronounced reduction trends. Analysis of the mortality projections revealed a reduction in mortality rates, starting from the first projected period, with a considerable reduction for the South region. Mortality rates through to the year 2030 are explained, principally, by reductions in the risk of the disease. Cervical cancer mortality presents reducing trends, however these are unequally distributed throughout the country, where the North and Northeast regions present the highest mortality rates.

Oropharyngeal Cancer Survival: A Population-Based Study of Patients Diagnosed between 1978 and 2002

Objective. This paper aims at studying oropharyngeal cancer survival from the Population-Based Cancer Registry of Zaragoza, Spain, for the 1978–2002 period. Methods. The survival rates were calculated by the Kaplan-Meier method, and the automated calculation method of the Catalan Institute of Oncology was utilized to obtain the relative survival. Results. The oropharyngeal cancer survival rate was 61.3% in the first year and 33.9% in the fifth year. One-year relative survival was 62.2% (CI 95%: 57.4–67.4), and five-year relative survival was 36.6% (CI 95%: 31.8–42.1). Comparison of survival rates by sex revealed statistically significant differences (P value = 0.017) with better survival in women. There were no differences when comparing the three age groups and the three studied time periods 1978–1986, 1987–1994, and 1995–2002. Conclusions. The data suggests that there were no significant changes in oropharyngeal cancer survival in the province of Zaragoza throughout the years.

Trends in the incidence of major salivary gland cancer in Spain (1978-2002)

OBJECTIVE: To analyze the trend in the incidence rates of major salivary gland cancer in population-based cancer registries in Spain. METHODS: The following Spanish cancer registries with a minimum follow-up period of 10 years were selected: Albacete, Asturias, Granada, Murcia, Navarre, Tarragona and Zaragoza. Adjusted incidence rates were calculated. Joinpoint software was utilized to calculate change estimations in incidence rates for the period 1991-2001. RESULTS: Joinpoint analysis revealed a statistically significant decreasing trend with an annual percent change of -5.3% (95% CI: -8.7 to -1.8). CONCLUSION: The incidence of major salivary gland cancers in Spain was low and a decreasing trend was identified between 1991 and 2001.

Current Trends and Future Burden of Breast Cancer Mortality in Brazil: A Population-Based Study

To the Editor: In Brazil, 52,680 breast cancer new cases were predicted for the year 2012 and where triage through mammograms is carried out in an opportunist manner, with the loss of information from the clinical history of patients, it is difficult to evaluate the quality of screening programs (1). The objective of this study was to analyze the temporal trend of breast cancer mortality in Brazil and its geographic regions for the period 1996–2010 and calculate the mortality projection for the period 2011–2030. An ecological, retrospective temporal series study was carried out, based on secondary data collected from the Mortality Information System of the Informatics Department of the Unified Health System (Datasus), with analysis of the deaths due to breast malignant neoplasms occurred in Brazil during the period 1996–2010. Data for female population in Brazil and its regions were obtained from the Brazilian Institute of Geography and Statistics (IBGE). Mortality trend analysis was carried out through Joinpoint regression analysis, utilizing the software Joinpoint Regression Program, version 4.1.0, according to de Souza et al. (2). The predictions were made for each period utilizing the model age–period–cohort of the Nordpred program, within the statistical program R (3). For each period, adjusted mortality rates were calculated by the direct method, based on the world standard population for global comparisons, expressed as 100,000 women per year (4). Changes in the number of cases in the last projected period (2026–2030) were calculated in comparison with the last observed period (1996–2010), where the proportion of this change occurred in terms of risk changes or demographical changes (size or structure of population). These two components can be different from zero and present a positive or negative direction (5). From 1996 to 2010, 144,403 deaths due to breast malignant neoplasms were registered in Brazil. The Brazilian mortality rate standardized to the world population presented stability for the observed period. When comparing mortality rates for Brazil and its geographic regions, it was observed that the rates presented by the regions South and Southeast are above the national average, varying from 13.00 to 14.60 deaths per 100,000 women between the years of 1996 and 2010. In the historical series analysis of mortality rates for Brazil, Joinpoint analysis verified stability for the period analyzed (APC = 0.4%), as well as for the Midwest (APC = 1.2%) and South (APC = 0.2%) regions; for the Southeast region, significant decreasing trends of 0.8% per year were verified, with significant annual increasing trends of 2.9% for the North region. The Northeast region presented two segments with significant increases (1996–2002 and 2002– 2006), followed by a stable period. Cohort analysis of 15 years highlighted the significant increasing trend for the Northeast region (AAPC = 3.6% annually; Table 1). The Figure 1 presents the number of deaths and adjusted mortality rates for the observed period (2006–2010) and projections (2026–2030) for Brazil and regions. The most pronounced increment will be observed for the Northeast region: an increase of 36.4% in mortality rates until the year 2030; the North region follows, with an increase of 20.8%. For the South and Southeast regions, reductions will be verified in mortality rates until 2030. For Brazil and all Brazilian geographic regions, the highest number of deaths will be registered in the age group between 45 and 64 years of age, however, the highest mortality rates will be registered for individuals in the age group over 75-year old. In the projected number of deaths in accordance with the influence of risk and population structure of Brazil and its regions in 2030 showed that there will a Address correspondence and reprint requests to: Dyego Leandro Bezerra de Souza, PhD in Public Health, Departament of Collective Health, Graduate Program in Collective Health, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho 1787, CEP: 59010-000, Lagoa Nova, Natal-RN, Brazil, or e-mail: dysouz@yahoo.com.br

Incidencia y supervivencia del cáncer de esófago en la provincia de Zaragoza, un estudio de base poblacional

BACKGROUND AND OBJECTIVE The objective of the present paper is to study the incidence and survival of esophageal cancer from data of the Population-Based Cancer Registries of Zaragoza. PATIENTS AND METHODS Crude and adjusted incidence rates were calculated according to sex and the Joinpoint log-linear regression was utilized to calculate trends in adjusted incidence rates for the period 1978-2002. The observed survival was calculated by utilizing the Kaplan-Meier method. For relative survival, the automate calculation of the Oncology Institute of Catalonia was utilized. RESULTS Joinpoint analysis revealed stability in the incidence rates with Annual Percentage Change of 0.16 (CI 95%: -0.8; 1.1) for men and 0.04 for women (CI 95%: -2.8; 2.8). Observed survival in the period 1978-2002 was 33.2% in the first year and 15.3% in the last year. Relative 1-year survival for males and females was 36.3% (CI 95%: 32.7-40.4) and 23.8% (CI 95%: 20.0-28.4) after 5 years. CONCLUSIONS Data suggest that there were no significant changes in the incidence rates of esophageal cancer in the province of Zaragoza and that survival was low.