ABSTRACT
Background: Maps have played a critical role in public health since 1855, when John Snow associated a cholera outbreak with contaminated water source in London. After cardiovascular diseases, cancer is the second leading cause of death in Chile. Cancer was responsible for 22.7 percent of all deaths in 1997-2004 period. Aim To describe the geographical distribution of stomach, trachea, bronchi and lung cancer mortality. Material and methods: Mortality statistics for the years 1997-2004, published by the National Statistics Institute and Chilean Ministry of Health, were used. The standardized mortality ratio (SMR) for sex and age quinquennium was calculated for 341 counties in the country. A hierarchical Bayesian analysis of Poisson regression models for SMR was performed. The maps were developed using adjusted SMR (or smoothed) by the Poisson model. Results: There is an excess mortality caused by stomach cancer in south central Chile, from Teno to Valdivia. There is an excess mortality caused by trachea, bronchi and lung cancer in northern Chile, from Copiapó to Iquique. Conclusions: The geographical analysis of mortality caused by cancer shows cluster of counties with an excess risk. These areas should be considered for health care decision making and resource allocation.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Neoplasms/mortality , Bayes Theorem , Bronchial Neoplasms/mortality , Cause of Death , Chile/epidemiology , Lung Neoplasms/mortality , Poisson Distribution , Stomach Neoplasms/mortality , Tracheal Neoplasms/mortalityABSTRACT
Background: Death certification is the basis for the study of mortality patterns and the identification of leading causes of death. These data are used for planning health policies and prevention programs. Aim: To evaluate the quality of mortality statistics in Chile from 1997 and 2003. Material and methods: Mortality data from 1997 to 2003 available at the Chilean Ministry of Health was used. Quality of information was evaluated using the percentage of certifications done by physicians and ill-defined causes of death according to rural or urban residence, medical services, age and gender. Results: Death certification done by physicians increased from 97.6 percent to 99.0 percent in the studied period. The greatest increase was observed in rural areas, from 89.9 percent to 94,8 percent. There was a steady reduction in the percentage of ill-defined causes of deaths, from 4.7 percent in 1997 to 2.8 percent in 2003. The percentage of ill-defined causes had a great variation among the different medical services. The variation went from 1.5 percent in Magallanes to 13.7 percent in Araucania Sur. There was an inverse linear correlation between death certification by physicians and ill-defined conditions. Conclusions: Quality of Chilean mortality statistics has improved over time. Nevertheless, there is still space for enhancement for the appropriate use of this information.