Tabaquismo activo y cancer pulmonar: determinación de fracciones atribuibles por sexo / Smoking and Lung Cancer: attributable risks according to gender

Background: The association between Lung Cancer and smoking is well documented. However there is less information about the estimation of its attributable fraction and population burden. Aim: To estímate the attributable risk and population attributable risk of smoking among Lung Cancer patients attended in Public Health Services at Santiago. Material and methods: A case control study matched by age was carried out. Crude and adjusted attributable and population attributable risks were estimated, controlling for potential confounders and interaction variables. Results: Mean age for cases was 63 years for women and 67 years for men. Lung Cancer patients had a higher smoking prevalence than controls (64.5 percent and 39.7 percent respectively among women; 95.8 and 67.1 respectively among men p <0.01). Heavy smoker proportion was 4 times higher among patients that smoked 5 to 10 years more (women and men respectively, p <0.01) and 3 times more cigarettes per day (p <0.01). Attributable risk for women was 64.4 percent and 90.4 percent for men. Population attributable fraction was 41.9 percent and 86.3 percent for women and men, respectively. Projecting these estimates to the Chilean population, approximately 1975 new cases per year of Lung Cancer caused by smoking will be diagnosed. Conclusions: Attributable risks of smoking for Lung Cancer are high and significant, even when they are adjusted by confounding variables.

Tabaquismo y enfermedad pulmonar obstructiva crónica: determinación de fracciones atribuibles / Smoking and chronic obstructive pulmonary disease: attributable risk determination

Background: Smoking is the main risk factor for Chronic Obstructive Pulmonary Disease (COPD), an important cause of morbidity and mortality. Aim: To estimate smoking attributable risk and population attributable risk in COPD patients attended in Public Health Services of Santiago. Materials and methods: A case control study matched by sex and age was carried out. Crude and adjusted attributable risks as well as population attributable risk were estimated, controlled by potential confounders and by interaction variables. Results: Mean ages for cases and controls were 68 and 67 years respectively. When compared to the control group, COPD patients had a higher smoking prevalence (at least 100 cigarettes in their life span: 89.7 percent vs 60.3 percent; p <0.01). Among COPD patients, heavy smokers proportion was 4 times higher than in controls, they smoked for more years (43 vs 31; p <0.01) and more cigarettes per day (18 vs 5; p <0.01). Adjusted attributable risk was 87 percent (95 percent Confidence Interval (CI): 63.7-94.8). If a patient smoked at least 100 cigarettes in his/her life span and this risk was 92.7 percent (CI: 82.4-96.9) for heavy smokers. Projecting this index to Santiago inhabitants, about 87,000 individuals older than 40 years would be suffering COPD due to smoking. Conclusions: This article confirms the strong association between smoking and COPD. Attributable risks are high and significant, even when they are adjusted by confounding variables. Women had a higher risk than men, at lower levels of tobacco consumption.

Factores de riesgo para las enfermedades no transmisibles: metodología y resultados globales de la encuesta de base del programa CARMEN: conjunto de acciones para la reducción multifactorial de las enfermedades no transmisibles / Risk factors for chronic non communicable diseases: methods and results of CARMEN program basal survey

Background: In the last decades, chronic non communicable diseases are becoming the main cause of disability and mortality among adults. The risk factor surveillance and management is the most efficient mean of reducing the impact of these diseases. Aim: To report the results of a non communicable disease risk factor surveillance program in Valparaiso, Chile. Material and methods: a random samples of people aged 25 to 64 years old living in Valparaiso, Chile was studied. Subjects were questioned about smoking and physical activity habits. Blood pressure, height and weight were measured using standardized techniques at their homes and blood samples were obtained to measure serum lipid levels and oral glucose tolerance test at the nearest outpatient clinic. Results: Of the initial 3852 homes selected, 752 individuals did no agree to answer the inquiry, therefore 3120 subjects were finally interviewed. Of these, 40.6 percent were smokers, 15 percent drank alcohol in two or more occasions per month, 84.6 percent were physically inactive, 19.7 percent had a body mass index over 30 kg/m2, 11.1 percent had high blood pressure, 3.9 percent were diabetic and 46.9 percent had high serum cholesterol levels. Conclusions: The basal survey for the CARMEN program shows a high prevalence of cardiovascular risk factors among chileans

Prevalencia de hipertensión arterial en Valparaíso: resultados de la encuesta de base el programa CARMEN: conjunto de acciones para la reducción multifactorial de las enfermedades no transmisibles / Prevalence of hypertension in Valparaíso: results of the base survey of CARMEN program

Background: There is little information about the real prevalence of hypertension in Chile. Aim: To assess the adjusted prevalence of hypertension and its main therapeutic measures among adults living in Valparaiso, Chile. Material and methods: A random sample of dwellings in Valparaiso was chosen. Among these, an individual of 25 to 64 years old was randomly surveyed for risk factors for chronic diseases and sociodemographic parameters. Blood pressure, weight, height, oral glucose tolerance test, fasting cholesterol and triglycerides were also measured. Prevalence was pondered according to age, sex, and probability of selection in the dwelling interior. Results: Three thousand one hundred twelve individuals were studied. The adjusted prevalence of hypertension was 11.4 percent (11.6 percent among females and 10.6 percent among men). The prevalence increased along with age from 3 and 1.9 percent in men and women of 25 to 34 years old respectively, to 18.2 and 27.4 percent among men and women of 55 to 64 years old (p< 0.01). People of low socioeconomic level had a higher prevalence of hypertension than those of high socioeconomic level (14.2 and 9.3 percent respectively, p < 0.05). Diabetes, obesity and hypercholesterolemia were significantly more frequent in subjects with hypertension than in the general population. Forty four percent of diagnosed hypertensives were receiving medications (angiotensin converting enzyme inhibitors 40 percent, calcium antagonists 34 percent, beta blockers 22 percent). Twenty five percent of patients were treated with a combination of medications. Of those treated, only 22 percent had normal blood pressure levels at the moment of examination. Conclusions: High blood pressure is an important public health problem that requires more efficient detection and treatment programs