Cancer incidence in the Northern Ecuadorian Amazon Basin: An epidemiological descriptive study

ABSTRACT

Objetive Despite the fact that cancer is underreported in most Latin American countries, available data suggest that it has progressively become a major cause of concern throughout the region. To provide additional descriptive information on cancer incidence in the Northern Ecuadorian Amazon Basin (NEAB), different sources of data were used. Methods: Cancer cases from the NEAB in the period 1985-2003 reported by the National Cancer Registry (NCR) of Ecuador were used to calculate incidence rates. Incidence rates were obtained in periods of five-years and were compared with those found at national and international level. The population at risk was estimated according to two consecutive national censuses (1990; 2001). Results: 1 415 cases of cancer (858 women and 557 men) reported by the NCR were analyzed. The most frequent cancers in the NEAB are in line with those found at national level. During the period 2000-2003, the age standardized rates (ASR) were highest for cervical and stomach cancer among women with 19.9 (IC95% 10.9 - 28.9) and 5.9 (IC95% 0.6 - 10.8) cancer cases per 100 000 habitants/year respectively. For men stomach cancer was the most frequent type with 7.7 (IC95% 2.3 - 13) cases per 100 000 habitants/year. The ASR of cervix cancer is among the highest reported by cancer registries internationally. About 50% of the cancer cases were diagnosed in people with primary education (6 school years) in both men and women. Conclusion: The analysis that evidenced a high underreporting rate, outlines first but incomplete insights into pattern of cancer incidence trends in NEAB. It will be of high importance for the health system to develop sound monitoring and registration practices to inform and generate evidence-based health policy and support comprehensive cancer care and its prevention without neglecting sociocultural aspects.

RESUMEN

Objetivo: A pesar de que el cáncer es una patología sub-registrada en la mayor¡a de pa¡ses latinoamericanos, información disponible sugiere que se ha convertido progresivamente en una de las principales causas de preocupación en toda la región. Para proporcionar datos descriptivos adicionales sobre la incidencia del cáncer en la Cuenca Norte de la Amazon¡a Ecuatoriana (CNAE), varias fuentes de información fueron utilizadas. Métodos: Casos de cáncer de la CNAE, en el periodo 1985 – 2003 reportados por el Registro Nacional de Tumores (RNT) fueron usados para calcular tasas de incidencia. Las tasas de incidencia fueron obtenidas en periodos de cinco años y comparadas con aquellas encontradas a nivel nacional e internacional. La población en riesgo fue estimada de acuerdo a dos censos nacionales consecutivos (1990; 2001). Resultados: Se analizaron 1 415 casos de cáncer (858 mujeres and 557 hombres) reportados por el RNT. Los tipos de cáncer mas frecuentes en la CNAE coinciden con aquellos encontrados a nivel nacional. Durante el periodo 2000 – 2003, la Tasa de Incidencia Estandarizada por edad (TIE) del cáncer de cérvix y estómago entre las mujeres fue 19.9 (IC95% 10.9 – 28.9) y 5.9 (IC95% 0.6 – 10.8) casos por 100 000 habitantes/año respectivamente, entre hombres el cáncer de estómago fue el más frecuente con 7.7 (IC95% 2.3 - 13) casos por 100 000 habitantes/año...