Prostate cancer incidence and mortality in Navarre (Spain) / Incidencia y mortalidad del cáncer de próstata en Navarra (España)

Background: Prostate cancer is one of the most commonly diagnosed malignancies among males worldwide. In this study, overall and age-specific incidence and mortality trends are analyzed in order to present the past and current epidemiological situation of the disease in Navarre (Spain). Methods: Population-based incidence data from the 1975- 2010 period, provided by the Cancer Registry of Navarre and prostate cancer specific mortality data for 1975-2013, provided by the Spanish Statistical Office, were used in the analysis. Age-standardized incidence and mortality rates, change-points and annual percentage changes (APC) were estimated by joinpoint regression analysis. One-dimensional P-spline models were used to estimate projections up to 2016. Results: Considerable increases of cancer incidence rates in men aged 45-74 years were observed, with APC of +4.5% (p<0.001), +9.5% (p<0.001) and +2.4% (p<0.05) in the 1975- 1990, 1990-2000 and 2000-2010 periods, respectively. In the older than 74 age-group, an increase of incidence rates in the 1975-1999 period was registered (APC +3.3%, p<0.001), followed by a significant decrease up to 2010 (APC -4.0%, p<0.01). Mortality rates rose until 1995 (APC +2.2%, p<0.001) whereas a decline occurred afterwards up to 2013 (APC -3.4%, p<0.001). Conclusion: Even though overall prostate cancer incidence rates seem to have stabilized in 2002-2010 in Navarra, trends were different by age groups: increased in men 45-74 years old and decreased in the 75+ year age-group. A decline in mortality rates was observed in both age groups since about 1995. Changes in the use of prostate specific antigen test for screening in oncoming years could affect future prostate cancer trends

Fundamento: A nivel mundial, el cáncer de próstata es uno de los tumores malignos más comúnmente diagnosticados en los hombres. En este estudio, se analizan las tendencias de la incidencia y mortalidad de cáncer de próstata, global y por grupos de edad, para mostrar la situación epidemiológica pasada y actual de la enfermedad en Navarra (España). Método: Para el estudio se utilizaron los casos incidentes diagnosticados entre 1975 y 2010, y las muertes observadas entre 1975 y 2013. Los datos fueron proporcionados por el Registro de Cáncer de Navarra y el Instituto Nacional de Estadística respectivamente. Se calcularon las tasas de incidencia y mortalidad estandarizadas por edad, los puntos de cambio y el porcentaje de cambio anual (PCA) mediante modelos de regresión de joinpoint. Se usaron modelos unidimensionales de P-splines para estimar proyecciones hasta 2016. Resultados: Se observó un considerable incremento en lastasas de incidencia de cáncer de próstata en hombres de 45-74 años, con PCA de +4,5% (p<0,001), +9,5% (p<0,001) y +2,4% (p<0,05) en los periodos 1975-1990, 1990-2000 y 2000- 2010, respectivamente. En el grupo de mayores de 74 se registró un aumento de incidencia en el período 1975-1999 (PCA +3,3%, p<0,001), seguido de una disminución significativa hasta 2010 (PCA -4,0%, p<0,01). Las tasas de mortalidad aumentaron hasta 1995 (PCA +2,2%, p<0,001), mientras que descendieron en el periodo 1995-2013 (PCA -3.4%, p<0,001). Conclusión: Aunque las tasas globales de incidencia de cáncer de próstata parecen estabilizarse en 2002-2010 en Navarra, las tendencias fueron diferentes según los grupos de edad, aumentando en los hombres de 45-74 años y disminuyendo en el grupo de mayores de 74 años. Se observó una disminución en las tasas de mortalidad en ambos grupos de edad desde 1995. Cambios en el uso del antígeno prostático específico para cribado en los próximos años podrían afectar las futuras tendencias del cáncer de próstata

Prostate cancer incidence and mortality in Navarre (Spain).

BACKGROUND: Prostate cancer is one of the most commonly diagnosed malignancies among males worldwide. In this study, overall and age-specific incidence and mortality trends are analyzed in order to present the past and current epidemiological situation of the disease in Navarre (Spain). METHODS: Population-based incidence data from the 1975-2010 period, provided by the Cancer Registry of Navarre and prostate cancer specific mortality data for 1975-2013, provided by the Spanish Statistical Office, were used in the analysis. Age-standardized incidence and mortality rates, change-points and annual percentage changes (APC) were estimated by joinpoint regression analysis. One-dimensional P-spline models were used to estimate projections up to 2016. RESULTS: Considerable increases of cancer incidence rates in men aged 45-74 years were observed, with APC of +4.5% (p<0.001), +9.5% (p<0.001) and +2.4% (p<0.05) in the 1975-1990, 1990-2000 and 2000-2010 periods, respectively. In the older than 74 age-group, an increase of incidence rates in the 1975-1999 period was registered (APC +3.3%, p<0.001), followed by a significant decrease up to 2010 (APC -4.0%, p<0.01). Mortality rates rose until 1995 (APC +2.2%, p<0.001) whereas a decline occurred afterwards up to 2013 (APC -3.4%, p<0.001). CONCLUSION: Even though overall prostate cancer incidence rates seem to have stabilized in 2002-2010 in Navarra, trends were different by age groups: increased in men 45-74 years old and decreased in the 75+ year age-group. A decline in mortality rates was observed in both age groups since about 1995. Changes in the use of prostate specific antigen test for screening in oncoming years could affect future prostate cancer trends.

Brain and central nervous system cancer incidence in navarre (Spain), 1973-2008 and projections for 2014.

Different studies have pointed out Navarre as one of the regions of Spain with the highest incidence rates of brain and other central nervous system (CNS) cancer. Trend analysis for cancer incidence rates for long periods of time, might help determining risk factors as well as, assessing prevention actions involved in this disease. The objective of this study was to describe the incidence of brain and CNS cancer using data from the population-based cancer registry of Navarre, (Spain) during the period 1973-2008 and provide forecast figures up to-2014. Crude and age-standardized (world population) incidence rates of brain cancer per 100,000 person-years were calculated by the direct method separately by gender, area (Pamplona and others), and age-groups. Penalized splines for smoothing rates in the temporal dimensions were applied in order to estimate and forecast cancer incidence rates. Age-adjusted incidence rates showed an increase over the study and forecast periods in both sexes more marked in women than in men. Higher incidence rates were observed in men compared with women but the differences became smaller with time. The increase was due to the rise of rates in the oldest age groups since the rates for younger age groups remained stable or decreased over time. As the entire aetiology of brain and other CNS cancer is not still clear, keep promoting healthful lifestyles for cancer primary prevention among the whole population is necessary.

Asistencia ventricular definitiva como alternativa al trasplante cardíaco en un paciente ingresado en una unidad de cuidados intensivos: un caso clínico / Ventricular assist device as alternative to heart transplant in a hospitalized patient in an intensive care unit: Clinical case

Objetivo Presentar y analizar un caso clínico con el que se aborde el plan de cuidados de un paciente con asistencia ventricular permanente en una unidad de cuidados intensivos (UCI).Presentación del caso clínico Varón de 65 años de edad que ingresa en la UCI de un hospital universitario de nivel terciario en septiembre de 2011, tras implantarle el dispositivo de asistencia ventricular permanente (Heartmate II®).Discusión e implicaciones para la práctica El análisis del caso se estructura según las categorías que se identifican en la revisión de la literatura médica: prevención de riesgos y complicaciones, manejo del dispositivo y educación para la salud. Conclusión Este trabajo evidencia la importancia de instaurar un plan de cuidados protocolizado para los pacientes portadores de asistencia ventricular permanente en la UCI, lo que evitaría complicaciones en el post-operatorio inmediato, reduciría los costes y el tiempo de hospitalización (AU)

Objective To present and analyze a clinical case that addresses the care plan for a patient with permanent ventricular assist in an intensive care unit (ICU).Clinical case presentation A 65-year-old man admitted to an ICU in a tertiary teaching hospital in September 2011 after receiving an implant of a permanent ventricular assist device (Heartmate II®).Discussion and implications for practice The case analysis has been structured into 3 categories identified in the review of the literature: prevention of risks and complications, management of the device and health education. Conclusion This study shows the importance of establishing a protocolized care plan for the patients who are carriers of permanent ventricular assist in the ICU. This would avoid postoperative complications, reduce costs and hospitalization time (AU)

[Ventricular assist device as alternative to heart transplant in a hospitalized patient in an intensive care unit: clinical case]. / Asistencia ventricular definitiva como alternativa al trasplante cardíaco en un paciente ingresado en una unidad de cuidados intensivos: un caso clínico.

OBJECTIVE: To present and analyze a clinical case that addresses the care plan for a patient with permanent ventricular assist in an intensive care unit (ICU). CLINICAL CASE PRESENTATION: A 65-year-old man admitted to an ICU in a tertiary teaching hospital in September 2011 after receiving an implant of a permanent ventricular assist device (Heartmate II). DISCUSSION AND IMPLICATIONS FOR PRACTICE: The case analysis has been structured into 3 categories identified in the review of the literature: prevention of risks and complications, management of the device and health education. CONCLUSION: This study shows the importance of establishing a protocolized care plan for the patients who are carriers of permanent ventricular assist in the ICU. This would avoid postoperative complications, reduce costs and hospitalization time.

[Incidence rate trends for colorectal cancer in Navarre (North of Spain) in the 1990-2005 period]. / Tendencias en las tasas de incidencia de cáncer colorrectal en Navarra en el periodo 1990-2005.

BACKGROUND: In Spain, an increase in the incidence of colorectal cancer (CRC) has been observed in both sexes in recent years, probably due to an improved diagnostic, the westernization of dietary habits, and worse obesity levels, among others factors. In this work, the CRC incidence rate trends in different health areas in Navarre (northern Spain) are studied during the 1990-2005 period. METHODS: An estimated incidence trend curve for each health area and the corresponding confidence bands were obtained for each gender using P-spline models. RESULTS: These results show an increasing trend of CRC in most of the areas in both sexes, being less pronounced in women than in men. In the central area of Pamplona (the capital) a decreasing trend has been observed for men during the period studied. CONCLUSIONS: Primary prevention is the best strategy to change the increasing trend observed in most areas of the province of Navarre. However, a healthy lifestyle has long-term results, so it is important to have an early detection program that would serve as a short-term prevention strategy.