¿Los trastornos por cocaína asociados al infarto agudo de miocardio son lo mismo que el infarto de miocardio asociado al consumo reciente de cocaína?. Respuesta / Is cocaine-associated acute myocardial infarction the same as myocardial infarction associated with recent cocaine consumption?. Response

No disponible

Epidemiología de los efectos clínico-asistenciales asociados al consumo de cocaína. Respuesta / The epidemiology of the clinical and health effects associated with cocaine. Response

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Trastornos por cocaína e infarto agudo de miocardio, prolongación de estancias y exceso de costes hospitalarios / Cocaine Use Disorders and Acute Myocardial Infarction, Excess Length of Hospital Stay and Overexpenditure

Introducción y objetivos Analizar la relación entre la prevalencia de trastornos por cocaína y el infarto agudo de miocardio en pacientes ≥ 18 años y su influencia en la mortalidad, la prolongación de estancias y el exceso de costes de los pacientes con infarto agudo de miocardio. Métodos Estudio retrospectivo de los datos del conjunto mínimo básico de datos de 87 hospitales españoles durante 2008-2010.ResultadosSe estudiaron 5.575.325 ingresos, entre los cuales hubo 24.126 pacientes con trastornos por cocaína y 79.076 casos de infarto agudo de miocardio. La prevalencia de infarto agudo de miocardio entre los pacientes con trastornos por cocaína aumentó con la edad, y fue máxima entre los de 55-64 años de edad (p < 0,0001). El análisis multivariable indicó que los trastornos por cocaína son más prevalentes entre los pacientes con infarto agudo de miocardio (odds ratio = 3,0) e independientemente de edad, sexo, otras adicciones y 30 comorbilidades. Entre los pacientes con infarto agudo de miocardio, aquellos con trastornos por cocaína no presentaron mayor mortalidad, pero sí una prolongación indebida de las estancias hospitalarias (1,5 días) y un exceso de costes (382 euros).Conclusiones Hay una asociación entre los trastornos por cocaína y el infarto agudo de miocardio. Estos trastornos prolongan las estancias hospitalarias y aumentan los costes de los pacientes hospitalizados. La interrupción del uso de la droga debe ser uno de los principales objetivos terapéuticos tras el alta del paciente (AU)

Introduction and objectives To investigate the relationship between the prevalence of cocaine use disorders and acute myocardial infarction in patients aged ≥ 18 years and to estimate the influence of cocaine use disorders on mortality, excess length of stay, and overexpenditure among hospitalized patients with acute myocardial infarction. Methods Retrospective study of the minimum basic data set of 87 Spanish hospitals from 2008 to 2010.ResultsAmong 5 575 325 admissions reviewed, there were 24 126 patients with cocaine use disorders and 79 076 cases of acute myocardial infarction. The incidence of acute myocardial infarction among patients with cocaine use disorders increased with age and reached a peak at 55 years to 64 years (P < .0001). Multivariate analysis showed that cocaine use disorders were more prevalent among patients with acute myocardial infarction independently of age, sex, other addictive disorders, and 30 other comorbidities (odds ratio = 3.0). Among patients with acute myocardial infarction, those with cocaine use disorders did not show an increase of in-hospital death, but did show excess length of hospital stay (1.5 days) and overexpenditure (382 euros). Conclusions Cocaine use disorders are associated with acute myocardial infarction and increase the length of hospital stay and overexpenditure among acute myocardial infarction patients. Cessation of cocaine use among these patients should be one of the primary therapeutic goals after hospital discharge(AU)

Cocaine use disorders and acute myocardial infarction, excess length of hospital stay and overexpenditure.

INTRODUCTION AND OBJECTIVES: To investigate the relationship between the prevalence of cocaine use disorders and acute myocardial infarction in patients aged ≥ 18 years and to estimate the influence of cocaine use disorders on mortality, excess length of stay, and overexpenditure among hospitalized patients with acute myocardial infarction. METHODS: Retrospective study of the minimum basic data set of 87 Spanish hospitals from 2008 to 2010. RESULTS: Among 5 575 325 admissions reviewed, there were 24 126 patients with cocaine use disorders and 79 076 cases of acute myocardial infarction. The incidence of acute myocardial infarction among patients with cocaine use disorders increased with age and reached a peak at 55 years to 64 years (P < .0001). Multivariate analysis showed that cocaine use disorders were more prevalent among patients with acute myocardial infarction independently of age, sex, other addictive disorders, and 30 other comorbidities (odds ratio = 3.0). Among patients with acute myocardial infarction, those with cocaine use disorders did not show an increase of in-hospital death, but did show excess length of hospital stay (1.5 days) and overexpenditure (382 euros). CONCLUSIONS: Cocaine use disorders are associated with acute myocardial infarction and increase the length of hospital stay and overexpenditure among acute myocardial infarction patients. Cessation of cocaine use among these patients should be one of the primary therapeutic goals after hospital discharge.

Enfermedad celiaca y trastornos por consumo de alcohol: prolongación de estancias, exceso de costes y mortalidad atribuible / Celiac disease and alcohol use disorders: Increased length of hospital stay, overexpenditures and attributable mortality

Antecedentes y objetivos: los trastornos por consumo de alcohol se han asociado a una mayor incidencia de ciertas comorbilidades entre los pacientes con enfermedad celiaca. En la actualidad no disponemos de información sobre si estos trastornos tienen un impacto en la prolongación de las estancias hospitalarias, mayores costes por estancia y un exceso de mortalidad entre estos pacientes. Métodos: Se hizo un estudio de casos y controles a partir de una muestra de pacientes de 18 o más años de edad hospitalizados durante 2008-2010 en 87 hospitales de España. Las estimaciones de prolongación de estancias, exceso de costes y mortalidad atribuible se calcularon mediante un modelo de análisis multivariante de la covarianza que incluyó edad, género, grupo hospitalario, trastornos por alcohol, trastornos por tabaco y 30 comorbilidades. Resultados: los pacientes de enfermedad celiaca con trastornos por alcohol presentaron una prolongación de estancias de 3,1 días en las mujeres y de 1,7 días en los varones, un exceso de costes por estancia de 838,7 euros en las mujeres y de 389,1 euros en los varones, y un exceso de mortalidad atribuible de 15,1 % en las mujeres y de 12,2 % en los varones. Conclusiones: además de una dieta sin gluten y otras medidas asistenciales, en estos pacientes está indicada la prevención del abuso de alcohol, y los hospitalizados que presentan estos trastornos deberían recibir asistencia especializada tras el alta hospitalaria. La detección e intervención precoz debería intentar prevenir el desarrollo de lesiones orgánicas y no centrarse exclusivamente en varones (AU)

Background and objectives: alcohol use disorders are associated with a greater incidence of certain comorbidities in patients with celiac disease. Currently there is no available information about the impact that these disorders may have on length of hospital stays, overexpenditures during hospital stays, and excess mortality in these patients. Methods: a case-control study was conducted with a selection of patients 18 years and older hospitalized during 2008-2010 in 87 hospitals in Spain. Estimations of excess length of stays, costs, and attributable mortality were calculated using a multivariate analysis of covariance, which included age, gender, hospital group, alcohol use disorders, tobacco related disease and 30 other comorbidities. Results: patients who had both celiac disease and alcohol use disorders had an increased length of hospital stay, an average of 3.1 days longer in women, and 1.7 days longer in men. Excess costs per stay ranged from 838.7 euros in female patients, to 389.1 euros in male patients. Excess attributable mortality was 15.1 % in women, 12.2 % in men. Conclusions: apart from a gluten-free diet and other medical measures, the prevention of alcohol abuse is indicated in these patients. Patients hospitalized who present these disorders should receive specialized attention after leaving the hospital. Early detection and treatment should be used to prevent the appearance of organic lesions and should not be solely focused on male patients (AU)

Celiac disease and alcohol use disorders: increased length of hospital stay, overexpenditures and attributable mortality.

BACKGROUND AND OBJECTIVES: alcohol use disorders are associated with a greater incidence of certain comorbidities in patients with celiac disease. Currently there is no available information about the impact that these disorders may have on length of hospital stays, overexpenditures during hospital stays, and excess mortality in these patients. METHODS: a case-control study was conducted with a selection of patients 18 years and older hospitalized during 2008-2010 in 87 hospitals in Spain. Estimations of excess length of stays, costs, and attributable mortality were calculated using a multivariate analysis of covariance, which included age, gender, hospital group, alcohol use disorders, tobacco related disease and 30 other comorbidities. RESULTS: patients who had both celiac disease and alcohol use disorders had an increased length of hospital stay, an average of 3.1 days longer in women, and 1.7 days longer in men. Excess costs per stay ranged from 838.7 euros in female patients, to 389.1 euros in male patients. Excess attributable mortality was 15.1 % in women, 12.2 % in men. CONCLUSIONS: apart from a gluten-free diet and other medical measures, the prevention of alcohol abuse is indicated in these patients. Patients hospitalized who present these disorders should receive specialized attention after leaving the hospital. Early detection and treatment should be used to prevent the appearance of organic lesions and should not be solely focused on male patients.

Incidence of colorectal cancer and influence of dietary habits in fifteen European countries from 1971 to 2002

Objective This study aimed to analyze the incidence of colorectal cancer in 15 European countries in recent decades and the relationship between the incidence found and changes in dietary habits .Methods Pearson's or Spearman's correlation coefficients were calculated by comparing incidence rates obtained from the International Agency for Research on Cancer for 1971-2002 with data on per capita consumption obtained from the Food and Agriculture Organization of the United Nations using 10-year delay intervals. Results Incidence rates increased in all countries except France in men and except Austria, Denmark, England and France in women. Of the dietary variables considered, there were marked increasing trends (linear regression coefficient, R ≥0.5) in red meat consumption in Germany (R = 0.9), Austria (R = 0.7), Finland (R = 0.8), Italy (R = 0.9), Poland (R = 0.5), Spain (R = 2.1), Sweden (R = 0.6), and the Netherlands (R = 0.7).Conclusions Changes in dietary habits may be consistent with the observed trends in the incidence of colorectal cancer in the distinct European countries (AU)

Introducción Este estudio analiza la incidencia de cáncer colorrectal en 15 países europeos en las últimas décadas y su relación con cambios en los hábitos alimenticios. Métodos Coeficientes de correlación de Pearson/Spearman calculados comparando las tasas de incidencia obtenidas de International Agency for Research on Cancer durante 1971-2002 con los consumos per cápita obtenidos de Food and Agriculture Organization con intervalos de retardo de 10 años. Resultados Las tasas de incidencia aumentan en todos los países, excepto en Francia, en los hombres, y en Austria, Dinamarca, Inglaterra y Francia en las mujeres. De las variables de la dieta estudiadas, hay marcadas tendencias crecientes (coeficiente de regresión lineal, R ≥0,5) para carne roja en Alemania (R = 0,9), Austria (R = 0,7), España (R = 2,1), Finlandia (R = 0,8), Italia (R = 0,9), Países Bajos (R = 0,7), Polonia (R = 0,5) y Suecia (R = 0,6).Conclusiones Los cambios en los hábitos dietéticos pueden ser concordantes con las tendencias de la incidencia de cáncer colorrectal observadas en diferentes países (AU)

Incidence of colorectal cancer and influence of dietary habits in fifteen European countries from 1971 to 2002.

OBJECTIVE: This study aimed to analyze the incidence of colorectal cancer in 15 European countries in recent decades and the relationship between the incidence found and changes in dietary habits. METHODS: Pearson's or Spearman's correlation coefficients were calculated by comparing incidence rates obtained from the International Agency for Research on Cancer for 1971-2002 with data on per capita consumption obtained from the Food and Agriculture Organization of the United Nations using 10-year delay intervals. RESULTS: Incidence rates increased in all countries except France in men and except Austria, Denmark, England and France in women. Of the dietary variables considered, there were marked increasing trends (linear regression coefficient, R ≥0.5) in red meat consumption in Germany (R = 0.9), Austria (R = 0.7), Finland (R = 0.8), Italy (R = 0.9), Poland (R = 0.5), Spain (R = 2.1), Sweden (R = 0.6), and the Netherlands (R = 0.7). CONCLUSIONS: Changes in dietary habits may be consistent with the observed trends in the incidence of colorectal cancer in the distinct European countries.

Impacto de las comorbilidades en la mortalidad hospitalaria por infarto agudo de miocardio durante el periodo 2003-2009 / Impact of comorbidities on in-hospital mortality from acute myocardial infarction, 2003-2009

Introducción y objetivos. El tratamiento del infarto agudo de miocardio ha cambiado notablemente en los últimos años. El objetivo del estudio es analizar la tendencia de su mortalidad hospitalaria durante el periodo 2003-2009, la evolución de los indicadores de comorbilidad y su impacto en los modelos predictivos de mortalidad usando los datos del conjunto mínimo básico de datos. Métodos. Durante el periodo estudiado, ingresaron 5.275 casos de infarto agudo de miocardio. Se miden las tasas de mortalidad por edad y sexo y se calculan los índices de comorbilidad de Charlson y de Elixhauser de cada paciente en el momento del ingreso. Se analizan sus tendencias y se estudia su validez. Se elaboran y se comparan modelos multivariables predictivos de mortalidad. Resultados. Durante 2003-2009 aumentaron la media de edad y las comorbilidades. A pesar de ello, la mortalidad disminuyó. Al aplicar el criterio «presente en el momento del ingreso», los índices de comorbilidad mantuvieron su validez. Los modelos multivariables incluyeron edad, sexo, tratamiento médico, revascularización coronaria y un índice de comorbilidad o comorbilidades específicas. Este presentó la mejor capacidad predictiva. Todos los modelos encontraron que la edad y las comorbilidades aumentaban el riesgo de mortalidad y que la revascularización y el tratamiento con anticoagulantes, fibrinolíticos y antiagregantes plaquetarios la disminuían. Conclusiones. A pesar de que cada año ingresan pacientes con infarto agudo de miocardio de más edad y con más comorbilidades, su mortalidad va reduciéndose, probablemente por el uso más frecuente de la revascularización coronaria y al mejor tratamiento médico (AU)

Introduction and objectives. Treatment of acute myocardial infarction has changed notably in recent years. The objective of this study was to analyze trends in in-hospital mortality during the period 2003-2009 and to examine how changes in comorbidity indices affected mortality prediction models for acute myocardial infarction using the minimum basic data set. Methods. During the study period, 5275 cases of acute myocardial infarction were admitted. Mortality rates were calculated by age and sex and Charlson and Elixhauser comorbidity index scores were obtained on admission for every patient. Trends were analyzed and their validity studied. Multivariate models predictive of mortality were derived and compared. Results. Mean age and comorbidities increased in all patients over the period 2003-2009. In spite of these trends, acute myocardial infarction mortality decreased. Comorbidity indices remained valid when the criterion “present on admission” was applied. Multivariate predictive models included age, sex, medical treatment, coronary revascularization and a comorbidity index or specific comorbidities. The model with specific comorbidities showed the best predictive ability. All models found that age and comorbidities increased the risk of death, and that coronary revascularization and treatment with anticoagulants, fibrinolytics, and platelet antiaggregants were protective factors. Conclusions. Despite the fact that the mean age and number of comorbidities in acute myocardial infarction patients has increased year over year, acute myocardial infarction mortality has decreased, probably because of more frequent reperfusion and revascularization therapy and better medical treatment (AU)

Effects of changes in dietary habits on colorectal cancer incidence in twenty countries from four continents during the period 1971-2002.

INTRODUCTION: the incidence of colorectal cancer is one of the highest on a global level. Many epidemiological studies have identified risk and protective factors, many of which have a behavioral component and, therefore, are potentially avoidable or subject to modification. This study investigated the incidence rates of colorectal cancer by gender in twenty different countries, taking into account the dietary habits of the habitants of each country. MATERIAL AND METHODS: adjusted incidence rates, according to gender, were obtained for each country from the International Agency for Research on Cancer during the period 1971-2002.Annual per capita consumption data of the different dietary variables were obtained for the period 1961-2007 from the Food and Agriculture Organization of the United Nations. Pearson's correlation coefficients were calculated comparing incidence rates according to gender with different dietary variable using ten-year delay intervals. RESULTS: there is an important variation in trends of colorectal cancer incidence worldwide which were found to be related with the dietary habits of each country. DISCUSSION: based on the trends observed, each country was classified into one of four different situations based on the range of values of their incidence rates and linear trends observed. Due to the potential of primary prevention programs for colorectal cancer and to the delay between changes in the exposure to risk and protective factors and the effects on the incidence of this tumor, the application of legislative and educational measures promoting a healthy diet has become an urgent issue to stop the increasing tendency of colorectal cancer reported worldwide.

[Impact of comorbidities on in-hospital mortality from acute myocardial infarction, 2003-2009]. / Impacto de las comorbilidades en la mortalidad hospitalaria por infarto agudo de miocardio durante el periodo 2003-2009.

INTRODUCTION AND OBJECTIVES: Treatment of acute myocardial infarction has changed notably in recent years. The objective of this study was to analyze trends in in-hospital mortality during the period 2003-2009 and to examine how changes in comorbidity indices affected mortality prediction models for acute myocardial infarction using the minimum basic data set. METHODS: During the study period, 5275 cases of acute myocardial infarction were admitted. Mortality rates were calculated by age and sex and Charlson and Elixhauser comorbidity index scores were obtained on admission for every patient. Trends were analyzed and their validity studied. Multivariate models predictive of mortality were derived and compared. RESULTS: Mean age and comorbidities increased in all patients over the period 2003-2009. In spite of these trends, acute myocardial infarction mortality decreased. Comorbidity indices remained valid when the criterion "present on admission" was applied. Multivariate predictive models included age, sex, medical treatment, coronary revascularization and a comorbidity index or specific comorbidities. The model with specific comorbidities showed the best predictive ability. All models found that age and comorbidities increased the risk of death, and that coronary revascularization and treatment with anticoagulants, fibrinolytics, and platelet antiaggregants were protective factors. CONCLUSIONS: Despite the fact that the mean age and number of comorbidities in acute myocardial infarction patients has increased year over year, acute myocardial infarction mortality has decreased, probably because of more frequent reperfusion and revascularization therapy and better medical treatment.

Efectos de cambios en los patrones dietéticos sobre la incidencia de cáncer colorrectal en veinte países de cuatro continentes durante 1971-2002 / Effects of changes in dietary habits on colorectal cancer incidence in twenty countries from four continents during the period 1971-2002

Introducción: el cáncer colorrectal es uno de los tumores de mayor incidencia a nivel mundial. Numerosos estudios epidemiológicos han identificado diversos factores de riesgo y protección, muchos de ellos asociados al comportamiento y que, por tanto, son potencialmente evitables o modificables. Este estudio analiza la incidencia de cáncer colorrectal, según género, en veinte países diferentes, teniendo en cuenta los hábitos dietéticos de la población en cada país. Material y métodos: las tasas ajustadas de incidencia, según género, se obtuvieron para cada país de Internacional Agency for Research on Cancer en el periodo 1971-2002. Los datos de consumo anual per cápita de las diferentes variables dietéticas se obtuvieron para el periodo 1961-2007 de Food and Agriculture Organization of United Nations. Los coeficientes de correlación de Pearson se calcularon comparando las tasas de incidencia, según género, con las diferentes variables dietéticas con un retardo de diez años. Resultados: hay importantes variaciones en las tendencias de incidencia de cáncer colorrectal en todo el mundo que pueden estar relacionadas con los hábitos dietéticos de cada país. Discusión: cada uno de los países analizados queda encuadrado en una de cuarto situaciones distintas considerando el rango de valores que toman sus tasas de incidencia y las tendencias lineales de estas en el periodo de estudio. Partiendo del enorme potencial de prevención primaria de este tumor y del desfase temporal para que los cambios en la exposición a los factores de riesgo y protección modifiquen la incidencia del tumor, se deben aplicar, de forma urgente, medidas legislativas y educativas que promuevan dietas saludables que contribuyan a detener la tendencia creciente de la incidencia del cáncer colorrectal a nivel mundial(AU)

Introduction: the incidence of colorectal cancer is one of the highest on a global level. Many epidemiological studies have identified risk and protective factors, many of which have a behavioral component and, therefore, are potentially avoidable or subject to modification. This study investigated the incidence rates of colorectal cancer by gender in twenty different countries, taking into account the dietary habits of the habitants of each country. Material and methods: adjusted incidence rates, according to gender, were obtained for each country from the International Agency for Research on Cancer during the period 1971-2002. Annual per capita consumption data of the different dietary variables were obtained for the period 1961-2007 from the Food and Agriculture Organization of the United Nations. Pearson’s correlation coefficients were calculated comparing incidence rates accord ing to gender with different dietary variable using ten-year delay intervals. Results: there is an important variation in trends of colorectal cancer incidence worldwide which were found to be related with the dietary habits of each country. Discussion: based on the trends observed, each country was classified into one of four different situations based on the range of values of their incidence rates and linear trends observed. Due to the potential of primary prevention programs for colorectal cancer and to the delay between changes in the exposure to risk and protective factors and the effects on the incidence of this tumor, the application of legislative and educational measures promoting a healthy diet has become an urgent issue to stop the increasing tendency of colorectal cancer reported worldwide(AU)

Tendencia de cáncer colorrectal en España durante 1951–2007 y consumo de alcohol y cigarrillos / Trends in colorectal cancer in Spain from 1951–2007 and alcohol and cigarette consumption

Material y métodosAnálisis de correlación entre las tasas de incidencia, mortalidad y años potenciales de vida perdidos y la edad media del fallecimiento y el consumo per cápita de alcohol y cigarrillos con un período de retardo de 15 años.ResultadosLa incidencia de cáncer colorrectal ha experimentado un aumento constante en ambos sexos en contraposición con lo ocurrido en otros países. La mortalidad aumentó durante el período 1951–2000, para después estabilizarse en varones y decrecer en mujeres. Los años potenciales de vida perdidos presentan un comportamiento similar a la mortalidad, mientras que la edad media del fallecimiento experimenta un continuo aumento en el período de estudio en ambos sexos.ResultadosEn cuanto al consumo de alcohol, los coeficientes en ambos sexos varían desde 0,41 a 0,67 y destacan los valores obtenidos en relación con la incidencia en Zaragoza. Para el consumo de cigarrillos, los coeficientes de correlación presentan valores positivos próximos a uno respecto a la incidencia en Navarra y Zaragoza y algo menores para la mortalidad y los años potenciales de vida perdidos en ambos sexos.ConclusionesSe deben aplicar medidas legislativas y educativas en materia de promoción de la salud respecto al consumo de alcohol y cigarrillos por parte de las autoridades de forma urgente para disminuir las tasas de incidencia, mortalidad y años potenciales de vida perdidos por cáncer colorrectal(AU)

ObjectivesTo analyze trends in colorectal cancer in Spain from 1951–2007, and their relationship with alcohol and cigarette consumption.Material and methodsWe performed a correlation analysis between incidence, mortality and potential years of life lost rates, the mean age at death, and per capita consumption of alcohol and cigarettes with a time span of 15 years.ResultsIn contrast with the tendency in other countries, the incidence of colorectal cancer steadily increased in both genders. Mortality increased from 1951–2000 and then stabilized in men and decreased in women. Years of potential life lost showed a similar pattern to mortality, while the mean age at death continuously increased during the study period in both genders.ResultsFor alcohol consumption, the coefficients in both genders ranged from 0.41 to 0.67, with the highest incidence values being obtained for Zaragoza. For cigarette consumption, the correlation coefficients showed positive values close to 1 in the incidence in Zaragoza and Navarre, and somewhat lower values for mortality and potential years of life lost in both genders.ConclusionsLegislative measures on alcohol and cigarette consumption should be urgently applied by authorities in the field of education and health promotion to decrease the incidence, mortality and potential years of life lost rates for colorectal cancer(AU)

[Trends in colorectal cancer in Spain from 1951-2007 and alcohol and cigarette consumption]. / Tendencia de cáncer colorrectal en España durante 1951-2007 y consumo de alcohol y cigarrillos.

OBJECTIVES: To analyze trends in colorectal cancer in Spain from 1951-2007, and their relationship with alcohol and cigarette consumption. MATERIAL AND METHODS: We performed a correlation analysis between incidence, mortality and potential years of life lost rates, the mean age at death, and per capita consumption of alcohol and cigarettes with a time span of 15 years. RESULTS: In contrast with the tendency in other countries, the incidence of colorectal cancer steadily increased in both genders. Mortality increased from 1951-2000 and then stabilized in men and decreased in women. Years of potential life lost showed a similar pattern to mortality, while the mean age at death continuously increased during the study period in both genders. For alcohol consumption, the coefficients in both genders ranged from 0.41 to 0.67, with the highest incidence values being obtained for Zaragoza. For cigarette consumption, the correlation coefficients showed positive values close to 1 in the incidence in Zaragoza and Navarre, and somewhat lower values for mortality and potential years of life lost in both genders. CONCLUSIONS: Legislative measures on alcohol and cigarette consumption should be urgently applied by authorities in the field of education and health promotion to decrease the incidence, mortality and potential years of life lost rates for colorectal cancer.

Incidence and mortality by colorectal cancer in Spain during 1951-2006 and its relationship with behavioural factors.

Incidence of colorectal cancer has steadily increased in both the sexes and across all age groups during the last decades in Spain, in contrast with other countries where incidence decreased during this period. This increase is more marked among men, probably due to a high exposure to risk factors such as smoking, heavy drinking, overweight and diabetes. Annual age-adjusted mortality rates have increased in Spain during the period 1951-2000, but from that time until 2006 these rates have kept steady in males and fallen in females. When analyzing the evolution of exposure to behavioural factors during this period, known as risk or protective factors for colorectal cancer in Spain, notorious increases in tobacco and alcohol consumption, red and processed meats intake and a decreased ingestion of vegetables, cereals and beans were observed. Cigarette smoking, alcohol consumption, red meats, poultry, fish, vegetables and fruit were highly, positively correlated with colorectal cancer incidence and mortality, and cereals and beans consumption showed strong, negative correlations. At the same time and during this period, physical exercise decreased and overweight, obesity and diabetes mellitus notably increased. Certain changes in diet and lifestyle can be attributed to the growth in income during the last decades, but the lack and delay in implementing legislative and educational measures by the State and Regional Governments during decades cannot be ignored. In colorectal cancer, a minimal time span of 10-15 years is necessary for changes in exposure to risk factors to be able to modify the incidence of the tumour. Therefore, the implementation of more vigorous legislative and educational measures in Spain against smoking, heavy drinking, red meat intake, sedentary lifestyle, overweight and others reviewed in this study, is urgent.

Mortalidad evitable y cáncer de colon y recto / Avoidable mortality and colorectal cancer

No disponible