ABSTRACT
The incidence of malignant trophoblastic diseases from 1960 to 1969 and 1970 to 1974 in the population of Parguay was low, as shown by the analysis of unselected hospital admissions as compared to the total population. Paraguay showed disease characteristics comparable to those of developing countries where malignant diseases of the trophoblast have elevated frequencies. The apparently high frequencies in lower socioeconomic groups appear to be due to the fact that these groups make up a large proportion of the hospital population. The hardship of poverty predisposes to the hospital concentration of pathologic pregnancies from around the country and to the home delivery of grossly normal gestations. Thus, a biased incidence of diseases results.
PIP: The incidence of malignant trophoblastic diseases in the population of Paraguay was low in the 1960-1969 and 1970-1974 periods, as shown by the analysis of unselected hospital admissions as compared to the total population. The Institute of Pathologic Anatomy and the National Tumor Registry in Asuncion, Paraguay, receive material from the entire republic. Cases are reported from all the affiliated centers. During the 10 years from 1960-1970, 227 cases of hydatidiform mole, 21 of choriocarcinoma, and 13 of chorioadenoma destruens were registered. In the 1970-1974 period, 121 hydatiform moles, 10 choriocarcinomas, and 3 chorioadenomas destruens were registered. To determine the incidence of choriocarcinoma and chorioadenoma destruens for Paraguay, the number of cases was divided by the number of total pregnancies, calculated from an analysis of 1965 estimates and related to the fertility rate in each age group. Using the estimated number of total pregnancies per year in Paraguay, there is 1 choriocarcinoma per 43,489 pregnancies and 1 chorioadenoma destruens per 70,252 pregnancies if all the probable pregnancies in the period of fertility are considered. Thus, the incidence of choriocarcinoma and chorioadenoma destruens is 0.229 and 0.142/1000 pregnancies, respectively. This means that 25.22 hydatidiform moles occur for 1 carcinoma or 17.46 hydatidiform moles for 1 chorioadenoma destruens. There were no differences in the calculations for the 1970-1974 period. Vaginal metastases were found in 28.57% of the patients with choriocarcinoma.