Disparities in Cancer Control in Central America and the Caribbean.

Central America and the Caribbean is a highly heterogeneous region comprising more than 30 countries and territories with more than 200 million inhabitants. Although recent advances in the region have improved access to cancer care, there are still many disparities and barriers for obtaining high-quality cancer treatments, particularly for those from disadvantaged populations, immigrants, and rural areas. In this article, we provide an overview of cancer care in Central America and the Caribbean, with selected examples of issues related to disparities in access to care and suggest solutions and strategies to move forward.

Anti-SARS-CoV-2 IgG antibodies pre- and post-vaccination behavior in health workers from a Guatemalan cancer center.

INTRODUCTION: The study of anti-SARS-CoV-2 IgG antibodies allows asymptomatic individuals with COVID-19 to be identified, and post-infection and post-vaccination immunity status to be evaluated. OBJECTIVE: To know the behavior of anti-SARS-CoV-2 IgG antibodies before and after vaccination in workers of a cancer center. METHODS: Prior to the application of the vaccine, the presence of anti-SARS-CoV-2 IgG antibodies (n = 171) was analyzed by evaluating anti-N IgG antibodies; post-vaccination, after receiving the second dose, anti-S IgG antibodies were evaluated (n = 60). RESULTS: Prior to vaccination, IgG antibodies were present in 18.71% of participants; they were detected in 65.22% of those with prior history of COVID-19 diagnosis and in 11.49% of those without it. The positions with the highest prevalence were nurses (28.26%), paramedics (27.59%) and administrative workers (27.78%), p < 0.01. Anosmia, ageusia and chest tightness were associated with the presence of IgG (p < 0.05). Post-vaccination, all participants developed IgG antibodies; people with a previous COVID-19 diagnosis had higher titers: 10,277 vs. 6,819 AU/mL, p < 0.001. CONCLUSIONS: The study of anti-SARS-CoV-2 IgG antibodies allowed asymptomatic health workers to be identified. A high percentage of participants with prior COVID-19 diagnosis had antibodies. All participants developed IgG antibodies after vaccination, with higher titers being identified in those with previous infection.

INTRODUCCIÓN: El estudio de anticuerpos IgG anti-SARS-CoV-2 permite identificar individuos asintomáticos con COVID-19 y evaluar la inmunidad posinfección y posvacunación. OBJETIVO: Conocer el comportamiento de los anticuerpos IgG anti-SARS-CoV-2 pre y posvacunación en trabajadores de un centro oncológico. MÉTODOS: Antes de aplicar la vacuna se analizaron los anticuerpos IgG anti-SARS-CoV-2 (n = 171) con la evaluación de IgG anti-N; después de la segunda dosis se evaluó IgG anti-S (n = 60). RESULTADOS: Prevacunación, los anticuerpos IgG estaban presentes en 18.71 % de los participantes; se detectaron en 65.22 % de aquellos con antecedente de diagnóstico de COVID-19 y en 11.49 % de aquellos sin antecedentes. Los profesiones con mayor prevalencia fueron enfermeros (28.26 %), paramédicos (27.59 %) y administrativos (27.78 %), p < 0.01. La anosmia, ageusia y opresión en el pecho se asociaron a la presencia de IgG (p < 0.05). Posvacunación, todos los participantes desarrollaron IgG; las personas con diagnóstico previo de COVID-19 presentaron mayores títulos: 10 277 versus 6819 UA/mL, p < 0.001. CONCLUSIONES: El estudio de anticuerpos IgG anti-SARS-CoV-2 permitió identificar a trabajadores de salud asintomáticos. Un alto porcentaje de los participantes con diagnóstico previo de COVID-19 presentó anticuerpos. Todos los participantes desarrollaron anticuerpos IgG posvacunación; las personas con infección previa presentaron una cuantificación más alta de títulos.

Comportamiento de anticuerpos IgG anti-SARS-CoV-2 en trabajadores de salud pre y posvacunación en un centro oncológico de Guatemala / Anti-SARS-CoV-2 IgG antibodies pre- and post-vaccination behavior in health workers from a Guatemalan cancer center

Resumen Introducción: El estudio de anticuerpos IgG anti-SARS-CoV-2 permite identificar individuos asintomáticos con COVID-19 y evaluar la inmunidad posinfección y posvacunación. Objetivo: Conocer el comportamiento de los anticuerpos IgG anti-SARS-CoV-2 pre y posvacunación en trabajadores de un centro oncológico. Métodos: Antes de aplicar la vacuna se analizaron los anticuerpos IgG anti-SARS-CoV-2 (n = 171) con la evaluación de IgG anti-N; después de la segunda dosis se evaluó IgG anti-S (n = 60). Resultados: Prevacunación, los anticuerpos IgG estaban presentes en 18.71 % de los participantes; se detectaron en 65.22 % de aquellos con antecedente de diagnóstico de COVID-19 y en 11.49 % de aquellos sin antecedentes. Los profesiones con mayor prevalencia fueron enfermeros (28.26 %), paramédicos (27.59 %) y administrativos (27.78 %), p < 0.01. La anosmia, ageusia y opresión en el pecho se asociaron a la presencia de IgG (p < 0.05). Posvacunación, todos los participantes desarrollaron IgG; las personas con diagnóstico previo de COVID-19 presentaron mayores títulos: 10 277 versus 6819 UA/mL, p < 0.001. Conclusiones: El estudio de anticuerpos IgG anti-SARS-CoV-2 permitió identificar a trabajadores de salud asintomáticos. Un alto porcentaje de los participantes con diagnóstico previo de COVID-19 presentó anticuerpos. Todos los participantes desarrollaron anticuerpos IgG posvacunación; las personas con infección previa presentaron una cuantificación más alta de títulos.

Abstract Introduction: The study of anti-SARS-CoV-2 IgG antibodies allows asymptomatic individuals with COVID-19 to be identified, and post-infection and post-vaccination immunity status to be evaluated. Objective: To know the behavior of anti-SARS-CoV-2 IgG antibodies before and after vaccination in workers of a cancer center. Methods: Prior to the application of the vaccine, the presence of anti-SARS-CoV-2 IgG antibodies (n = 171) was analyzed by evaluating anti-N IgG antibodies; post-vaccination, after receiving the second dose, anti-S IgG antibodies were evaluated (n = 60). Results: Prior to vaccination, IgG antibodies were present in 18.71% of participants; they were detected in 65.22% of those with prior history of COVID-19 diagnosis and in 11.49% of those without it. The positions with the highest prevalence were nurses (28.26%), paramedics (27.59%) and administrative workers (27.78%), p < 0.01. Anosmia, ageusia and chest tightness were associated with the presence of IgG (p < 0.05). Post-vaccination, all participants developed IgG antibodies; people with a previous COVID-19 diagnosis had higher titers: 10,277 vs. 6,819 AU/mL, p < 0.001. Conclusions: The study of anti-SARS-CoV-2 IgG allowed asymptomatic health workers to be identified. A high percentage of participants with prior COVID-19 diagnosis had antibodies. All participants developed IgG after vaccination, with higher titers being identified in those with previous infection.

Years of Potential Life Lost Because of Breast and Cervical Cancers in Guatemala.

PURPOSE: Worldwide cervical and breast cancers are among the most commonly diagnosed cancers and are leading cause of cancer deaths among females in low- and middle-income countries. In Guatemala, breast and cervical cancers are the main cause of cancer-related deaths among women. Therefore, the aim of this study was to determine the years of potential life lost (YPLL) as an indicator of premature deaths as a result of breast and cervical cancers. METHODS: Data on the number of deaths as a result of breast and cervical cancers (International Classification of Diseases [10th revision] codes C50 and C53) between 2012 and 2016 and age composition by quinquennials were retrieved from the Health Information System of the Guatemalan Health Ministry. On the basis of each individual's age at death, YPLL was estimated for females between 20 and 70 years of age. RESULTS: A total of 1,476 deaths related to breast and cervical cancers was reported over the study period. The trend in breast cancer mortality rate and YPLL did not change from 2012 to 2016. The cervical cancer mortality rate has decreased to 10 deaths per 1 million habitants (P = .046). There has been a reduction in YPLL because of cervical cancer, from 50.18 YPLL in 2012 to 29.19 YPLL by 2016, mainly in women between 30 and 34 years of age, in whom YPLL decreased from 600 to 112.50 (P = .046). CONCLUSION: Cervical cancer screening has significantly reduced the mortality rate of this malignancy, and screening of breast cancer must include creating awareness of the disease and providing access to women at risk.

Liver Cancer in Guatemala: An Analysis of Mortality and Incidence Trends From 2012 to 2016.

PURPOSE: Guatemala has the highest mortality and incidence of liver cancer in Central and South America. The aim of this study is to describe the extent of liver cancer in the country from 2012 to 2016 and the associated risk factors. METHODS: A secondary analysis was performed using liver cancer mortality and morbidity data and data on risk factors, such as hepatitis B virus infection, cirrhosis, and alcoholism. RESULTS: Analysis revealed that liver cancer causes approximately 20% of cancer deaths in the country, is more frequent in the population older than age 65 years old, and is increasing in those age 30 to 44 years. More than 25% of deaths occurred in the North and West regions. The incidence of major risk factors for development of liver cancer has decreased. CONCLUSION: The high mortality of liver cancer compared with its incidence indicates that most patients are diagnosed at late stages. To reduce the burden of liver cancer, creation of strategies for earlier detection is needed.