Survival in stomach cancer: analysis of a national cancer information system and a population-based cancer registry in Colombia

Background: Stomach cancer is among the most frequent, is a leading cause of mortality in low- and middle-income countries. Assessing its survival is important to guide evidence-based health policies. Aims: To estimate stomach cancer survival in Colombia (2014-2019) with data from the National Cancer Information System (NCIS) and in Cali with data from the Cali Population Cancer Registry (RPCC) (1998-2017). Methods: NCIS estimated the overall 3-year net survival for 8,549 people, while RPCC estimated 5-year net survival for 6,776 people. Results: The 3-year net survival was 36.8% (95% CI: 35.5-38.1). Net survival was higher in people with special insurance (61.7%; 95% CI: 44.8-74.8) or third payer (40.5%; 95% CI: 38.7-42.3) than state insurance (30.7%; 95% CI: 28.7-32.8). It was also higher in women and people diagnosed at early stages. Multivariable analysis showed consistency with survival estimations with a higher risk of death in men, people with state insurance, and diagnosed at advanced stages. In Cali, the 5-year net survival remained stable in men during the last 20 years. In women the 5-year net survival in women increased 8.60 percentage points, equivalent to a 50% increase compared to the 1998-2002 period. For 2013-17, it was 19.1% (95%CI: 16.2-22.2) in men, and 24.8% (95% CI: 20.4-29.3) in women. Conclusions: Population survival estimates from the RPCC were lower than those observed in the NCIS. The differences in their methods and scope can explain variability. Nevertheless, our findings could be complementary to improve cancer control planning in the country.

Antecedentes: El cáncer de estómago se encuentra entre los más frecuentes y es una de las principales causas de mortalidad en los países de ingresos bajos y medianos. Evaluar su supervivencia es importante para orientar las políticas de salud basadas en la evidencia. Objetivos: Estimar la supervivencia del cáncer de estómago en Colombia (2014-2019) con datos del Sistema Nacional de Información del Cáncer (NCIS) y en Cali con datos del Registro Poblacional de Cáncer de Cali (RPCC) (1998-2017). Métodos: El NCIS estimó la supervivencia neta a tres años para 8,549 personas y el RPCC la calculó a 5 años para 6,776 personas registradas en sus bases de datos. Resultados: La supervivencia neta a tres años en Colombia fue del 36.8% (IC 95%: 35.5-38.1). La supervivencia neta fue mayor en personas con seguro especial (61.7%; IC 95%: 44.8-74.8) o tercer pagador (40.5%; IC 95%: 38.7-42.3) que el seguro estatal (30.7%; IC 95%: 28.7-32.8). También fue mayor en mujeres y personas diagnosticadas en etapas tempranas. El análisis multivariable mostró consistencia con la estimación de supervivencia con mayor riesgo de muerte en hombres, personas con seguro estatal y diagnosticados en estadios avanzados. En Cali, la supervivencia neta a 5 años se mantuvo estable en los hombres durante los últimos 20 años. En las mujeres aumentó 8.60 puntos porcentuales, equivalente a un aumento del 50% en comparación con el período 1998-2002. Para el período 2013-17 fue 19.1% (IC 95%: 16.2-22.2) en los hombres y 24.8% (IC 95%: 20.4-29.3) en las mujeres. Conclusiones: Las estimaciones de supervivencia del RPCC fueron más bajas que las obtenidas por el NCIS. Las diferencias en sus métodos y alcance pueden explicar la variabilidad. Sin embargo, nuestros hallazgos pueden ser complementarios para mejorar la planificación del control del cáncer en el país..

Protocolo del Estudio Poblacional Multinivel de las Desigualdades Socioeconómicas en la Distribución Geográfica de la Incidencia, la Mortalidad y la Supervivencia Neta del Cáncer en España: Estudio DESOCANES / Study protocol on Socioeconomic and Geographic Inequalities in Cancer Incidence, Mortality and Survival in Spain: Multilevel Population-Base Study: DESOCANES study

La incidencia y la mortalidad brindan información sobre la carga de la morbilidad del cáncer y los años potenciales de vida perdidos debido al cáncer. Se ha desarrollado el Índice de Privación (IP) como una medida estandarizada para medir la privación socioeconómica en España a nivel de sección censal. Además, se puede combinar la información del IP con variables ecológicas poblacionales y los datos de los Estudios Europeos de Alta Resolución en Cáncer. El objetivo de este estudio es caracterizar las desigualdades socioeconómicas en la incidencia, el exceso de mortalidad, la mortalidad prematura y la supervivencia neta para tres de los cánceres más incidentes (pulmón, colon-recto y mama) en España usando el IP. Este estudio nacional multinivel de base poblacional evaluará el impacto de las desigualdades socioeconómicas. Se usarán el análisis espacial, la modelización multinivel, la supervivencia neta y la evaluación del impacto económico. Los resultados serán útiles para el apoyo a la toma de decisiones y la planificación y la gestión de intervenciones en salud pública destinadas a reducir el impacto de las desigualdades socioeconómicas en el diagnóstico y el pronóstico de los pacientes de cáncer en España. (AU)

Incidence and mortality provide information on the burden of cancer morbidity and the potential years of life lost due to cancer. The Spanish Deprivation Index (SDI) has been developed as a standardized measure to study socioeconomic deprivation in Spain at the census tract level. In addition, SDI information can be combined with ecological variables at the population level and data from the High-Resolution European Studies in Cancer. The aim of this study is to characterize socioeconomic inequalities in incidence, excess mortality, premature mortality and net survival for three of the most incident cancers (lung, colon-rectum and breast) in Spain using the SDI. This national population-based study will assess the impact of socioeconomic inequalities using a multilevel modelling approach. Spatial analysis, multilevel modeling, net survival and economic impact assessment will be used. The results will be useful for supporting decision-making, planning, and management of public health interventions aimed at reducing the impact of socioeconomic inequalities in the diagnosis and prognosis of cancer patients in Spain. (AU)

[Study protocol on Socioeconomic and Geographic Inequalities in Cancer Incidence, Mortality and Survival in Spain: Multilevel Population-Base Study: DESOCANES study]. / Protocolo del Estudio Poblacional Multinivel de las Desigualdades Socioeconómicas en la Distribución Geográfica de la Incidencia, la Mortalidad y la Supervivencia Neta del Cáncer en España: Estudio DESOCANES.

Incidence and mortality provide information on the burden of cancer morbidity and the potential years of life lost due to cancer. The Spanish Deprivation Index (SDI) has been developed as a standardized measure to study socioeconomic deprivation in Spain at the census tract level. In addition, SDI information can be combined with ecological variables at the population level and data from the High-Resolution European Studies in Cancer. The aim of this study is to characterize socioeconomic inequalities in incidence, excess mortality, premature mortality and net survival for three of the most incident cancers (lung, colon-rectum and breast) in Spain using the SDI. This national population-based study will assess the impact of socioeconomic inequalities using a multilevel modelling approach. Spatial analysis, multilevel modeling, net survival and economic impact assessment will be used. The results will be useful for supporting decision-making, planning, and management of public health interventions aimed at reducing the impact of socioeconomic inequalities in the diagnosis and prognosis of cancer patients in Spain.

Acesso a diagnóstico e tratamento de paciente com câncer de mama e colo uterino no Brasil: Análise dos dados dos registros hospitalares de câncer / Access to diagnosis and treatment of breast and cervical cancer in Brazil: analysis of data from the hospital based cancer registries

Câncer de mama e de colo uterino são patologias responsáveis por morbidade e mortalidade significativas. Ambas as doenças apresentam prognóstico reservado quando o diagnóstico é feito em estágios avançados. O objetivo do presente trabalho foi estudar os fatores relacionados com o estadiamento de câncer de mama e colo uterino no Brasil. Foram analisados os dados oriundos dos Registros Hospitalares de Câncer (RHC) de unidades de saúde de todo o país de 2000 a 2012, através de modelo de regressão logística multinomial tendo como desfecho o estadiamento ao diagnóstico. Houve aumento significativo do percentual de casos diagnosticados em estágios III e IV durante período de estudo, para ambas as doenças. Os fatores relacionados com estadiamento avançado, para os dois tipos de câncer foram idade, escolaridade, tipo histológico, região da unidade de saúde, raça-cor e estado conjugal. Concluiu-se que o acesso a diagnóstico e tratamento para os cânceres de mama e colo uterino no país é desigual e mulheres com menor nível socioeconômico correm maior risco de ter diagnóstico tardio de ambas as patologias, estando sujeitas as suas consequências em termos de prognóstico

Registros poblacionales de cáncer: avances en Colombia, Chile y Brasil / Population-based cancer registries: progress in Colombia, Chile and Brazil

OBJETIVO : revisar los avances en materia de registros poblacionales de cáncer en Colombia, Chile y Brasil. METODOLOGIA: búsqueda de literatura en español, portugués e inglés a través de lilacs, bireme, scielo, medline, isi, y sitios web especializados. RESULTADOS Colombia cuenta con 8 registros, 4 indexados ante la iacr (10% población nacional), y 4 aún sin indexar (18% población nacional); el registro de Cali con 50 años de existencia es referente regional. Tres registros chilenos indexados cubren el 6,2% de la población nacional y dos sin indexación abarcan un 7,2% de población adicional; el Registro Nacional de Cáncer Infantil de Chile cubre el 100% de la población menor de 15 años y opera desde el año 2006. Brasil tiene registros poblacionales en 20 ciudades que cubren el 19% de la población total, y operan en integración con los registros hospitalarios. DISCUSION Y CONCLUSION la cobertura poblacional en la región es baja en comparación con Europa y Norteamérica. Se evidencian avances en los tres países, en especial por la existencia de respaldo político y normativo. Es necesario ampliar la cobertura poblacional y continuar mejorando la calidad de los datos. El uso de tecnologías informáticas favorece el desarrollo y la integración de los registros.

OBJECTIVE: to review the progress in the area of population-based cancer registries in Colombia, Chile and Brazil. METHODOLOGY an ethnographic study whose participants were 20 mothers of children with Down's syndrome. Data were collected using semi-structured interviews and field observations. Similarly, this study included a categorical analysis and a literature review. RESULTS : Colombia has 8 records, 4 of them are indexed by the iacr (10% of the national population), and 4 are still not indexed (18% of the national population). The registry of Cali city is 50 years old and is considered a regional reference. Likewise, three Chilean registries are indexed and cover 6.2% of the national population. In addition, two unindexed registries cover a further 7.2% of the Chilean population. Also, the National Childhood Cancer Registry of Chile covers 100% of the population under 15 years and operates since 2006. Brazil, in turn, has population-based registries for 20 cities which cover 19% of the total population. These registries operate jointly with hospital registries. DISCUSSION AND CONCLUSION: population coverage in the region is low compared to Europe and North America. There is evidence of progress in all three countries, particularly the existence of political and regulatory support. It is necessary to expand population coverage and further improve data quality. The use of information technologies promotes the development and integration of registries.

Indicadores de cobertura em registros de cancer: proposta metodológica para avaliação dos registros de cancer de base populacional

A informação sobre incidência de câncer, obtida através dos registros de câncer de base populacional – RCBP é um componente essencial de qualquer estratégia de controle de câncer. Nos últimos vinte anos o papel dos registros de câncer tem se ampliado, incorporando o planejamento e avaliação das atividades de controle de câncer. Neste cenário, torna-se de fundamental importância a qualidade das informações fornecidas pelos registros. Uma breve revisão das metodologias para realizar o controle de qualidade dos dados nos registros de câncer, das mais tradicionalmente utilizadas às alternativas propostas torna claro que tais processos não são de fácil aplicação. O RCBP de Porto Alegre foi escolhido para verificar a aplicabilidade desta metodologia à realidade dos registros de câncer brasileiros. O Método de Fluxos apresenta-se neste contexto como adaptável a registros de câncer de diferentes padrões, de rápida execução e sem custos financeiros adicionais. O método proposto permite que o registro de câncer estabeleça uma rotina de vigilância de cobertura, segundo variáveis, tais como, localização primária, idade, sexo e área geográfica.

Population-based cancer registries are essential to public health and research. The cancer registries provide information on the surveillance of cancer incidence and survival. At the last 20 years, because of the emerging importance of cancer as a health problem, the cancer registries play a important role to evaluate and to frame public health policy to cancer control. A high-quality cancer registration is fundamental to monitoring cancer burden and identifies patterns and trends in various population groups, in different geographic areas,and over time. Cancer registries try to achieve maximum completeness in case-findings procedures in order to ensure that comparative studies are not distorted by variations on efficacy of registry procedures. A brief review about available methods used to estimate completeness of cancer registrations shows that these methodologies are not easy to use, especially in developing countries. The PBCR Porto Alegre was chosen to verify if the method could be applied to Brazilian cancer registries reality. In this context the Flow Method claims to be adaptable to cancer registries with different patterns of registration and can be executed rapidly and inexpensively. The proposed method allows to a cancer registry to provide a routine surveillance of completeness by variables such as tumor site, age, sex and geographic area.

El Registro Nacional de Cáncer de Cuba: procedimientos y resultados / The National Cancer Registry of Cuba: process and result

El cáncer representa un problema de salud en Cuba debido a que desde 1958 constituye la segunda causa de muerte en nuestro país. El Registro Nacional de Cáncer fue creado en 1964 como un instrumento para el estudio estadístico epidemiológico de esta enfermedad. A partir de 1986 se han introducido cambios importantes en el Registro Nacional de Cáncer desde el punto de vista de la organización, procesamiento y validación de la información con la implementación del nuevo sistema de información automatizada, lográndose em 1990 el desarrollo de una versión en microcomputadora y en 1992 la descentralización del procesamiento de la información a todas las provincias del país (14 Registros Provinciales de Cáncer). Las estadísticas obtenidas a través del Registro muestran como principales localizaciones en incidencia: pulmón, piel y colon en ambos sexos; próstata y laringe en los hombres y mama y cuello de útero en las mujeres. En la mortalidad pulmón y colon en ambos sexos, próstata en los hombres y mama en las mujeres. La mejoría de la calidad de la información del Registro ha permitido usar los datos para realizar investigaciones que ayuden a planificar y controlar la marcha del Programa Nacional de Control del Cáncer(AU)

Cancer represents a health problem in Cuba, being the second cause of death in our country. TheNational Cancer Registry went created in 1964 as an instrument for the epidemiological studyof this disease. In 1986, important changes were introduced in the National Cancer Registry regardingorganization, process and validation of the information with the implementation of a new automationinformation system; in 1990 a PC version of the system was developed, and in 1992 the decentralization of the process of the information to all provinces of the country (fourteen provincial cancer registries) was accomplished. The data obtained through the registry shows as main sites of incidence: lung, skin and colon for both sexes; prostate and larynx for men, and breast and cervixuteri for women. As for mortality, lung and colon for both sexes, prostate for men and breast for women are the main sites. The improvement of the quality of the information of the registry haspermitted the use of the data for carrying out investigations that help to plan and assess the NationalCancer Control Program(AU)