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Objective: To analyze thyroid cancer (TC) mortality rates from 1990 to 2016 in Ecuadorian men and women and compare their trends with Latin American and international trends. Design: A population-based temporal-trend study using the database of the Ecuadorian National Death Registry. Methods: Crude and age-adjusted mortality rates were calculated, and age-related mortality rates were standardized with the world population (WHO). Trends in age-standardized mortality rates were estimated by jointpoint regression analysis. The trends were expressed as annual percentage change (APC) and average annual percentage change (AAPC). Results: In total, TC caused 2,107 deaths (1,475 women and 632 men) in the selected period. The mortality in men showed a statistically non-significant decrease. The estimated APC was −0.4% (P = 0.70), and the AAPC was −0.4% (P = 0.70) without any identified jointpoint. In women, the mortality decreased significantly between 1990 and 1998, with the estimated APC being −6.6% (P < 0.05). However, it increased significantly from 1998 to 2016, with the estimated APC of 5.4% (P < 0.05), and a jointpoint was identified; the AAPC was 1.4 (P = 0.30). Conclusions: While TC mortality in Ecuadorian men showed a decrease, that in Ecuadorian women showed an initial decrease and a final increase. Our findings can be contrasted with the global data, which show decreases in TC mortality in both sexes.

Background The incidence of thyroid cancer is increasing worldwide. This is not accompanied by a corresponding increase in mortality. In contrast, in most populations’ thyroid cancer mortality has been decreasing in recent decades, although there are some notable exceptions. Main body of the abstract Relatively few studies focus on mortality and in Latin America we do not find evidence on the temporal trend of mortality. The study of the epidemiology of the thyroid cancer should be approached with a suitable methodology and with data based on the population. Trends should be expressed as an annual percentage of change and/or average annual rate of change. An appropriate method for analyzing trends in thyroid cancer mortality rates is the Joinpoint regression analysis. Previously published findings are described, and the methodology used is compared . Short conclusion At the global level, Ecuador is one of the countries with the highest incidence rate of thyroid cancer. However, mortality data are scarce and not rigorous. It is important to raise awareness of updated and reliable population-based data on the trend of thyroid cancer mortality in Eccuador.

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Objectives: To determine the prevalence of primary hyperparathyroidism (HPTP) using PTH and Ionic calcium screening in a population sample of Guayaquil (Ecuador). Materials and methods: Prospective, cross-sectional study carried out between January 1, 2009 and November 30, 2014 of 13,860 people who attended routine control tests. All were tested in serum parathyroid hormone (PTH), ionic calcium, serum creatinine and the 25 (OH) total vitamin D (total VD). The diagnosis of HPTP was confirmed if PTH or Ionic calcium levels remained high at least in two different occasions. We excluded patients with raised serum creatinine, vitamin D insufficiency, malabsorption, chronic liver disease, or those receiving treatments that alter phosphocalcic metabolism. Results: 61 cases were found with raised PTH on at least two different occasions. Among these, 34 presented vitamin D insufficiency and were excluded from the analysis. In 27 cases (4 men and 23 women) the diagnosis of HPTP was confirmed. The average age for women was 64.5±15.4 years and men of 71.3±12.8 years; average PTH values were 115±24.2 pg/ml; Ionic calcium, 5.15±0.4 mg/dl; total VD, 47.1±20.2 ng/ml; and serum creatinine 0.84±0.2 mg/ml; prevalence of HPTP corresponds to 2 cases per thousand adults (95% CI: 1.71-2.18). The greatest increase in prevalence occurred in women aged 60 years. Conclusion: PTH prevalence in this sample is low compared to that reported in international series, being higher in advanced ages and in women. With the proposed screening for PTH and ionic calcium, we detected the normocalcemic form of HPTP in most cases.