Objective. To describe the burden of colorectal cancer (CRC) in Mexico and understand mortality patterns based on sex, geography, and insurance status. Materials and methods. Mortality data (1998-2018) from the Instituto Nacional de Estadística y Geografía was obtained. We included colon (C18.0, C18.2-18.9) and rectal cancer ICD-10 codes (C19, C20), and estimated age-standardized national, state-level and health insurance mortality rates. We estimated the average annual percent change using joinpoint regression. Results. Between 1998 and 2018, the observed women and men mortality rate increased annually by 1.3 and 2.7%, respectively. Higher CRC mortality was observed in northern and more urbanized states and in groups with greater access to health insurance, which currently facilitates but does not routinely cover screening. Conclusion. CRC mortality in Mexico is increasing rapidly, with marked differences based on sex, geography, and insurance status. Our findings underscore potential benefits of increased investment in comprehensive screening, diagnosis, and treatment strategies for the general population.
Objective. To determine the magnitude of mortality due to acute lymphoblastic leukemia (ALL) nationally and by age group, sex, state of residence and insurance status, as well as to evaluate time trends during the period 1998-2018 Materials and methods. We obtained ALL mortality data and estimated age-standardized national, state-level and health insurance mortality rates. We conducted a joinpoint regression analysis to describe mortality trends across the study period and estimate the average annual percent change (AAPC). Results. In a 20-year period, age-standardized ALL mortality rates increased from 1.6 per 100 000 in 1998 to 1.7 in 2018. Nationally, a constant annual increase in mortality was observed for both sexes (1998-2002 AAPC 0.6 in boys, and 1998-2002 AAPC 0.3 in girls). We observed heterogeneity in childhood ALL at a state level. Conclusion. Our results reflect the social, economic, geographic diversity of the country. Monitoring and surveillance of this disease is crucial to assess quality of care.
PURPOSE Hispanics and Indigenous women are underrepresented in cancer research. We aimed to estimate the incidence of breast cancer (BC) among indigenous and non-indigenous women and describe reproductive and lifestyle risk factors. METHODS The baseline questionnaire was completed by 115,307 women (2006-2008). Indigenous ancestry was defined by self-adscription and/or speaking an indigenous language. Incident BC-cases were confirmed using self-reports, administrative and clinical databases, cancer registries, and death certificates. We calculated person-years from the baseline questionnaire to the date of diagnosis, death, or the end of follow-up (December 31, 2019). We age-standardized reproductive and lifestyle information. RESULTS After a median follow-up of 10.8 years, we confirmed 1,212 BC-cases. The crude incidence rate per 100,000 person-years was 55 for indigenous and 95 for non-indigenous women; the mean age at diagnosis was 48.2 and 50.8, respectively. In indigenous BC-cases, early menarche (11.9 v 26.7%), first pregnancy > 25 years (36.8% v 51.7%), and nulliparity (11.7% v 14.1%) were less frequent compared to non-indigenous. The number of children (3.0 v 2.6) and breastfeeding > 12 months (71.6% v 45.2%) were higher among indigenous. Indigenous had earlier menopause (44.8 v 47.5 years) and more premenopausal-BC (27.8% v 25.1%). Oral contraceptives use (42.6% v 48.0%), hormone-replacement therapy (12.4% v 24.6%), family history of BC (11.9% v 15.1%) and benign breast-disease (17.8% v 23.0%) were less frequent in indigenous cases. Physical activity (> 150 min/week) was higher in indigenous women (34.3% v 27.8%). Smoking (6.6% v 11.2%) and alcohol consumption (47.9% v 61.3%) were lower in indigenous women; however, they had more diabetes (14.6% v 6.0%) and were at the highest tertile of the dietary glycemic index (40.2% v 35.0%). CONCLUSION In the MTC, BC-incidence in indigenous women is lower than in non-indigenous; this might be explained by a lower prevalence of hormonal and reproductive risk factors and higher physical activity among indigenous women.
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