This study characterized the HIV epidemic among men who have sex with men (MSM) in Quito, Ecuador and contrasted risk patterns with other STI's. 416 MSM ages 15 years and older were recruited using respondent-driven sampling in 2010-2011. Biological testing and a self-interview survey assessed HIV and STI infections and risk behaviors. Analysis incorporated recruiter-level variables and clustering adjustments to control for recruitment patterns. We identify high levels of HIV (11 %), HSV-2 (14 %) and active syphilis (5.5 %) infections, low levels of lifetime HIV testing (57 %), limited knowledge of HIV and STI's (<48 %) and limited consistent condom use independent of partner type (<40 %). Sex work was associated with all infections while associations with residential location, how casual partners are met and other variables, varied. Scale-up of behavioral prevention and HIV testing is urgently needed. Interventions should target male sex workers and exploit differential patterns of HIV-STI risk to stay ahead of the epidemic.

Introduction: The National Registry of Tumors has collected, processed, analyzed and regularly disseminated information on new cases of cancer diagnosed in the city of Quito, Ecuador over the last three decades. Aim: This article analyzed the trend of cancer incidence and mortality rates for the period 1985-2013.Methods: Incidence and mortality rates standardized by age were estimated by the direct method, using the world standard population. Analysis of the time trends, from selected locations, the joinpoint regression was used. Results: A decrease in the incidence and mortality rates of cervical and stomach cancers were documented. There was an increase in breast and colorectal cancer rates. The increase of the incidence rate of thyroid cancer in women was notorious. Lung cancer also increased in women while in men their values remained stable.Conclusion: There are important variations in the evolution of cancer in Quito; the information presented is an instrument for monitoring and evaluating the interventions that are developed in the Country.

Introducción: el cáncer representa un desafío para la salud pública global, ya que requiere de una estrategia integral, transdisciplinaria y sustentable para su control. En este contexto, los sistemas de vigilancia epidemiológica, como los Registros de Cáncer de Base Poblacional (PBCR), se convierten en actores clave para el desarrollo y seguimiento de las acciones implementadas. Objetivo: en el marco del plan nacional de cáncer propuesto en 2017 para el país, este estudio analiza la tendencia de las tasas de incidencia y mortalidad por cáncer durante el período 1985-2017. Métodos: se estimaron las tasas de incidencia y mortalidad estandarizadas por edad utilizando datos del PBCR de Quito. Para el análisis de las tendencias, de ubicaciones seleccionadas, se utilizó la regresión de puntos de unión y el cambio porcentual anual promedio (AAPC). Resultados: Un aumento sostenido en la incidencia de cáncer (AAPC Hombres = 1.5%, Intervalo de confianza al 95% [IC 95%]: 1.2 - 1.7; AAPC Mujeres: 0.7%, IC 95%: 0.4 - 1.0) y tasas de mortalidad (AAPC Hombres = 2.0%, IC 95%: 1.8 - 2.3; AAPC Mujeres = 1.3%, IC 95%: 1.1 - 1.6) se observó en Quito durante todo el período de estudio. Hubo un aumento sostenido en las tasas de incidencia y mortalidad de cánceres de mama, próstata, colon-recto, tiroides y linfoma. Mientras que las tasas de incidencia de cáncer de cuello uterino y estómago, relacionado con agentes infecciosos, disminuyeron. Conclusión: La información presentada por el PBCR de Quito sirve como referencia para el pronóstico del cáncer en el país y como línea de base para su control. Son urgentes acciones para fortalecer las estrategias de prevención y promoción del cáncer, especialmente en el cáncer de mama y de cuello uterino, para mitigar su impacto en la sociedad ecuatoriana.

Background. Despite the significant global decline in mortality and incidence, gastric cancer (GC) remains a very common cause of illness and death in the Latin American region. This article seeks to describe, in depth, the time trend of incidence and mortality of GC in the city of Quito, from 1985 to 2013. Methods. Using data from the Quito Cancer Registry, annual sex-specific age-standardized incidence and mortality rates were calculated. The analysis included all types of GC together, as well as by histological subtype. Joinpoint regression analysis was performed to estimate the annual percentage change (EAPC). To evaluate cohort and period effects, Age-Period-Cohort (APC) modeling was performed. Results. Over time, incidence rate decreased from 30.4 to 18.8 cases in men and from 20.1 to 12.9 cases in women. The mortality rate decreased from 17.5 to 14.4 deaths in men and from 14.2 to 10.9 deaths in women. The incidence trend was composed of a first period (1986-1999) of strong decline (EAPC Men= -2.6, 95% Confidence Interval [CI]: -4.2, -0.9; EAPC Women= -3.2, 95% CI: -4.6, -1.9), followed by a less important decrease in men (EAPC= -0.8, 95% CI:-2.5, 0.9) and a slight increase in women (EAPC= 0.7, 95% CI: -1.4; 2.8). Mortality rates were constantly decreasing in both men (EAPC= -0.5, 95% CI: -0.9, -0.1) and women (EAPC= -0.9, 95% CI: -1.7, -0.1) throughout the period of analysis. Conclusions. The declines in incidence and mortality rates are stagnating. It is important to take measures to further reduce the high burden of GC.

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