The Descriptive Epidemiology of Gastric Cancer in Central America and Comparison with United States Hispanic Populations

Corral, Juan E.; Hurtado, Juan J Delgado; Domínguez, Ricardo L.; Cuéllar, Marisabel Valdez de; Cruz, Carlos; Morgan, Douglas R.

doi:10.1007/s12029-014-9672-1

Cited by 23 publications

(23 citation statements)

References 27 publications

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“…In agreement with other studies, 12 37 the male to female ratio was 1.64 and GC was most common in the elderly. 12 38 Nevertheless, we found a high proportion of EOGC (14.7%) compared with those reported in most countries of the region, 38 only surpassed by Guatemala in Central America with national estimates of 16.5%, 12 a comparison worth noting even if our results are based on a single institution. Likewise, in a hospital-based study conducted in Mexico, a similar proportion of EOGC was reported.…”

Section: Discussionsupporting

confidence: 93%

“…Cases in which the endoscopic report could not be found in the clinical files were labelled as ‘unspecified’. 12 Histological type was based on the Lauren classification (intestinal, diffuse), 13 and mixed tumours were shown as a different category. 14 Tumour grade was categorised using ICD for Oncology, and clinical stage was based on the seventh edition of the TNM Staging System of the American Joint Committee on Cancer, taking into consideration the first staging reported in the clinical file by the physician at the NOI.…”

Section: Methodsmentioning

confidence: 99%

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Baseline characteristics, survival and direct costs associated to treatment of gastric cancer patients at the National Oncology Institute of Panama from 2012 to 2015: a hospital-based observational study

Castro¹,

Shahal²,

Tarajia³

et al. 2017

BMJ Open

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ObjectivesComprehensive epidemiological and economic studies of gastric cancer (GC) in Panama are limited. This study aims to evaluate the association between socioeconomic and clinical variables with survival, describe the survival outcomes according to clinical stage and estimate the direct costs associated to GC care in a Panamanian population with GC.Design and settingA retrospective observational study was conducted at the leading public institution for cancer treatment in Panama.ParticipantsData were obtained from 611 records of patients diagnosed with gastric adenocarcinoma (codes C16.0–C16.9 of the International Classification of Diseases 10th revision), identified between 1 January 2012 and 31 December 2015.MethodsCox proportional hazards models were used to calculate HRs with 95% CI to examine associations between the variables and survival. Kaplan-Meier curves were used to assess overall and stage-specific survival. Direct costs (based on 2015 US$) were calculated per patient using standard costs provided by the institution for hospital admission (occupied bed-days), radiotherapy, surgery and chemotherapy, yielding total and overall mean costs (OMC). A comparison of OMC between groups (sex, social security status, clinical stage) was performed applying the bootstrap method with a t-test of unequal variances.ResultsAn increased risk of dying was observed for patients without social security coverage (HR: 2.02; 95% CI 1.16 to 3.53), overlapping tumours (HR: 1.50; 95% CI 1.02 to 2.22), poorly differentiated tumours (HR: 2.27; 95% CI 1.22 to 4.22) and stage IV disease (HR: 5.54; 95% CI 3.38 to 9.08) (adjusted models). Overall 1-year survival rate was 41%. The estimated OMC of GC care per patient was 4259 US$. No statistically significant differences were found in OMC between groups.ConclusionsSocioeconomic disparities influence GC outcomes and healthcare utilisation. Policies addressing healthcare disparities related to GC are needed, as well as in-depth studies evaluating barriers of access to GC-related services.

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Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Baseline characteristics, survival and direct costs associated to treatment of gastric cancer patients at the National Oncology Institute of Panama from 2012 to 2015: a hospital-based observational study

Castro¹,

Shahal²,

Tarajia³

et al. 2017

BMJ Open

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“…[7][8][9][10] Despite robust data on GAC and the role of HP from Asia, nearly all large studies in the United States have used national cancer databases, which contain limited demographic and environmental exposures, medical history, and, most importantly, no data on HP. [11][12][13][14][15][16] As a result, there are critical knowledge gaps in our understanding of the incidence of nonproximal GAC in the setting of HP in the United States, risk factors associated with future GAC, and the impact of HP treatment. Modeling studies have been performed to assess which populations in the United States may benefit from screening, but they were limited by a lack of robust data on the incidence of GAC in a US population.…”

mentioning

confidence: 99%

Risk Factors and Incidence of Gastric Cancer After Detection of Helicobacter pylori Infection: A Large Cohort Study

et al. 2020

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This article has an accompanying continuing medical education activity, also eligible for MOC credit, on page e17. Learning Objective: Upon completion of this CME activity, successful learners will be able to discuss the management of Helicobacter pylori and describe its importance in gastric cancer. See Covering the Cover synopsis on page 453; see editorial on page 466. BACKGROUND & AIMS: Nearly all studies of gastric adenocarcinoma in the United States have relied on national cancer databases, which do not include data on Helicobacter pylori infection, the most well-known risk factor for gastric cancer. We collected data from a large cohort of patients in the United States to calculate the incidence of and risk factors for nonproximal gastric adenocarcinomas after detection of H pylori. Secondary aims included identifying how treatment and eradication affect cancer risk. METHODS: We performed a retrospective cohort study, collecting data from the Veterans Health Administration on 371,813 patients (median age 62 years; 92.3% male) who received a diagnosis of H pylori infection from January 1, 1994, through December 31, 2018. The primary outcome was a diagnosis of distal gastric adenocarcinoma 30 days or more after detection of H pylori infection. We performed a time to event with competing risk analysis (with death before cancer as a competing risk). RESULTS: The cumulative incidence of cancer at 5, 10, and 20 years after detection of H pylori infection was 0.37%, 0.5%, and 0.65%, respectively. Factors associated with cancer included older age at time of detection of H pylori infection (subhazard ratio [

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“…Nearly half of population in the CA‐4 resides in rural areas very similar to western Honduras, and our findings may be generalizable and helpful in the region. In addition, there is significant immigration to the United States from the CA‐4, and thus, our findings may have implications for patient care in the United States . In the treatment of H. pylori infection, resistance to clarithromycin and levofloxacin has been shown to be the central determinants of regimen efficacy.…”

Section: Discussionmentioning

confidence: 86%

Helicobacter pylori antimicrobial resistance and antibiotic consumption in the low‐resource Central America setting

et al. 2019

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Background Antimicrobial resistance is a global public health problem, particularly in low‐ and middle‐income countries (LMICs), where antibiotics are often obtained without a prescription. H. pylori antimicrobial resistance patterns are informative for patient care and gastric cancer prevention programs, have been shown to correlate with general antimicrobial consumption, and may guide antimicrobial stewardship programs in LMICs. We report H. pylori resistance and antimicrobial utilization patterns for western Honduras, representative of rural Central America. Methods In the context of the western Honduras gastric cancer epidemiology initiative, gastric biopsies from 189 patients were studied for culture and resistance patterns. Antimicrobial utilization was investigated for common H. pylori treatment regimens from regional public (7 antimicrobials) and national private (4 antimicrobials) data, analyzed in accordance with WHO anatomical therapeutic chemical defined daily doses (DDD) method and expressed as DDD/1000 inhabitants per day (DID) and per year (DIY). Results H. pylori was successfully cultured from 116 patients (56% males, mean age: 54), and nearly all strains were cagA+ and vacAs1m1+ positive (99% and 90.4%, respectively). Unexpectedly, high resistance was noted for levofloxacin (20.9%) and amoxicillin (10.7%), while metronidazole (67.9%) and clarithromycin (11.2%) were similar to data from Latin America. Significant associations with age, gender, or histology were not noted, with the exception of levofloxacin (28%, P = 0.01) in those with histology limited to non‐atrophic gastritis. Total antimicrobial usage in western Honduras of amoxicillin (17.3 DID) and the quinolones had the highest relative utilizations compared with other representative nations. Conclusions We observed significant H. pylori resistance to amoxicillin and levofloxacin in the context of high community antimicrobial utilization. This has implications in Central America for H. pylori treatment guidelines as well as antimicrobial stewardship programs.

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The Descriptive Epidemiology of Gastric Cancer in Central America and Comparison with United States Hispanic Populations

Cited by 23 publications

References 27 publications

Baseline characteristics, survival and direct costs associated to treatment of gastric cancer patients at the National Oncology Institute of Panama from 2012 to 2015: a hospital-based observational study

Baseline characteristics, survival and direct costs associated to treatment of gastric cancer patients at the National Oncology Institute of Panama from 2012 to 2015: a hospital-based observational study

Risk Factors and Incidence of Gastric Cancer After Detection of Helicobacter pylori Infection: A Large Cohort Study

Helicobacter pylori antimicrobial resistance and antibiotic consumption in the low‐resource Central America setting

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