Efectos de edad, periodo y cohorte en la mortalidad por cáncer de cuello uterino en Colombia entre 1985 y 2014.

Reyes, Lina Angélica Buitrago; Garay, Oscar Andrés Gamboa; Gómez, Jairo Alonso Hernández

doi:10.25100/cm.v53i1.4873

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…Today, cervical cancer shows elevated incidence rates among women aged 35 to 40 and between 65 and 80 years old. In Colombia, there’s an observed secondary peak in incidence around 55 [ 42 , 43 ]. However, it has been documented that after menopause, there is a population group where HPV infections are even more frequent, surpassing the frequency observed in other age groups.…”

Section: Discussionmentioning

confidence: 99%

High frequency of alpha7-HPV in Colombian Caribbean coast women: cervical cancer screening analysis

Arteaga-Pautt,

Bru-Cordero,

Ricardo-Caldera

et al. 2024

BMC Infect Dis

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SUMMARY Background Cervical cancer (CC) is a significant global public health concern, particularly in developing countries such as Colombia. The main risk factor involves high-risk HPV types (HR-HPV) infection, coupled with population-specific variables. The Caribbean region in Colombia lacks research on HR-HPV-type frequencies. Therefore, this study aims to establish the prevalence of type-specific HR-HPV and its association with sociodemographic factors among women undergoing cervical cytology screening. Methods A cross-sectional study involving voluntary women who provided informed consent and completed a questionnaire capturing sociodemographic, clinical, and sexual behavior information was conducted. All participants underwent cervical cytology and molecular analysis. Generic HPV detection employed three simultaneous PCRs (GP5+/6+, MY09/11, and PU1R/2 M), and positive samples were genotyped using the Optiplex HPV Genotyping kit. The analysis encompassed the 12 types of high-risk HPV (HR-HPV-16,-18,-31,-33,-35,-39,-45,-51,-52,-56,-58, and − 59). Frequencies were reported based on geographic subregions within the Córdoba department, and disparities were made between single and multiple infections. Sociodemographic and clinical variables were subjected to ordinal logistic regression, with statistical significance at a p-value < 0.05. The statistical analyses utilized STATA 14® and R-Core Team-software. Results We included 450 women, mean age 40 (SD$$\pm$$11.44). PCR analysis revealed 43% HPV-positive (n=192). GP5+/6+ detected the most positives at 26% (n=119), followed by PU1R/2 M at 22% (n = 100) and MY09/11 at 15% (n=69). Multiple infections occurred in 87.3% (n=142), primarily 2 to 4 types (47.37%, n=90). Dominant types were HPV-18 (15.6%, n=61), HPV-16 (14.9%, n=58), HPV-31 (13.0%, n = 51), and HPV-45 (11.5%, n=45). Logistic regression identified age above 60 as a risk for concurrent multiple types (OR=6.10; 95% CI 1.18–31.63). Menopause was protective (OR=0.31; 95% CI 0.11–0.89). Conclusions Our study reveals a notable prevalence of multiple (2–4) high-risk HPV infections among adult women engaged in CC detection initiatives. Predominantly, α7 species constitute the prevalent HR-viral types, with the Medio Sinú subregion showing elevated prevalence. Menopausal status confers protection against diverse HR-HPV infections. Nevertheless, advancing age, particularly beyond 60 years, is linked to an increased susceptibility to simultaneous infections by multiple HPV-types.

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Section: Discussionmentioning

confidence: 99%

High frequency of alpha7-HPV in Colombian Caribbean coast women: cervical cancer screening analysis

Arteaga-Pautt,

Bru-Cordero,

Ricardo-Caldera

et al. 2024

BMC Infect Dis

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“…As a result, Colombian women diagnosed with breast cancer demonstrate a five year survival probability of 81% versus 53% for women with cervical cancer [4]. Reasons for the difference in mortality rates are not well-understood, but multiple barriers to accessing adequate care and the lack of an organized cervical cancer control program could be playing important roles [5]. Some of the barriers reported are excessive waittimes for service authorizations [6,7], lack of oncologists, lack of care standardization, and inability to access reliable and affordable transportation within rural areas are other barriers at play [8,9].…”

Section: Introductionmentioning

confidence: 99%

Impact of the universal health insurance benefits on cervical cancer mortality in Colombia

Lewis,

Hernandez,

Garcés-Palacio

et al. 2024

BMC Health Serv Res

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Background Cervical cancer patients in Colombia have a lower likelihood of survival compared to breast cancer patients. In 1993, Colombia enrolled citizens in one of two health insurance regimes (contributory-private insurance and subsidized- public insurance) with fewer benefits in the subsidized regime. In 2008, the Constitutional Court required the Colombian government to unify services of both regimes by 2012. This study evaluated the impact of this insurance change on cervical cancer mortality before and after 2012. Methods We accessed 24,491 cervical cancer mortality records for 2006–2020 from the vital statistics of Colombia’s National Administrative Department of Statistics (DANE). We calculated crude mortality rates by health insurance type and departments (geopolitical division). Changes by department were analyzed by rate differences between 2006 and 2012 and 2013–2020, for each health insurance type. We analyzed trends using join-point regressions by health insurance and the two time-periods. Results The contributory regime (private insurance) exhibited a significant decline in cervical cancer mortality from 2006 to 2012, characterized by a noteworthy average annual percentage change (AAPC) of -3.27% (P = 0.02; 95% CI [-5.81, -0.65]), followed by a marginal non-significant increase from 2013 to 2020 (AAPC 0.08%; P = 0.92; 95% CI [-1.63, 1.82]). In the subsidized regime (public insurance), there is a non-significant decrease in mortality between 2006 and 2012 (AAPC − 0.29%; P = 0.76; 95% CI [-2.17, 1.62]), followed by a significant increase from 2013 to 2020 (AAPC of 2.28%; P < 0.001; 95% CI [1.21, 3.36]). Examining departments from 2013 to 2020 versus 2006 to 2012, the subsidized regime showed fewer cervical cancer-related deaths in 5 out of 32 departments, while 6 departments had higher mortality. In 21 departments, mortality rates remained similar between both regimes. Conclusion Improvement of health benefits of the subsidized regime did not show a positive impact on cervical cancer mortality in women enrolled in this health insurance scheme, possibly due to unresolved administrative and socioeconomic barriers that hinder access to quality cancer screening and treatment.

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Trends and risk factors analysis of aortic aneurysm mortality in China over thirty years: based on the global burden of disease 2019 data

Huang,

Tang,

Liu

et al. 2024

European Heart Journal - Quality of Care and Clinical Outcomes

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Objectives This study aims to analyze the variation in mortality burden of aortic aneurysms (AA) and explore the associated risk factors based on Global Burden of Disease (GBD) 2019 data, investigating the mortality burden of AA in China. Methods Using GBD 2019 data, the mortality burden of AA in China from 1990 to 2019 was analyzed. The age-period-cohort model was utilized to analyze time trends, period, and cohort effects of 4 attributable risk factors of AA by age. Results In 2019, the total number of AA deaths in China increased by 136.1% compared to 1990, while the age-standardized mortality rate (ASMR) decreased by 6.8%. Male deaths and ASMR were higher than those of females, and ASMR increased with age. Whether viewed overall (Average Annual Percent Change (AAPC): -0.261, 95% Confidence Interval (CI): -0.383 to -0.138) or by sex (female AAPC: -0.812, 95% CI: -0.977 to -0.646; male AAPC: -0.011, 95% CI: -0.183 to 0.162), the ASMR for AA in China has shown a declining trend since 1990. Attributable risk factors such as high blood pressure, a diet high in sodium, smoking, and lead exposure increase AA mortality with age. Smoking mortality peaks between ages 80–85. The cyclical effect of high blood pressure on AA mortality significantly increases, while the cyclical effects of the other three risk factors decrease. For the population born after 1940, the cohort effect of high systolic blood pressure (SBP), a diet high in sodium, and smoking increased, while the cohort effect of lead exposure decreased. The local drift values of high SBP, a diet high in sodium, and smoking decreased, while the local drift value of lead exposure increased. High SBP was identified as the most significant attributable risk factor for AA mortality burden among both males and females, and smoking was another major attributable risk factor, particularly in males. Conclusion From 1990 to 2019, fatality due to AA in China increased notably, but the ASMR showed a decreasing trend. The mortality rate of AA was influenced by age, sex, and attributable risk factors, with elderly male smokers carrying a heavy burden of death. Moreover, tobacco control and treatment of hypertension should be strengthened to reduce the burden and its impact on AA.

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Efectos de edad, periodo y cohorte en la mortalidad por cáncer de cuello uterino en Colombia entre 1985 y 2014.

Cited by 4 publications

References 21 publications

High frequency of alpha7-HPV in Colombian Caribbean coast women: cervical cancer screening analysis

High frequency of alpha7-HPV in Colombian Caribbean coast women: cervical cancer screening analysis

Impact of the universal health insurance benefits on cervical cancer mortality in Colombia

Trends and risk factors analysis of aortic aneurysm mortality in China over thirty years: based on the global burden of disease 2019 data

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