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McCully M, Lipkis J, Heller A, Huñis A. Challenges and opportunities in NMIBC management across Latin America: insights from healthcare providers and a patient advocacy group. Ecancermedicalscience 2024; 18:1711. [PMID: 39021547 PMCID: PMC11254412 DOI: 10.3332/ecancer.2024.1711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Indexed: 07/20/2024] Open
Abstract
Non-muscle invasive bladder cancer (NMIBC) is characterised by high rates of recurrence and progression, requiring substantial healthcare resources. In Latin America, the incidence of NMIBC is set to increase due to an aging population and lifestyle changes. To better understand the current challenges for NMIBC treaters and patients, a mixed-methods approach was leveraged combining secondary research with qualitative interviews from healthcare providers in Brazil, Colombia, Mexico and Argentina. Our analysis found that significant challenges persist across the region, particularly due to Bacillus Calmette-Guérin shortages, inconsistent adherence to clinical guidelines and significant socioeconomic disparities for patients accessing healthcare services. Addressing these challenges requires improved patient advocacy, strategic use of clinical trials and better resource distribution to enhance NMIBC management across Latin America.
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Affiliation(s)
- Mark McCully
- PharmaValue Partners, 603 Mattison Avenue, Suite 319, Asbury Park, NJ 07712, USA
| | - Julia Lipkis
- PharmaValue Partners, 603 Mattison Avenue, Suite 319, Asbury Park, NJ 07712, USA
| | - Aryel Heller
- PharmaValue Partners, 603 Mattison Avenue, Suite 319, Asbury Park, NJ 07712, USA
| | - Adrian Huñis
- A. Hunis & Associates, Oncology Consultants, Hollywood, FL 33019, USA
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Reyes-Hernández OD, Figueroa-González G, Quintas-Granados LI, Hernández-Parra H, Peña-Corona SI, Cortés H, Kipchakbayeva A, Mukazhanova Z, Habtemariam S, Leyva-Gómez G, Büsselberg D, Sharifi-Rad J. New insights into the anticancer therapeutic potential of icaritin and its synthetic derivatives. Drug Dev Res 2024; 85:e22175. [PMID: 38567708 DOI: 10.1002/ddr.22175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/06/2024] [Accepted: 03/04/2024] [Indexed: 04/05/2024]
Abstract
Icaritin is a natural prenylated flavonoid derived from the Chinese herb Epimedium. The compound has shown antitumor effects in various cancers, especially hepatocellular carcinoma (HCC). Icaritin exerts its anticancer activity by modulating multiple signaling pathways, such as IL-6/JAK/STAT3, ER-α36, and NF-κB, affecting the tumor microenvironment and immune system. Several clinical trials have evaluated the safety and efficacy of icaritin in advanced HCC patients with poor prognoses, who are unsuitable for conventional therapies. The results have demonstrated that icaritin can improve survival, delay progression, and produce clinical benefits in these patients, with a favorable safety profile and minimal adverse events. Moreover, icaritin can enhance the antitumor immune response by regulating the function and phenotype of various immune cells, such as CD8+ T cells, MDSCs, neutrophils, and macrophages. These findings suggest that icaritin is a promising candidate for immunotherapy in HCC and other cancers. However, further studies are needed to elucidate the molecular mechanisms and optimal dosing regimens of icaritin and its potential synergistic effects with other agents. Therefore, this comprehensive review of the scientific literature aims to summarize advances in the knowledge of icaritin in preclinical and clinical studies as well as the pharmacokinetic, metabolism, toxicity, and mechanisms action to recognize the main challenge, gaps, and opportunities to develop a medication that cancer patients can use. Thus, our main objective was to clarify the current state of icaritin for use as an anticancer drug.
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Affiliation(s)
- Octavio Daniel Reyes-Hernández
- Laboratorio de Biología Molecular del Cáncer, UMIEZ, Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Gabriela Figueroa-González
- Laboratorio de Farmacogenética, UMIEZ, Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Laura Itzel Quintas-Granados
- Colegio de Ciencias y Humanidades, Plantel Cuautepec, Universidad Autónoma de la Ciudad de México. Ciudad de México, México, México
| | - Hector Hernández-Parra
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
- Departamento de Farmacología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), Ciudad de México, Mexico
| | - Sheila I Peña-Corona
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Hernán Cortés
- Laboratorio de Medicina Genómica, Departamento de Genómica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de Mexico, Mexico
| | - Aliya Kipchakbayeva
- Faculty of Chemistry and Chemical Technology, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Zhazira Mukazhanova
- Higher School of IT and Natural Sciences, Sarsen Amanzholov East Kazakhstan University, Ust-Kamenogorsk, Kazakhstan
| | - Solomon Habtemariam
- Pharmacognosy Research & Herbal Analysis Services UK, Central Avenue, Chatham-Maritime, London, UK
| | - Gerardo Leyva-Gómez
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
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Buteau AC, Castelo-Loureiro A, Barragan-Carrillo R, Bejarano S, Kihn-Alarcón AJ, Soto-Perez-de-Celis E. Disparities in Cancer Control in Central America and the Caribbean. Hematol Oncol Clin North Am 2024; 38:35-53. [PMID: 37597998 DOI: 10.1016/j.hoc.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2023]
Abstract
Central America and the Caribbean is a highly heterogeneous region comprising more than 30 countries and territories with more than 200 million inhabitants. Although recent advances in the region have improved access to cancer care, there are still many disparities and barriers for obtaining high-quality cancer treatments, particularly for those from disadvantaged populations, immigrants, and rural areas. In this article, we provide an overview of cancer care in Central America and the Caribbean, with selected examples of issues related to disparities in access to care and suggest solutions and strategies to move forward.
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Affiliation(s)
| | - Alicia Castelo-Loureiro
- Medical Oncology Division, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, 28041, Madrid, Spain
| | - Regina Barragan-Carrillo
- Department of Hemato-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Vasco de Quiroga 15, Sección XVI, Tlalpan, Mexico City, Mexico
| | - Suyapa Bejarano
- Excelmedica, Liga Contra el Cancer Honduras, Condominios Médicos del Valle I Apt 318, San Pedro Sula, Honduras
| | - Alba J Kihn-Alarcón
- Research Department, Liga Nacional Contra el Cáncer & Instituto de Cancerología, 6a Avenida 6-58, Cdad. de Guatemala 01011, Guatemala
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Sección XVI, Tlalpan, Mexico City, Mexico.
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Ju W, Zheng R, Wang S, Zhang S, Zeng H, Chen R, Sun K, Li L, Wei W. The occurence of cancer in ageing populations at global and regional levels, 1990 to 2019. Age Ageing 2023; 52:afad043. [PMID: 37725972 DOI: 10.1093/ageing/afad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND population ageing contributes to increased cancer cases and deaths and has profound implications for global healthcare systems. We estimated the trends of cancer cases and deaths in ageing populations at global and regional levels. METHODS using data from the Global Burden of Disease Study 2019, we analysed the change in cancer cases and deaths associated with population ageing, population growth and epidemiological factors from 1990 to 2019 using decomposition analysis. Additionally, we estimated the proportions of people aged 65 years and over accounting for total cases and deaths, and investigated relationships between the proportions and the Sociodemographic Index (SDI) using the Pearson correlation coefficient. RESULTS from 1990 to 2019, there was an increase of 128.9% for total cases and 74.8% for total deaths in all cancers combined; the percentages of older people increased from 48.6% to 56.4% for cases and from 52.0% to 61.9% for deaths. Population ageing contributed to the largest increase in global cancer occurrence, with 56.5% for cases and 63.3% for deaths. However, the changes attributed to epidemiological factors was 5.2% for cancer cases and -33.4% for cancer deaths. The proportions of total cases and deaths of older adults were positively correlated with socioeconomic development of the country. CONCLUSION our findings revealed that the main contributor to increased cancer cases and deaths has changed from comprehensive epidemiological factors to demographic shifts. To respond to the rapidly growing occurrence of cancer in ageing populations, the global health priority should focus on meeting the rising demand for cancer diagnosis, treatment and care services for older people.
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Affiliation(s)
- Wen Ju
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Rongshou Zheng
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Shaoming Wang
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Siwei Zhang
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Hongmei Zeng
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Ru Chen
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Kexin Sun
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Li Li
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Wenqiang Wei
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Goh JC, Gourley C, Tan DSP, Nogueira-Rodrigues A, Elghazaly H, Edy Pierre M, Giornelli G, Kim BG, Morales–Vasquez F, Tyulyandina A. Optimizing treatment selection and sequencing decisions for first-line maintenance therapy of newly diagnosed advanced ovarian cancer – International considerations amongst upper middle- and high-income countries (UMIC and HIC). Gynecol Oncol Rep 2022; 42:101028. [PMID: 35813356 PMCID: PMC9263863 DOI: 10.1016/j.gore.2022.101028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/04/2022] [Accepted: 06/11/2022] [Indexed: 11/30/2022] Open
Abstract
Early BRCA testing is crucial and enables personalized treatment approach. BRCA mutation analysis is essential and should be utilized at the time of diagnosis. Single-agent PARP inhibitors seem most beneficial in BRCA mutations or HRD. Evidence suggests bevacizumab or niraparib-alone benefits for HRD-negative patients. HRD-tailored treatment should be explored further.
The incidence and mortality rates of ovarian cancer are increasing globally. Ovarian cancer is diagnosed at an advanced stage in 80% of women. After standard, platinum-based, front-line chemotherapy, poly (ADP-ribose) polymerase (PARP) inhibitors and antiangiogenic agents are successfully employed as maintenance strategies for newly diagnosed, advanced ovarian cancer patients. Landmark clinical studies, including SOLO-1, PAOLA-1, PRIMA, and VELIA, have provided crucial insights on optimizing first-line maintenance treatment using PARP inhibitors. A group of ovarian cancer experts, primarily from low- and middle-income countries, met in September 2019 to discuss new developments for the first-line treatment of ovarian cancer and its implications. Key implications of the evolving clinical data included: (1) olaparib or niraparib maintenance therapy appears to be the preferred choice for patients with BRCA1/2 mutations; hence, BRCA testing is beneficial in identifying these patients; (2) niraparib monotherapy and olaparib in combination with bevacizumab have demonstrated significant benefit in progression-free survival (PFS) in homologous recombination deficiency (HRD)-positive patients; (3) bevacizumab, niraparib alone, or observation can be an alternative for HRD-negative patients; (4) further data is warranted to explore the role of PARP inhibitors in treating HRD-negative, ovarian cancer patients to confirm findings of the exploratory analysis of PRIMA; (5) PARP inhibitors may be beneficial for stage IV ovarian cancer patients with inoperable disease and patients with prior neoadjuvant chemotherapy; and (6) there is an urgent need to increase awareness in both clinicians and patients on BRCA and HRD testing for optimizing treatment decision-making and improving clinical outcomes in newly diagnosed, advanced ovarian cancer patients. In clinical medicine, the limited availability of family history (FH) information and the complexity of FH criteria has hampered the implementation of BRCA testing. Moreover, many cancer patients with BRCA mutations are not tested because they do not meet the criteria for FH. Consequently, BRCA testing in many high income countries, including the US and Australia, is underused and used inappropriately, which has resulted in the loss of valuable opportunities for better cancer management and cancer prevention.
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Affiliation(s)
- Jeffrey C.H. Goh
- Department of Oncology – Cancer Care Services, Level 5, Joyce Tweddell Building, Royal Brisbane & Women’s Hospital, Butterfield Street, Herston, Queensland 4029, University of Queensland, St Lucia, Australia
- Corresponding author at: Department of Oncology – Cancer Care Services, Level 5, Joyce Tweddell Building, Royal Brisbane & Women’s Hospital, Butterfield Street, Herston, Queensland 4029, Australia.
| | - Charlie Gourley
- Edinburgh Cancer Research UK Centre, MRC IGMM, University of Edinburgh, Western General Hospital, Crewe Road South Edinburgh, EH4 2XR, UK
| | - David S P Tan
- Department of Haematology-Oncology, National University Cancer Institute, Singapore
| | - Angélica Nogueira-Rodrigues
- Federal University of Minas Gerais, DOM Oncologia, Grupo Oncoclınicas, EVA Brazilian Group of Gynecologic Cancer, LACOG, Porto Alegre, Brazil
| | - Hesham Elghazaly
- Clinical Oncology Head of Medical Research Center MASRI, Ain Shams University, Cairo, Egypt
| | - Marc Edy Pierre
- Gynecology Oncology Unit, Luis Carlos Samiento Angulo Cancer Treatment and Research Center - CTIC,Bogotá, Colombia
| | - Gonzalo Giornelli
- Department of Oncology, Instituto Alexander Fleming, Buenos Aires, Argentina
| | - Byoung-Gie Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | - Alexandra Tyulyandina
- Department of Clinical Pharmacology And Chemotherapy, N. N. Blokhin Russian Cancer Research Center, Moscow, Russia
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Verduzco-Aguirre HC, Bolaño Guerra LM, Culakova E, Chargoy JM, Martínez-Said H, Quintero Beulo G, Mohile SG, Soto-Perez-De-Celis E. Barriers and Facilitators for the Implementation of Geriatric Oncology Principles in Mexico: A Mixed-Methods Study. JCO Glob Oncol 2022; 8:e2100390. [PMID: 35353596 PMCID: PMC9005260 DOI: 10.1200/go.21.00390] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
There is limited information regarding the use of the geriatric assessment (GA) for older adults with cancer in developing countries. We aimed to describe geriatric oncology practice among Mexican oncology professionals and to identify barriers and facilitators for the implementation of GA into the routine care of older adults with cancer in Mexico. Routine use of geriatric oncology principles in Mexico is limited by insufficient personnel and knowledge.![]()
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Affiliation(s)
- Haydee C Verduzco-Aguirre
- Department of Hemato-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Laura M Bolaño Guerra
- Department of Thoracic Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Eva Culakova
- Department of Surgery, University of Rochester Cancer Center National Cancer Institute (NCI) Community Oncology Research Program (NCORP) Research Base, Rochester, NY
| | - Javier Monroy Chargoy
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Gregorio Quintero Beulo
- Breast Tumor Unit, Oncology Service, Hospital General de México "Dr Eduardo Liceaga," Mexico City, Mexico
| | - Supriya G Mohile
- Department of Surgery, University of Rochester Cancer Center National Cancer Institute (NCI) Community Oncology Research Program (NCORP) Research Base, Rochester, NY.,Department of Medicine, University of Rochester Medical Center, Rochester, NY
| | - Enrique Soto-Perez-De-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Soto-Perez-de-Celis E, Martínez-Peromingo J, Chávarri-Guerra Y, Loh KP, Demichelis-Gómez R, Rodrigues M, Yabeta F, Cengiz Seval G, Ilhan O, Cordoba R. Implementation of geriatric haematology programmes for the treatment of older people with haematological malignancies in low-resource settings. THE LANCET HEALTHY LONGEVITY 2021; 2:e754-e763. [DOI: 10.1016/s2666-7568(21)00182-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/14/2021] [Accepted: 07/21/2021] [Indexed: 12/16/2022]
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Association between genetic variations at 8q24 and prostate cancer risk in Mexican Men. Prostate Cancer Prostatic Dis 2021; 25:507-512. [PMID: 34599275 DOI: 10.1038/s41391-021-00461-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/10/2021] [Accepted: 09/20/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Variants of 8q24 locus have been associated with prostate cancer (PCa) susceptibility. This study aims to analyze the genetic basis of PCa susceptibility in Mexican men by analyzing SNPs in the 8q24 locus for the first time. METHODS A case-control study was performed in 875 men recruited from the Mexican Social Security Institute, 326 patients with PCa, and 549 non-PCa patients (88 with benign prostatic hyperplasia BPH and 461 healthy controls). The 8q24 locus SNPs: rs16901979, rs16983267, rs1447295, and rs7837328 were genotyped by allelic discrimination assays using TaqMan probes. Statistical analysis was performed using Epi Info statistical 7.0 and SNPstats softwares. RESULTS All genotype frequencies were in Hardy-Weinberg Equilibrium. No differences were observed in genotype distribution between PCa and non-PCa patients for rs6983267. Under different inheritance models, the rs16901979, rs1447295, and rs7837328 SNPs were associated with PCa (OR = 2.8, 1.8, and 1.72, respectively; Pc < 0.001) when comparing PCa patients against controls. This association remains between PCa and BPH patients under different models (OR = 8.5, 2.2, and 1.9, respectively; Pc < 0.001). There were no significant differences in allele and genotype distribution among BPH patients and controls. The combined effect of the alleles CGAA for the SNPs rs16901979, rs6983267, rs1447295, and rs7837328 showed significant differences between PCa patients and controls (OR = 2.9, 95% CI = 1.48-5.83, Pc = 0.008). Four 8q24 variants were not associated with D'Amico score, age at diagnosis, and bone metastases. CONCLUSIONS Our study provides the first confirmation that variants rs16901979, rs1447295, and 7837328 at 8q24 locus are associated with PCa susceptibility in Mexican men.
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Cabrera‐Galeana P, Soto‐Perez‐de‐Celis E, Reynoso‐Noveron N, Villarreal‐Garza C, Lara‐Medina F, Alvarado‐Miranda A, Espinosa‐Fernandez JR, Esparza‐Arias N, Mohar A, Bargallo‐Rocha JE. Real-World Outcomes Among Older Mexican Women with Breast Cancer Treated with Neoadjuvant Chemotherapy. Oncologist 2020; 25:1023-1031. [PMID: 32275801 PMCID: PMC7938403 DOI: 10.1634/theoncologist.2019-0891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 03/24/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Older patients with breast cancer treated in high-income countries often present with early-stage disease, leading to a lack of information on the use of neoadjuvant chemotherapy in this population. We analyzed the real-world outcomes of older women with breast cancer treated with neoadjuvant chemotherapy at a single institution in Mexico. MATERIALS AND METHODS The study included 2,216 patients treated with neoadjuvant chemotherapy. Regarding achievement of pathologic complete response (defined as no invasive residual tumor in the breast and lymph nodes), 243 patients aged ≥65 years were compared with 1,973 patients aged <65 years. Disease-free survival and overall survival were compared between groups according to pathologic complete response and subtype, defined by hormone receptor and human epidermal growth receptor 2 (HER2) status. RESULTS Older women were less likely to have a pathologic complete response than their younger counterparts (26.3 vs. 35.3%, p < .001). When response rates by subtype were analyzed, this difference was significant only for women with triple-negative tumors. Achieving less than a pathologic complete response was associated with a greater chance of recurrence, but age was not an independent factor for recurrence for any subtype. Reaching a pathologic complete response was significantly associated with improved survival among older women with breast cancer, with the exception of those with hormone receptor-positive, HER2- disease. CONCLUSION Although older women have fewer pathological complete responses, their outcomes after neoadjuvant chemotherapy are comparable to those of younger patients. This is particularly relevant for the treatment of older adults with breast cancer in developing countries, who present in advanced stages and more often need neoadjuvant therapy. IMPLICATIONS FOR PRACTICE The majority of older patients with breast cancer in high-income countries present with early-stage disease, leading to a lack of information regarding the use of neoadjuvant chemotherapy in real-world settings. This article reports the outcomes of older Mexican women with breast cancer who received neoadjuvant chemotherapy compared with their younger counterparts. Although older women (particularly those with triple-negative tumors) were less likely to have a pathologic complete response after neoadjuvant treatment, age was not an independent factor for recurrence. Achieving a pathologic complete response was associated with improved survival, regardless of age.
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Affiliation(s)
- Paula Cabrera‐Galeana
- Departamento de Oncología Médica—Tumores Mamarios, Instituto Nacional de CancerologíaMexico CityMexico
| | - Enrique Soto‐Perez‐de‐Celis
- Programa de Atención a Pacientes Post‐Mastectomía, Instituto Nacional de CancerologíaMexico CityMexico
- Cancer Care in the Elderly Clinic, Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico CityMexico
| | - Nancy Reynoso‐Noveron
- Subdirección de Investigación Clínica, y, Instituto Nacional de CancerologíaMexico CityMexico
| | - Cynthia Villarreal‐Garza
- Subdirección de Investigación Clínica, y, Instituto Nacional de CancerologíaMexico CityMexico
- Centro de Cancer de Mama del Hospital Zambrano Hellion, Tecnologico de MonterreySan Pedro Garza GarcíaMexico
| | - Fernando Lara‐Medina
- Departamento de Oncología Médica—Tumores Mamarios, Instituto Nacional de CancerologíaMexico CityMexico
| | - Alberto Alvarado‐Miranda
- Departamento de Oncología Médica—Tumores Mamarios, Instituto Nacional de CancerologíaMexico CityMexico
| | | | - Nereida Esparza‐Arias
- Departamento de Oncología Médica—Tumores Mamarios, Instituto Nacional de CancerologíaMexico CityMexico
- Programa de Atención a Pacientes Post‐Mastectomía, Instituto Nacional de CancerologíaMexico CityMexico
| | - Alejandro Mohar
- Unidad de Epidemiología, Instituto Nacional de CancerologíaMexico CityMexico
- Instituto de Biomédicas, Universidad Nacional Autónoma de México (UNAM)Mexico CityMexico
| | - Juan Enrique Bargallo‐Rocha
- Departamento de Oncología Médica—Tumores Mamarios, Instituto Nacional de CancerologíaMexico CityMexico
- Programa de Atención a Pacientes Post‐Mastectomía, Instituto Nacional de CancerologíaMexico CityMexico
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Perceived Barriers to Early Detection of Breast Cancer in Iranian Women: A Qualitative Content Analysis. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2020. [DOI: 10.5812/ijcm.101467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Breast cancer is one of the most common cancers among Iranian women. The early diagnosis of this disease can decrease the mortality rate and promote patient survival. Objectives: This study aimed at identifying the barriers to early detection of breast cancer in Iranian women. Methods: In this qualitative study, which was extracted from a large research project, an exploratory sequential mixed-methods design was used, and conventional content analysis was carried out. Twenty-one participants were selected by purposeful sampling (ten health professionals and 11 female patients with breast cancer). Data were collected through in-depth, semi-structured interviews from July 2018 to June 2019. Results: The content analysis revealed three major themes related to delay in presentation: individual barriers (limited/lack of knowledge, other life preferences, negative reactions to the disease, and belief in fate), environmental barriers (insufficient social support, inaccurate information sources, and alternative therapy recommendations), and organizational barriers (poor quality of health services, inadequate access to health services, and role of media in informing people). Conclusions: Various perceived barriers, at different levels, play influential roles in the patients’ early detection. Therefore, collaboration between public health professionals, healthcare providers, and policymakers seems necessary for reducing delays in presentation among women.
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Quintanilha LF, Souza LN, Sanches D, Demarco RS, Fukutani KF. The impact of cancer campaigns in Brazil: a Google Trends analysis. Ecancermedicalscience 2019; 13:963. [PMID: 31645890 PMCID: PMC6786828 DOI: 10.3332/ecancer.2019.963] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Indexed: 12/15/2022] Open
Abstract
It is estimated that more than 600,000 new cases of cancer will be reported in Brazil during the 2018-2019 biennium, especially with regard to prostate, breast, lung and colorectal cancers. Due to the high prevalence, incidence and mortality rates of these diseases, cancer campaigns such as 'Pink October' and 'Blue November' were strongly promoted in the past decade throughout the country to raise awareness of breast and prostate cancer, respectively. Nevertheless, whether the implementation of these campaigns has been proven efficient is still unknown. In the present study, we analysed the effectiveness of these campaigns on eliciting population online interest for cancer information. The Google Trends database was evaluated for the relative Internet search popularity for the terms 'breast cancer' and 'prostate cancer' from 2014 to 2019. Aside from some regional differences, we found that there was a high demand for 'breast cancer' and, to a lesser extent, 'prostate cancer' searches in a seasonal fashion (during October and November, respectively). Despite the worldwide high incidence of lung and colorectal cancers, searches including these keywords did not show increases in any specific period of the year, demonstrating the efficiency of the 'Pink October' and 'Blue November' campaigns in engaging the interest of the Brazilian population on the subject. These results allow us to infer that campaigns are effective in mobilising the attention of the Brazilian population with regard to breast and prostate cancers, but the practical aspects in reducing incidence and mortality should still be discussed.
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Affiliation(s)
- Luiz Fernando Quintanilha
- Universidade Salvador, Laureate Universities, Salvador 41770-235, Brazil
- Centro Universitário FTC, Faculdade de Medicina, Salvador 41741-590, Brazil
| | - Laumar Neves Souza
- Universidade Salvador, Laureate Universities, Salvador 41770-235, Brazil
| | - Daniel Sanches
- Division of Arts and Sciences, South Florida State College, Avon Park, FL 33825, USA
| | | | - Kiyoshi Ferreira Fukutani
- Centro Universitário FTC, Faculdade de Medicina, Salvador 41741-590, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Fundação José Silveira, Salvador 40210-320, Brazil
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12
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Kunnumakkara AB, Bordoloi D, Sailo BL, Roy NK, Thakur KK, Banik K, Shakibaei M, Gupta SC, Aggarwal BB. Cancer drug development: The missing links. Exp Biol Med (Maywood) 2019; 244:663-689. [PMID: 30961357 PMCID: PMC6552400 DOI: 10.1177/1535370219839163] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPACT STATEMENT The success rate for cancer drugs which enter into phase 1 clinical trials is utterly less. Why the vast majority of drugs fail is not understood but suggests that pre-clinical studies are not adequate for human diseases. In 1975, as per the Tufts Center for the Study of Drug Development, pharmaceutical industries expended 100 million dollars for research and development of the average FDA approved drug. By 2005, this figure had more than quadrupled, to $1.3 billion. In order to recover their high and risky investment cost, pharmaceutical companies charge more for their products. However, there exists no correlation between drug development cost and actual sale of the drug. This high drug development cost could be due to the reason that all patients might not respond to the drug. Hence, a given drug has to be tested in large number of patients to show drug benefits and obtain significant results.
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Affiliation(s)
- Ajaikumar B Kunnumakkara
- Cancer Biology Laboratory, DBT-AIST International Laboratory for Advanced Biomedicine (DAILAB), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, India
| | - Devivasha Bordoloi
- Cancer Biology Laboratory, DBT-AIST International Laboratory for Advanced Biomedicine (DAILAB), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, India
| | - Bethsebie Lalduhsaki Sailo
- Cancer Biology Laboratory, DBT-AIST International Laboratory for Advanced Biomedicine (DAILAB), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, India
| | - Nand Kishor Roy
- Cancer Biology Laboratory, DBT-AIST International Laboratory for Advanced Biomedicine (DAILAB), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, India
| | - Krishan Kumar Thakur
- Cancer Biology Laboratory, DBT-AIST International Laboratory for Advanced Biomedicine (DAILAB), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, India
| | - Kishore Banik
- Cancer Biology Laboratory, DBT-AIST International Laboratory for Advanced Biomedicine (DAILAB), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, India
| | - Mehdi Shakibaei
- Faculty of Medicine, Institute of Anatomy, Ludwig Maximilian University of Munich, Munich D-80336, Germany
| | - Subash C Gupta
- Department of Biochemistry, Institute of Science, Banaras Hindu University, Varanasi 221005, India
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13
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Goodman-Meza D, Medina-Mora ME, Magis-Rodríguez C, Landovitz RJ, Shoptaw S, Werb D. Where Is the Opioid Use Epidemic in Mexico? A Cautionary Tale for Policymakers South of the US-Mexico Border. Am J Public Health 2019; 109:73-82. [PMID: 30495992 PMCID: PMC6301408 DOI: 10.2105/ajph.2018.304767] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2018] [Indexed: 12/31/2022]
Abstract
In North America, opioid use and its harms have increased in the United States and Canada over the past 2 decades. However, Mexico has yet to document patterns suggesting a higher level of opioid use or attendant harms.Historically, Mexico has been a country with low-level use of opioids, although heroin use has been documented. Low-level opioid use is likely attributable to structural, cultural, and individual factors. However, a range of dynamic factors may be converging to increase the use of opioids: legislative changes to opioid prescribing, national health insurance coverage of opioids, pressure from the pharmaceutical industry, changing demographics and disease burden, forced migration and its trauma, and an increase in the production and trafficking of heroin. In addition, harm-reduction services are scarce.Mexico may transition from a country of low opioid use to high opioid use but has the opportunity to respond effectively through a combination of targeted public health surveillance of high-risk groups, preparation of appropriate infrastructure to support evidence-based treatment, and interventions and policies to avoid a widespread opioid use epidemic.
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Affiliation(s)
- David Goodman-Meza
- David Goodman-Meza and Raphael J. Landovitz are with Division of Infectious Diseases, David Geffen School of Medicine at University of California Los Angeles (UCLA). Raphael J. Landovitz is also with Center for Clinical AIDS Research and Education, Los Angeles. Maria Elena Medina-Mora is with Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico. Carlos Magis-Rodríguez is with National Center for the Prevention and Control of HIV and AIDS, Mexico City. Steve Shoptaw is with Department of Family Medicine, David Geffen School of Medicine at UCLA. Dan Werb is with Department of Medicine, University of California San Diego, La Jolla
| | - Maria Elena Medina-Mora
- David Goodman-Meza and Raphael J. Landovitz are with Division of Infectious Diseases, David Geffen School of Medicine at University of California Los Angeles (UCLA). Raphael J. Landovitz is also with Center for Clinical AIDS Research and Education, Los Angeles. Maria Elena Medina-Mora is with Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico. Carlos Magis-Rodríguez is with National Center for the Prevention and Control of HIV and AIDS, Mexico City. Steve Shoptaw is with Department of Family Medicine, David Geffen School of Medicine at UCLA. Dan Werb is with Department of Medicine, University of California San Diego, La Jolla
| | - Carlos Magis-Rodríguez
- David Goodman-Meza and Raphael J. Landovitz are with Division of Infectious Diseases, David Geffen School of Medicine at University of California Los Angeles (UCLA). Raphael J. Landovitz is also with Center for Clinical AIDS Research and Education, Los Angeles. Maria Elena Medina-Mora is with Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico. Carlos Magis-Rodríguez is with National Center for the Prevention and Control of HIV and AIDS, Mexico City. Steve Shoptaw is with Department of Family Medicine, David Geffen School of Medicine at UCLA. Dan Werb is with Department of Medicine, University of California San Diego, La Jolla
| | - Raphael J Landovitz
- David Goodman-Meza and Raphael J. Landovitz are with Division of Infectious Diseases, David Geffen School of Medicine at University of California Los Angeles (UCLA). Raphael J. Landovitz is also with Center for Clinical AIDS Research and Education, Los Angeles. Maria Elena Medina-Mora is with Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico. Carlos Magis-Rodríguez is with National Center for the Prevention and Control of HIV and AIDS, Mexico City. Steve Shoptaw is with Department of Family Medicine, David Geffen School of Medicine at UCLA. Dan Werb is with Department of Medicine, University of California San Diego, La Jolla
| | - Steve Shoptaw
- David Goodman-Meza and Raphael J. Landovitz are with Division of Infectious Diseases, David Geffen School of Medicine at University of California Los Angeles (UCLA). Raphael J. Landovitz is also with Center for Clinical AIDS Research and Education, Los Angeles. Maria Elena Medina-Mora is with Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico. Carlos Magis-Rodríguez is with National Center for the Prevention and Control of HIV and AIDS, Mexico City. Steve Shoptaw is with Department of Family Medicine, David Geffen School of Medicine at UCLA. Dan Werb is with Department of Medicine, University of California San Diego, La Jolla
| | - Dan Werb
- David Goodman-Meza and Raphael J. Landovitz are with Division of Infectious Diseases, David Geffen School of Medicine at University of California Los Angeles (UCLA). Raphael J. Landovitz is also with Center for Clinical AIDS Research and Education, Los Angeles. Maria Elena Medina-Mora is with Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico. Carlos Magis-Rodríguez is with National Center for the Prevention and Control of HIV and AIDS, Mexico City. Steve Shoptaw is with Department of Family Medicine, David Geffen School of Medicine at UCLA. Dan Werb is with Department of Medicine, University of California San Diego, La Jolla
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Sirohi B, Chalkidou K, Pramesh CS, Anderson BO, Loeher P, El Dewachi O, Shamieh O, Shrikhande SV, Venkataramanan R, Parham G, Mwanahamuntu M, Eden T, Tsunoda A, Purushotham A, Stanway S, Rath GK, Sullivan R. Developing institutions for cancer care in low-income and middle-income countries: from cancer units to comprehensive cancer centres. Lancet Oncol 2018; 19:e395-e406. [PMID: 30102234 DOI: 10.1016/s1470-2045(18)30342-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/26/2018] [Accepted: 04/26/2018] [Indexed: 12/27/2022]
Abstract
Global cancer centres operate across different sizes, scales, and ecosystems. Understanding the essential aspects of the creation, organisation, accreditation, and activities within these settings is crucial for developing an affordable, equitable, and quality cancer care, research, and education system. Robust guidelines are scarce for cancer units, cancer centres, and comprehensive cancer centres in low-income and middle-income countries. However, some robust examples of the delivery of complex cancer care in centres in emerging economies are available. Although it is impossible to create an optimal system to fit the unique needs of all countries for the delivery of cancer care, we summarise what has been published about the development and management of cancer centres in low-income and middle-income countries so far and highlight the need for clinical and political leadership.
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Affiliation(s)
| | - Kalipso Chalkidou
- Imperial College London, London UK; Centre for Global Development, London, UK
| | | | | | - Patrick Loeher
- Indiana University Medical Center, Indianapolis, IN, USA
| | - Omar El Dewachi
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | | | | | | | | | | | - Tim Eden
- University of Manchester, Manchester, UK
| | - Audrey Tsunoda
- Hospital Erasto Gaertner, Instituto de Oncologia do Paraná and Universidade Positivo, Curitiba, Brazil
| | - Arnie Purushotham
- Tata Trusts, Mumbai, India; King's Health Partners Comprehensive Cancer Centre and Institute of Cancer Policy, School of Cancer Sciences, Kings College London, London, UK
| | | | - Goura K Rath
- All India Institute of Medical Sciences, New Delhi, India
| | - Richard Sullivan
- King's Health Partners Comprehensive Cancer Centre and Institute of Cancer Policy, School of Cancer Sciences, Kings College London, London, UK
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Sánchez-García J, Candanedo-González F, Félix-Félix AK, Sánchez-Ramírez D, Medrano-Guzmán R, Quintana-Quintana M, Baas-Cabrera YB, Flores-Figueroa E. Retrospective cohort of pancreatic and Vater ampullary adenocarcinoma from a reference center in Mexico. Ann Med Surg (Lond) 2018; 30:7-12. [PMID: 29707208 PMCID: PMC5918165 DOI: 10.1016/j.amsu.2018.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 03/25/2018] [Accepted: 04/03/2018] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Pancreatic ductal adenocarcinoma (PDAC) and ampulla of Vater adenocarcinomas (AVAC) are periampullary tumors. These tumors have overlapping symptoms and a common treatment, but present differences in their survival and biology. No recent studies in Mexico have been published that describe the clinicopathological characteristics of these tumors. Therefore, the aim of this study was to describe the clinicopathological characteristics of PDAC and AVAC in patients at a reference center in Mexico. METHODS A retrospective cohort of patients with PDAC or AVAC was analyzed at our institution (July 2007 to June 2016). Inferential analysis of the clinical data was performed with Student's t-test or a χ2 test with odds ratios (OR) and confidence intervals (CI), depending on the variables. Overall survival was compared using Kaplan-Meier curves with log-rank p values. RESULTS Forty patients with PDAC and 76 with AVAC were analyzed, including 77 females and 39 males with a mean age of 60.6 years and a mean evolution time of 5.7 months. PDAC patients had more abdominal pain, a larger tumor size and more advanced stages than AVAC patients. In contrast, AVAC patients had more jaundice, a higher percentage of complete resections and higher overall survival. Up to 70% of patients were overweight. PDAC cohort included a higher proportion of smokers. CONCLUSIONS Our cohort was slightly younger, had a larger percentage of females, and a greater percentage of obese patients than those in many international reports. A high proportion of PDAC patients are diagnosed in advanced stages and have a low likelihood of resectability.
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Affiliation(s)
| | | | | | | | | | - Miguel Quintana-Quintana
- Medical Oncology Service, Oncology Hospital, National Medical Center Century XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Yair Benjamín Baas-Cabrera
- Medical Oncology Service, Oncology Hospital, National Medical Center Century XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
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Soto-Perez-de-Celis E, de Glas NA, Hsu T, Kanesvaran R, Steer C, Navarrete-Reyes AP, Battisti NML, Chavarri-Guerra Y, O’Donovan A, Avila-Funes JA, Hurria A. Global geriatric oncology: Achievements and challenges. J Geriatr Oncol 2017. [DOI: 10.1016/j.jgo.2017.06.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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17
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Mortality trends and risk of dying from colorectal cancer in the seven socioeconomic regions of Mexico, 2000-2012. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2017. [DOI: 10.1016/j.rgmxen.2017.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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18
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Sánchez-Barriga JJ. Mortality trends and risk of dying from colorectal cancer in the seven socioeconomic regions of Mexico, 2000-2012. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2017; 82:217-225. [PMID: 28320550 DOI: 10.1016/j.rgmx.2016.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 09/07/2016] [Accepted: 10/06/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND In Mexico, there has been an upward trend in mortality rates from colorectal cancer (CRC) over the past three decades. This tumor is ranked among the ten most prevalent causes of morbidity from malignancies in Mexico. AIMS To determine the mortality trends by socioeconomic region and by state, and to establish the relative risk between both educational level and socioeconomic region with mortality from CRC within the time frame of 2000-2012. MATERIALS AND METHODS Records of mortality associated with colorectal cancer were obtained. Rates of mortality by state and by socioeconomic region were calculated, along with the strength of association (obtained through the Poisson regression) between both socioeconomic region and educational level and the mortality from CRC. RESULTS A total of 45,487 individuals died from CRC in Mexico from 2000 to 2012. Age-adjusted mortality rates per 100,000 inhabitants increased from 3.9 to 4.8. Baja California, Baja California Sur, and Sonora had the highest mortality from CRC. Individuals with no school or incomplete elementary school had a higher risk of dying from this cancer (RR of 3.57, 95% CI: 3.46-3.68). Region 7 had the strongest association with mortality from CRC (Mexico City: RR was 2.84, 95% CI: 2.39-3.37 [2000] and 3.32, 95% CI: 2.89-3.82 [2012]). CONCLUSIONS In Mexico, the age-adjusted mortality rates per 100,000 inhabitants that died from CRC increased from 3.9 to 4.8 in the study period, using the world population age distribution as the standard. Baja California, Baja California Sur, and Sonora had the highest mortality from CRC. Mexico City, which was socioeconomic region 7, had the strongest association with mortality from CRC.
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Affiliation(s)
- J J Sánchez-Barriga
- Dirección de Investigación Operativa de Epidemiología, Dirección General de Epidemiología, Secretaría de Salud, Ciudad de México, México.
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Rodin D, Aggarwal A, Lievens Y, Sullivan R. Balancing Equity and Advancement: The Role of Health Technology Assessment in Radiotherapy Resource Allocation. Clin Oncol (R Coll Radiol) 2017; 29:93-98. [DOI: 10.1016/j.clon.2016.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 10/27/2016] [Indexed: 10/20/2022]
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20
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Akinyemiju T, Ogunsina K, Okwali M, Sakhuja S, Braithwaite D. Lifecourse socioeconomic status and cancer-related risk factors: Analysis of the WHO study on global ageing and adult health (SAGE). Int J Cancer 2016; 140:777-787. [PMID: 27813060 DOI: 10.1002/ijc.30499] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 10/19/2016] [Indexed: 12/13/2022]
Abstract
Few studies have examined cancer-related risk factors in relation to SES across the lifecourse in low to middle income countries. This analysis focuses on adult women in India, China, Mexico, Russia and South Africa, and examines the association between individual, parental and lifecourse SES with smoking, alcohol, BMI, nutrition and physical activity. Data on 22,283 women aged 18 years and older were obtained from the 2007 WHO Study on Global Aging and Adult Health (SAGE). Overall, 34% of women had no formal education, 73% had mothers with no formal education and 73% of women had low lifecourse SES. Low SES women were almost four times more likely to exceed alcohol use guidelines (OR: 3.86, 95% CI: 1.23-12.10), and 68% more likely to smoke (OR: 1.68, 95% CI: 1.01-2.80) compared with higher SES. Women with low SES mothers and fathers were more likely to have poor nutrition (Mothers OR: 1.59, 95% CI: 1.17-2.16; Fathers OR: 1.33, 95% CI: 1.11-1.59) and more likely to smoke (Mothers OR: 1.46, 95% CI: 1.15-1.87; Fathers OR: 2.17, 95% CI: 1.80-2.63) compared with those with high SES parents. Women with stable low lifecourse SES were more likely to smoke (OR: 2.55, 95% CI: 1.47-4.43), while those with declining lifecourse SES were more likely to exceed alcohol use guidelines (OR: 3.63, 95% CI: 1.07-12.34). Cancer-related risk factors varied significantly by lifecourse SES, suggesting that cancer prevention strategies will need to be tailored to specific sub-groups in order to be most effective.
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Affiliation(s)
- Tomi Akinyemiju
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL.,Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | - Kemi Ogunsina
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
| | - Michelle Okwali
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
| | - Swati Sakhuja
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
| | - Dejana Braithwaite
- Division of Cancer Epidemiology, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
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