Proportion of cancer cases and deaths attributable to potentially modifiable risk factors in Peru

BACKGROUND

Limited evidence exists on the population attributable fraction (PAF) of cancer cases and deaths in Latin America. In Peru several studies have been published regarding the PAF of various risk factors and their associated diseases. The objective of this study was to estimate the fraction of cancer cases and deaths attributable to potentially modifiable risk factors in Peru in 2018, before the COVID-19 pandemic in the population of 15 years old and older.

METHODS

An ecological study was conducted using the prevalence of exposure of the Peruvian population to modifiable risk factors for cancer, the relative risk associated with each factor, and the number of cancer cases and deaths in 2018 as inputs. We used the Parkin formula with a Montecarlo statistical simulation model to calculate the PAF and confidence intervals. The number of new cancer cases and deaths attributed to each risk factor was determined by multiplying the number of cases and deaths in each gender by the PAF of each risk factor.

FINDINGS

In Peru, 38.5% of new cases (34.5% in men and 42% in women) and 43.4% of cancer-related deaths (43.4% in men and 43.4% in women) were attributable to modifiable risk factors. The number of cancers attributable was 25,308 (10,439 in men and 14,869 in women) and the number of deaths attributable to cancer was 14,839 (6,953 in men and 7,886 in women). The predominant modifiable risk factors contributing to the highest number of cases and deaths were HPV infection (4,563 cases, 2,409 deaths), current tobacco use (3,348 cases, 2,180 deaths), and helicobacter pylori infection (2,677 cases, 1,873 deaths). Among the risk factors, oncogenic infections constituted the group with the highest PAF (16.6% for cases, 19.2% for deaths) followed by other unhealthy lifestyle factors (14.2% for cases, 16.7% for deaths), tobacco (7.2% for cases, 7.2% for deaths) and ultraviolet radiation (0.5% for cases, 0.3% for deaths).

CONCLUSIONS

Prior to the COVID-19 pandemic, 38.5% of cancer cases and 43.4% of cancer-related deaths in Peru were linked to modifiable risk factors in the population of 15 years old and older. Most preventable cancer cases and deaths were related to oncogenic infections, primarily caused by HPV and helicobacter pylori, followed by tobacco and obesity.

Two new species of dactylogyrids (Monogenea: Dactylogyridae) infecting the gill filaments of fishes in the southern Peruvian Amazon

Two new dactylogyrid species were found infecting the gill filaments of two freshwater fishes collected in the Amazon River basin around Madre de Dios, Peru, namely, Demidospermus wilveri n. sp. from Loricaria sp. (Siluriformes: Loricariidae), and Notozothecium agusti n. sp. from Brycon amazonicus (Spix & Agassiz) (Characiformes: Bryconidae). Demidospermus wilveri n. sp. is characterized by having the following combination of characteristics: (1) a male copulatory organ (MCO) with 1½ rings and a spoon-shaped distal end, (2) an accessory piece with expanded distal end, (3) dorsal and ventral bars with broadly V-shaped and expanded ends, and (4) hooks similar in size. Notozothecium agusti n. sp. differs from its ten congeners by the following combination of characteristics: (1) a coiled MCO with 1½ rings and a sinuous accessory piece with kidney-shaped distal end, (2) an rod-shaped and straight dorsal bar, (3) and anchors with robust superficial roots. Demidospermus wilveri n. sp. represents the thirty-second species in the genus, the eighth from Peru and the fifth parasitising a loricariid catfish from the Peruvian Amazon. Notozothecium agusti n. sp. is the second species of the genus described in Peru and the first species infecting a bryconid host.