Bladder cancer mortality trends in Spain: 1980-2021

OBJECTIVE

We propose to update bladder cancer mortality rates in Spain from 1980 to 2021, by sex and age-group, by autonomous community (AC).

MATERIALS AND METHODS

The public online databases of the National Statistical Institute were used to obtain data on population and bladder cancer mortality. Age-standardised mortality rates (ASMRs), all ages and truncated (<75 and ≥75) were estimated and reported as rates per 100,000 persons. Joinpoint regression software was used for estimation and trend analysis of ASMRs bladder cancer.

RESULTS

In the last decade, the ASMR for bladder cancer (all ages, <75 years and ≥75 years) decreased significantly in Spain for both sexes. This trend was observed in 12 ACs for men and in 4 ACs (Andalusia, Canary Islands, Catalonia and Madrid) for women, although to different degrees. For men, ASMR remained stable in Castilla-León and La Rioja (<75 years), Cantabria, Castilla-La Mancha and Valencia (≥75 years) and the 2 Castilian regions (all ages). For women, ASMR also decreased in Valencia (<75 and ≥75), Castilla-León (≥75), Galicia (≥75 and all ages) and Navarre (<75 and all ages).

CONCLUSION

Our results reveal significant variations in trends by AC, sex and age group, emphasizing the need for continued follow-up and targeted interventions to further reduce bladder cancer mortality rates in Spain.

[Epidemiological situation of post-pandemic sexually transmitted infections in Catalonia, Spain]

BACKGROUND

The growing trend of STIs in recent years was altered after the outbreak of the SARS-CoV-2 pandemic.

OBJECTIVES

Describe the impact of the SARS-CoV-2 pandemic on STI declarations received during the pre-pandemic to pandemic period and estimate the number of STI cases expected for the pandemic period.

MATERIAL AND METHODS

Descriptive analysis of STI declarations received during the pre-pandemic (2018-2019) and pandemic (2020-2021) periods. The influence of the number of positive cases of SARS-CoV-2 with the number of positive cases of STIs during the months of the pandemic was studied using a correlation model. Using the Holt-Wilson time series model, an estimate was made of the number of STI cases expected for the pandemic period.

RESULTS

The global incidence rate for all STIs in 2020 decreased by 18.3% compared to 2019. Chlamydia and syphilis presented a greater reduction in their incidence from 2019 to 2020 of 22.7% and 20.9%, respectively and 9.5% and 2.5% for gonorrhea and LGV. Estimates showed that in 2020 there would have been 44.6% more STIs than those declared. The proportions according to sex, country of birth and sexual orientation changed significantly in chlamydia and gonorrhea.

CONCLUSIONS

The measures adopted for the prevention of SARS-CoV-2 infections were able to achieve an initial decrease in STI cases in 2020, however, this change was not maintained during 2021, which ended with higher incidences recorded to date.

Past and projected temporal trends in arthroscopic hip surgery in Spain between 1998 and 2018

OBJECTIVE

Describe the population incidence of hip arthroscopy from 1998 to 2018 and to project the trends for the year 2030, as well as to describe the variations in the population incidence between the autonomous communities.

MATERIAL AND METHOD

A retrospective review of the minimum basic data set from 1998 to 2018 was carried out. Temporal evolution was analyzed and the variables associated with the indication (age, sex, regions) were identified. For each region, the crude rate per 100,000 inhabitants was calculated. The 2019-2030 projection was made using linear regression.

RESULTS

In Spain between 1998 and 2018 a total of 10,663 arthroscopic hip surgeries were carried out. The population incidence in 1998 was 0.14 CAC per 100,000 inhabitants, while in 2018 it was 4.09. For the year 2030 an increase of 156.9% in the number of arthroscopic hip surgeries is expected (P<.001). On average, 57.7% of all procedures (95% CI 55.2-60.2) were done in men and the highest incidence was found in ages ≤44 years. The geographical variation was 81%, being up to 15.4 times the difference in incidence per 100,000 inhabitants between some regions.

CONCLUSIONS

The number of hip arthroscopies in Spain has been increasing in the 1998-2018 period and this growing trend is expected to continue until 2030. In Spain, hip arthroscopic procedures are performed more frequently in male patients and in under 45 years old. The variability of the population incidence between the autonomous communities is high.

[Translated article] Past and projected temporal trends in arthroscopic hip surgery in Spain between 1998 and 2018

OBJECTIVE

Describe the population incidence of hip arthroscopy from 1998 to 2018 and to project the trends for the year 2030, as well as to describe the variations in the population incidence between the autonomous communities.

MATERIAL AND METHOD

A retrospective review of the minimum basic data set from 1998 to 2018 was carried out. Temporal evolution was analysed and the variables associated with the indication (age, sex, regions) were identified. For each region, the crude rate per 100,000 inhabitants was calculated. The 2019-2030 projection was made using linear regression.

RESULTS

In Spain between 1998 and 2018 a total of 10,663 arthroscopic hip surgeries were carried out. The population incidence in 1998 was 0.14 CAC per 100,000 inhabitants, while in 2018 it was 4.09. For the year 2030 an increase of 156.9% in the number of arthroscopic hip surgeries is expected (p<.001). On average, 57.7% of all procedures (95% CI 55.2-60.2) were done in men and the highest incidence was found in ages≤44 years. The geographical variation was 81%, being up to 15.4 times the difference in incidence per 100,000 inhabitants between some regions.

CONCLUSIONS

The number of hip arthroscopies in Spain has been increasing in the 1998-2018 period and this growing trend is expected to continue until 2030. In Spain, hip arthroscopic procedures are performed more frequently in male patients and in under 45 years old. The variability of the population incidence between the autonomous communities is high.

Impact of aging on the incidence and mortality of urological cancers: 20-year projection in Spain

INTRODUCTION

In 2020, 282,421 new cases of cancer were diagnosed in Spain, and urological neoplasms (UN) were among the most frequent ones. Cancer treatment in eldery people is challenging due to fragility and comorbidities of these patients. To meet the needs of treating UN in the eldery, it is necessary to optimize healthcare resources, for which a deep analysis of cancer registries becomes mandatory. The objective of this work was to provide a detailed analysis of the incidence and mortality of UN in Spanish people over 65 years old in the last year 2020, as well as the estimates for the year 2040.

MATERIAL AND METHODS

Incidence and mortality estimates were obtained from the GLOBOCAN database. The urological neoplasms that were included were: testicle, bladder, penis, kidney and prostate.

RESULTS

In 2020, 63,278 cases of UN were diagnosed in Spain. Most UN were much more frequent among patients >65 years old, except for testicular cancers. For the year 2040, an incidence increase of 41.5% is estimated, reaching 89,507 new cases of UN per year, with approximately 3 out of 4 patients being over 65 years old. Deaths in people over 65 will increase by 60.15% in 2040.

CONCLUSION

In the next two decades, it is expected that new cases UN in people over 65 years will increase above 50%. For Healthcare systems to face it, greater financial and human resources, as well as multidisciplinary teams with experience and geriatric training will be necessary.

Is the pace of decline in cardiovascular mortality decelerating in Spain?

INTRODUCTION AND OBJECTIVES

To update the information on mortality from cardiovascular diseases and assess recent trends in Spain.

METHODS

Deaths from cardiovascular diseases (codes I20-I25, I50, I05-I09, I00-I02, I26-I49, I51, I52, I60-I69, I10-I15, and I70-I79 of the 10th revision of the International Classification of Diseases and Causes of Death) were obtained from the National Statistics Institute. Trends were analyzed using Joinpoint regression models. The results revealed the years (periods) composing each trend, as well as the annual percent change for each of them. The direction and magnitude of recent trends (last available 5-year period) were assessed by using the average annual percent change.

RESULTS

The decline in mortality rates from cardiovascular diseases slowed from -3.7% and -4.0% in 1999-2013 to -1.7% and -2.2% since 2013 in men and women, respectively. During the study period (1999-2018) all the analyzed causes decreased significantly. Nevertheless, recent trends differed according to age, sex, and the cause analyzed. Truncated rates (35-64 years) slowed (cardiovascular disease and stroke in men and ischemic heart disease in both sexes), stabilized (cardiovascular disease, stroke, and other heart diseases in women, and blood vessel disease in men), or increased (other diseases of the heart in men and diseases of the blood vessels in women).

CONCLUSIONS

In Spain, as in other countries, the reduction in mortality rates from cardiovascular diseases slowed (overall rates for both sexes and truncated in men) or stabilized (truncated rates in women) from 2014 to 2018.

Recent trends in prostate cancer in Spain

OBJECTIVE

To assess recent trends in prostate cancer incidence, survival and mortality in Spain using updated data.

SUBJECTS AND METHOD

Prostate cancer mortality data have been obtained from the National Institute of Statistics (INE). Incidence cases have been obtained from the databases Cancer Incidence in Five Continents (CI5) and European Cancer Information System. Joinpoint regression models were used for trend analysis. The results show the duration (years) of each trend, as well as the Annual Percent Change (APC) for each of them. The direction and magnitude of recent trends (last 5 years available) were evaluated using the percentages of Average Annual Percent Change (AAPC).

RESULTS

Incidence rates increased significantly from 16.4 in 1980 to 61.3 in 2014. The joinpoint analysis shows three periods: two initial periods of significant rise (1980-1990; 3.5% and 1990-2004; 8.4%) followed by a final one in which rates stabilize (2004-2014; -0.5%, non-significant). Mortality rates drop from 12.9 in 1980 to 7.9 in 2018, with an AAPC of -1.2% (p<0.05). However, the joinpoint analysis identified three time periods: an initial period of statistically significant rise (1980-1998; APC: 0.6%, p<0.05) and two periods of decreasing rates (1992-2008; APC: -3.3%, p<0.05 and 2008-2018; APC: -2.4%, p<0.05).

CONCLUSION

Recent trends (last 5 years) show that mortality rates have decreased and incidence rates have stabilized or even decreased in some age groups.

National and sub national prevalence of Amblyopia and its trends from 1990 to 2018 in Iran

PURPOSE

To determine the national and subnational prevalence of amblyopia and the respective provincial distribution and trend during 1990-2018 in Iran.

METHODS

Amblyopia data retrieved from 26 original studies, systematic reviews, Data has been cleaned by STATA and a linear mixed effect spatio-temporal model was used to calculate Gaussian process regression mean functions. Using a Bayesian approach, by pooling empirical data based on the assumed prior, a posterior distribution obtained for age and sex specific prevalence prediction nationally during the study time and provincially.

RESULTS

The overall age-adjusted prevalence of Amblyopia was 0.03 (95% CI, 0.022-0.035). The prevalence was comparable in boys and girls (p = 0.85), highest prevalence was in >30 years old (p = 0.038). Our extrapolation revealed a stable trend of prevalence of Amblyopia in Iran during 1990-2018 (national screening program has been active from 1990 onwards). While Amblyopia prevalence suggested a declining trend in three provinces of Hormozgan, Qom and Tehran and it went up in 13 other provinces.

CONCLUSION

Amblyopia prevalence seems unchanged despite the concurrent screening program. It is noteworthy that the coverage of the program has been improved and has reached more than 85% in 2018. Our finding mandates a formal evaluation on the program.

Trend and seasonality of community-acquired Escherichia coli antimicrobial resistance and its dynamic relationship with antimicrobial use assessed by ARIMA models

INTRODUCTION

We studied the trend and seasonality of community-acquired Escherichia coli resistance and quantified its correlation with the previous use of certain antibiotics.

METHODS

A time series study of resistant community-acquired E. coli isolates and their association with antibiotic use was conducted in a Primary Health Care Area from 2008 to 2012. A Poisson regression model was constructed to estimate the trend and seasonality of E. coli resistance.

RESULTS

A significant increasing trend in mean E. coli resistance to cephalosporins, aminoglycosides and nitrofurantoin was observed. Seasonal resistance to ciprofloxacin and amoxicillin-clavulanic acid was significantly higher in autumn-winter. There was a delay of 7, 10 and 12 months between the use of cotrimoxazole (P<0.038), fosfomycin (P<0.024) and amoxicillin-clavulanic acid (P<0.015), respectively, and the occurrence of E. coli resistance.

CONCLUSIONS

An average delay of 10 months between the previous use of amoxicillin-clavulanic acid, cotrimoxazole and fosfomycin and the appearance of resistant community-acquired E. coli strains was detected.

Analysis of cerebrovascular disease mortality trends in Andalusia (1980-2014)

INTRODUCTION

In recent decades, mortality rates for cerebrovascular diseases (CVD) have decreased significantly in many countries. This study analyses recent tendencies in CVD mortality rates in Andalusia (1980-2014) to identify any changes in previously observed sex and age trends.

PATIENTS AND METHODS

CVD mortality and population data were obtained from Spain's National Statistics Institute database. We calculated age-specific and age-standardised mortality rates using the direct method (European standard population). Joinpoint regression analysis was used to estimate the annual percentage change in rates and identify significant changes in mortality trends. We also estimated rate ratios between Andalusia and Spain.

RESULTS

Standardised rates for both males and females showed 3 periods in joinpoint regression analysis: an initial period of significant decline (1980-1997), a period of rate stabilisation (1997-2003), and another period of significant decline (2003-2014).

CONCLUSIONS

Between 1997 and 2003, age-standardised rates stabilised in Andalusia but continued to decrease in Spain as a whole. This increased in the gap between CVD mortality rates in Andalusia and Spain for both sexes and most age groups.

[Trends and determinants factors of Chlamydia trachomatis genital infection in young people under 25 years. Catalonia 2007-2014]

INTRODUCTION

Chlamydia trachomatis (chlamydia) infection is the most common bacterial sexually transmitted diseases (STD). However, the prevalence among young people is unknown in our country. In 2007, the monitoring of the prevalence and behaviours related to acquiring it began in Catalonia in young people ≤25years.

OBJECTIVES

To determine and monitor the prevalence and determining factors of chlamydia among a young sexually active population ≤25years, treated in sexual and reproductive health care centras (CT/NG-ASSIR) and in prisons (CT/NG-Prisons).

MATERIALS AND METHODS

An analysis was performed on 6 cross-sectional data studies in two sentinel populations of young people from the period 2007-2014. Behavioural indicators were recorded and urine specimens were collected for analysis by PCR. The prevalence and trends are described, and the variables associated with infection were evaluated using multivariate logistic regression analysis.

RESULTS

The mean prevalence for CT/NG-ASSIR was 7.4%, with an upward trend (P=.174), and an increase of 46.5%. CT/NG-Prisons had a mean 8.0%, with an upward trend (P=.282), and an increase of 31.6%. Age and foreign origin are presented as risk factors in both populations. The concurrent sexual partners added to CT/NG-ASSIR and the time spent in prison to CT/NG-Prisons.

DISCUSSION

The results underscore the need for a more efficient approach to control activities related to chlamydia infection in Catalonia. Policies need to be strengthened to promote safer sexual behaviours and active case finding by opportunistic screening in less than 25year-old.

Has prostate cancer mortality stopped its decline in Spain?

OBJECTIVE

To describe the evolution of prostate cancer mortality in Spain during the period 1980-2013.

SUBJECT AND METHOD

The prostate cancer mortality data and population data needed to calculate the indicators were provided by the National Institute of Statistics. We calculated the specific rates by age group, raw and standardised globally using the direct method (European standard population). The rates are expressed for 100,000 person-years. For the analysis of trends in the rates, we used joinpoint regression models.

RESULTS

The overall rates adjusted for age in Spain decreased from 21.7 to 15.4 deaths per 100,000 men-years between the starting and ending date of the study period (annual percentage change: -.9%; P<.05). The joinpoint analysis reflects 2 periods: 1980-1998 (.7% annual increase; P<.05) and 1998-2013, during which the rates decreased significantly (-3%; P<.05). Except for the autonomous cities of Ceuta and Melilla where the rates remained stable over the course of the study period, the communities showed 1 or 2 points of inflection in the trends, and all had a final period with a reduction in the rates (except for Galicia and Catalonia, where the rates stabilised in 2008-2013).

CONCLUSION

The decline in prostate cancer mortality in Spain appears to have stopped in Galicia and Catalonia.

Municipal distribution and trends in bladder cancer incidence in health area of León, Spain (1996-2010)

OBJECTIVE

Spain is a country where bladder cancer incidence and mortality rates are some of the highest in the world. The aim of this study is to know the incidence, trends and geographical distribution of bladder cancer in the health area of León.

MATERIAL AND METHODS

the new cases of bladder cancer (CIE-188) in patients residing in the health area of León and registered in the Hospital Tumor Registry of the Centro Asistencial Universitario in León (Spain) between 1996-2010 were included in this study. Triennial crude incidence and adjusted incidence rates to the worldwide and European population were calculated. Population data of the municipalities of Leon (Spain) were obtained from National Institute of Statistic of Spain (INE, Instituto Nacional de Estadística). Data were disaggregated by sex-groups and five-year age groups. Spatial distribution of smoothed municipal relative risks (RR) of bladder cancer was carried out using a Besag, York and Mollié model. Bayesian model were used to calculate the posterior probability (PP) of RR greater than one.

RESULTS

1.573 cases were included. Incidence rates standardized to European population increased among men from 20,8/100.000 (1996-98) to 33,1/100.000 (2006-2008) and among women these rates increased from 1,9/100.000 to 5,9/100.000 for the same period of time. No relevant differences were found in the municipal distribution of the incidences.

CONCLUSIONS

bladder cancer incidence rates are high in the European context. Rising trends in incidence in both sexs, particularly in women are observed.

Analysis of cerebrovascular mortality trends in Spain from 1980 to 2011

INTRODUCTION

In recent decades, mortality rates for cerebrovascular diseases (CVD) have declined significantly in many countries. This study analyses changes in CVD mortality rates in Spain (1980-2011) to determine if previously observed trends remain.

PATIENTS AND METHODS

Data on CVD mortality rates and the population data needed for the analysis were provided by Spain's National Statistics Institute. We calculated age-specific mortality rate, age-standardised overall mortality, and age-truncated mortality (35-64 years) using the direct method and standard European population structure. Joinpoint analysis was used to estimate the percentage of annual change in rates and identify significant changes in trends.

RESULTS

CVD mortality rate decreased considerably and continuously over the last 32 years in all age groups and in both sexes in Spain. For both sexes, joinpoint analysis identifies a final period with more marked decline: 2005-2011 in women (-6.3%) and 2007-2011 in men (-7.2%).

CONCLUSIONS

CVD mortality rates displayed a marked and continuous decline in Spain between 1980 and 2011. Due to the ageing of the population, doctors expect an increase in CVD prevalence and therefore its magnitude in terms of disability and healthcare costs, which poses a challenge to our health system.

[Incidence of childhood type I diabetes in Extremadura, Spain, 2003-2007]

BACKGROUND AND OBJECTIVES

Studies have shown an increasing incidence of type I diabetes in children in Europe over the last 20 years. The present study was conducted to evaluate the incidence and development of type I diabetes in children under 15 years of age in Extremadura in the period 2003-2007.

MATERIAL AND METHODS

The study applied the capture-recapture method using the national hospital discharge database as primary source. Data were collected from children under 15 years of age diagnosed with diabetes type I during the study period. Secondary data source were insulin prescriptions from the public health system. Rates were standardised and a Poisson regression was used to assess the development of the disease during the study period.

RESULTS

The overall adjusted incidence rate was 25.2/100.000 (95%CI: 21.8-28.6) with 100% completeness; no significant differences were observed by sex or provinces. Age group rates were 20.2/100.000 (95%CI: 10.1-30.3) for aged 0-4 years, 24.8/100.000 (95%CI: 20.1-29.4) for aged 5-9 years, and 30.0/100.000 (95%CI: 25.8-34.1) for aged 10-14 years, with a RR of 1.67 (95%CI: 1.18-2.36; P=.004) for 10-14 year olds relative to 0-4 year olds. The number of cases among children aged 0-4 years increased from 5 cases in 2003 to 15 cases in 2006, although this increase was not significantly different.

CONCLUSION

The overall rates of incidence of type I diabetes were higher than the expected incidence values in Extremadura. Careful surveillance is required to confirm the increased trend in the incidence of type I diabetes observed among children aged 0-4 years.