Survival in stomach cancer: analysis of a national cancer information system and a population-based cancer registry in Colombia
Abstract
Background:
Stomach cancer is among the most frequent, is a leading cause of mortality in low- and middle-income countries. Assessing its survival is important to guide evidence-based health policies.
Aims:
To estimate stomach cancer survival in Colombia (2014-2019) with data from the national Cancer Information System (NCIS) and in Cali with data from the Cali Population Cancer Registry (RPCC) (1998-2017).
Methods:
NCIS estimated the overall 3-year net survival for 8,549 people, while RPCC estimated 5-year net survival for 6,776 people.
Results:
The 3-year net survival was 36.8% (95% CI: 35.5-38.1). Net survival was higher in people with special insurance (61.7%; 95% CI: 44.8-74.8) or third payer (40.5%; 95% CI: 38.7-42.3) than state insurance (30.7%; 95% CI: 28.7-32.8). It was also higher in women and people diagnosed at early stages. Multivariable analysis showed consistency with survival estimations with a higher risk of death in men, people with state insurance, and diagnosed at advanced stages. In Cali, the 5-year net survival remained stable in men during the last 20 years. In women the 5-year net survival in women increased 8.60 percentage points, equivalent to a 50% increase compared to the 1998-2002 period. For 2013-17, it was 19.1% (95%CI: 16.2-22.2) in men, and 24.8% (95% CI: 20.4-29.3) in women.
Conclusions:
Population survival estimates from the RPCC were lower than those observed in the NCIS. The differences in their methods and scope can explain variability. Nevertheless, our findings could be complementary to improve cancer control planning in the country.
Authors
Downloads
Keywords
- Cancer Registries
- Stomach Cancer
- Survival Analysis
- Epidemiology
- Early Detection of Cancer
- Incidence
- Stomach Neoplasms
- Helicobacter pylori
- Prognosis
References
Bray F. Ferlay J. Soerjomataram I. Siegel RL. Torre LA. Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. C.A. Cancer J Clin. 2018;68(6):394-424. https://doi.org/10.3322/caac.21492 PMid:30207593
Rawla P. Barsouk A. Epidemiology of gastric cancer: Global trends. risk factors and prevention. Prz Gastroenterol. 2019;14(1):26-38. https://doi.org/10.5114/pg.2018.80001 PMid:30944675 PMCid:PMC6444111
International Agency for Research on Cancer. Global Cancer Observatory. Estimated deaths in 2018. Colombia. [Internet]. 2018. Available from: http://gco.iarc.fr/today/online-analysis-table?v=2018&mode=cancer&mode_population=countries&population=900&populations=170&key=asr&sex=0&cancer=39&type=1&statistic=5&prevalence=0&population_group=0&ages_group%5B%5D=0&ages_group%5B%5D=17&nb_items=5&group_c
Yang D. Hendifar A. Lenz C. Togawa K. Lenz F. Lurje G. et al. Survival of metastatic gastric cancer: Significance of age. sex and race/ethnicity. J Gastrointest Oncol. 2011;2(2):77-84.
Llorens P. Gastric cancer mass survey in Chile. Semin Surg Oncol. 1991;7(6):339-43. https://doi.org/10.1002/ssu.2980070604 PMid:1759081
Asaka M. Mabe K. Strategies for eliminating death from gastric cancer in Japan. Proc Japan Acad Ser B Phys Biol Sci. 2014;90(7):251-8. https://doi.org/10.2183/pjab.90.251 PMid:25169671 PMCid:PMC4237896
Yuan Y. A survey and evaluation of population-based screening for gastric cancer. Cancer Biol Med. 2013;10(2):72-80.
Hamashima C. Kato K. Miyashiro I. Nishida H. Takaku R. Terasawa T. et al. Update version of the Japanese guidelines for gastric cancer screening. Jpn J Clin Oncol. 2018;48(7):673-83. https://doi.org/10.1093/jjco/hyy077 PMid:29889263
Pisani P. Oliver WE. Parkin DM. Alvarez N. Vivas J. Case-control study of gastric cancer screening in Venezuela. Br J Cancer. 1994;69(6):1102-5. https://doi.org/10.1038/bjc.1994.216 PMid:8198977 PMCid:PMC1969457
Rosero-Bixby L. Sierra R. X-ray screening seems to reduce gastric cancer mortality by half in a community-controlled trial in Costa Rica. Br J Cancer. 2007;97(7):837-43. https://doi.org/10.1038/sj.bjc.6603729 PMid:17912238 PMCid:PMC2360405
Goss PE. Lee BL. Badovinac-Crnjevic T. Strasser-Weippl K. Chavarri-Guerra Y. Louis JS. et al. Planning cancer control in Latin America and the Caribbean. Lancet Oncol. 2013;14(5):391-436.
Luna LF. Bravo MM. Kasamatsu E. Lazcano EC. Martinez T. Torres J. et al. Risk factors for gastric precancerous and cancers lesions in Latin American counties with difference gastric cancer risk. Cancer Epidemiol. 2021;64:1-21. https://doi.org/10.1016/j.canep.2019.101630 PMid:31756677 PMCid:PMC6983355
Fondo Colombiano de Enfermedades de Alto C de AC. Situación del cáncer en la población adulta atendida en el SGSS de Colombia. 2020. 6°. Bogotá D.C.; 2021.
Hernández Vargas JA. Ramírez Barbosa PX. Valbuena-Garcia AM. Acuña-Merchán LA. González-Diaz JA. Lopes G. National Cancer Information System Within the Framework of Health Insurance in Colombia: A Real-World Data Approach to Evaluate Access to Cancer Care. JCO Glob Oncol. 2021;(7):1329-40. https://doi.org/10.1200/GO.21.00155 PMid:34473526 PMCid:PMC8425322
Weir HK. Stewart SL. Claudia A. White MC. Thomas CC. White A. et al. Population-Based Cancer Survival (2001 to 2009) in the United States: Findings From the CONCORD-2 Study. 2018;123(Suppl 24):4963-8. https://doi.org/10.1002/cncr.31028 PMid:29205309 PMCid:PMC6117107
Coleman MP. Cancer survival: Global surveillance will stimulate health policy and improve equity. Lancet [Internet]. 2014;383(9916):564-73. https://doi.org/10.1016/S0140-6736(13)62225-4
The World Bank. Gross National Income (GNI) per capita in Colombia [Internet]. 2019. Available from: https://data.worldbank.org/indicator/NY.GNP.PCAP.CD?locations=CO
Ministry of Health and Social Protection R of C. Law 30. 1993. In Bogotá D.C.; 1993.
Ministry of Health and Social Protection R of C. Health insurance coverage in Colombia [Internet]. 2020. Available from: https://www.minsalud.gov.co/proteccionsocial/Paginas/cifras-aseguramiento-salud.aspx
Departamento Administrativo Nacional de Estadísticas [DANE]. Censo Nacional de Población y Vivienda (CNPV) 2018. Estimaciones de la población ajustada por cobertura censal [Internet]. 2018. Available from: https://www.dane.gov.co/index.php/estadisticas-por-tema/demografia-y-poblacion/censo-nacional-de-poblacion-y-vivenda-2018
García LS. Bravo L.E. Collazos P. Ramírez O. Carrascal E. Nuñez M. et al. Cali cancer registry methods. Colomb Med. 2018;49(1):109-20. https://doi.org/10.25100/cm.v49i1.3853 PMid:29983471 PMCid:PMC6018820
Ministry of Health and Social Protection R of C. Resolution 4496. 2012. Bogotá; 2012. 1-7 p.
Departamento Administrativo Nacional de Estadísticas [DANE]. Estimaciones y proyecciones de población periodo 1985-2020. Bogotá D.C.; 2010.
Bray F. Parkin D.M. Evaluation of data quality in the cancer registry: Principles and methods. Part I: Comparability. validity and timeliness. Eur J Cancer [Internet]. 2009;45(5):747-55. Available from: http://dx.doi.org/10.1016/j.ejca.2008.11.032 https://doi.org/10.1016/j.ejca.2008.11.032 PMid:19117750
Parkin DM. Bray F. Evaluation of data quality in the cancer registry: Principles and methods Part II. Completeness. Eur J Cancer [Internet]. 2009;45(5):756-64. https://doi.org/10.1016/j.ejca.2008.11.033 PMid:19128954
Bravo L.E. García LS. Collazos P. Carrascal E. Ramírez O. Collazos T. et al. Reliable information for cancer control in Cali. Colombia. Colomb Med. 2018;49(1):23-34. https://doi.org/10.25100/cm.v49i1.3689 PMid:29983461 PMCid:PMC6018818
World Health Organization. International Statistical Clasiffication of Diseases and Related Problems. 2nd ed. Geneva. Switzerland; 2003.
Fritz A. International Classification of Diseases for Oncology: ICD-O. 3rd ed. World Health Organization. editor. Geneva. Switzerland; 2000.
Perme MP. Stare J. Estève J. On Estimation in Relative Survival. Biometrics. 2012;68(1):113-20. https://doi.org/10.1111/j.1541-0420.2011.01640.x PMid:21689081
Pavlič K. Perme MP. On comparison of net survival curves. BMC Med Res Methodol. 2017;17(1):1-12. https://doi.org/10.1186/s12874-017-0351-3 PMid:28464839 PMCid:PMC5414380
Lambert PC. Royston P. Dickman PW. Rutherford MJ. Maringe C. Pohar Perme M. et al. Strcs: A command for fitting flexible parametric survival models on the log-hazard scale. Stata J [Internet]. 2016;15(1):1-13. Available from: http://dx.doi.org/10.1186/s12874-015-0057-3 https://doi.org/10.1186/s12874-015-0057-3 PMid:26275405 PMCid:PMC4537569
Maringe C. Pohar Perme M. Stare J. Rachet B. Explained variation of excess hazard models. Stat Med. 2018;37(14):2284-300. https://doi.org/10.1002/sim.7645 PMid:29633343 PMCid:PMC6001643
Lambert PC. Royston P. Further development of flexible parametric models for survival analysis. Stata J. 2009;9(2):265-90. https://doi.org/10.1177/1536867X0900900206
Brenner H. Gefeller O. Deriving more up-to-date estimates of long-term patient survival. J Clin Epidemiol. 1997;50(2):211-6. https://doi.org/10.1016/S0895-4356(97)00280-1
Allemani C. Matsuda T. Di Carlo V. Harewood R. Matz M. Nikšić M. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391(10125):1023-75.
Spika D. Bannon F. Bonaventure A. Woods LM. Harewood R. Carreira H. et al. Life tables for global surveillance of cancer survival (the CONCORD programme): Data sources and methods. BMC Cancer. 2017;17(1):1-14. https://doi.org/10.1186/s12885-017-3117-8 PMid:28241815 PMCid:PMC5327577
Corazziari I. Quinn M. Capocaccia R. Standard cancer patient population for age standardising survival ratios. Eur J Cancer. 2004;40(15):2307-16. https://doi.org/10.1016/j.ejca.2004.07.002 PMid:15454257
Tyczynski J. Démaret E. Parkin D. Standards and guidelines for cancer registration in Europe: The ENCR recommendations. In: International Agency for Research on Cancer. editor. The ENCR recommendations. 1st ed. Lyon. France; 2003.
Management C. Gastric cancer : epidemiology . prevention . classification . and treatment. 2018;239-48. https://doi.org/10.2147/CMAR.S149619 PMid:29445300 PMCid:PMC5808709
Bray F. Jemal A. Grey N. Ferlay J. Forman D. Global cancer transitions according to the Human Development Index (2008-2030): A population-based study. Lancet Oncol [Internet]. 2012;13(8):790-801. Available from: http://dx.doi.org/10.1016/S1470-2045(12)70211-5 https://doi.org/10.1016/S1470-2045(12)70211-5
Verdecchia A. Mariotto A. Gatta G. Bustamante-Teixeira MT. Ajiki W. Comparison of stomach cancer incidence and survival in four continents. Eur J Cancer. 2003;39(11):1603-9. https://doi.org/10.1016/S0959-8049(03)00360-5
Ministry of Health and Social Protection R of C. Resolution 247. 2014. Bogotá D.C; 2014. 1-22 p.
Pardo C. Cendales R. Cancer incidence estimates and mortality for the top five cancer in Colombia. 2007-2011. Colomb Med. 2018;49(1):16-22. https://doi.org/10.25100/cm.v49i1.3596 PMid:29983460 PMCid:PMC6018817
Uno Y. Prevention of gastric cancer by Helicobacter pylori eradication: A review from Japan. Cancer Med. 2019;8(8):3992-4000. https://doi.org/10.1002/cam4.2277 PMid:31119891 PMCid:PMC6639173
Strong V. Song K. Park C. Comparison of gastric cancer survival following R0 resection in the United States and Korea using an internationally validated nomogram. Ann Surg. 2010;251:640-6. https://doi.org/10.1097/SLA.0b013e3181d3d29b PMid:20224369
Noguchi Y. Yoshikawa T. Tsuburaya A. Is gastric carcinoma different between Japan and the United States? Cancer. 2000;89:2237-46. https://doi.org/10.1002/1097-0142(20001201)89:11<2237::AID-CNCR12>3.0.CO;2-9
Instituto Nacional de Salud. Control del cáncer de cuello uterino en Colombia: triunfos y desafíos de la tamización basadaen la citología cérvico-uterina. Biomédica [Internet]. 2008;28(4):1-7. https://doi.org/10.7705/biomedica.v28i4.52 PMid:19462552
Sato N. Ito Y. Ioka A. Tanaka M. Tsukuma H. Gender differences in stomach cancer survival in Osaka. Japan: Analyses using relative survival model. Jpn J Clin Oncol. 2009;39(10):690-4. https://doi.org/10.1093/jjco/hyp084 PMid:19687052
Arias-Ortiz NE. de Vries E. Health inequities and cancer survival in Manizales. Colombia: A population-based study. Colomb Med. 2018;49(1):63-72. https://doi.org/10.25100/cm.v49i1.3629 PMid:29983465 PMCid:PMC6018827
Woods L. Rachet P. Coleman M. Origins of socio-economic inequalities in cancer survival: a review. Ann Oncol. 2006;17(1):15-9. https://doi.org/10.1093/annonc/mdj007 PMid:16143594
Ramirez-Barbosa P. Merchan LA. Cancer risk management in Colombia. 2016. Colomb Med. 2018;49(1):128-36. https://doi.org/10.25100/cm.v49i1.3882 PMid:29983473 PMCid:PMC6018822
Bravo L.E. García LS. Collazos P. Carrasca E. Grillo E. Millán E. Descriptive epidemiology of cancer in Cali. 60 years of experience. Colomb Med. 2022;53(1)
![](https://colombiamedica.univalle.edu.co/colombiamedica311/public/journals/1/article_5126_cover_en_US.jpg)
Copyright (c) 2022 Universidad del Valle
![Creative Commons License](http://i.creativecommons.org/l/by-nc/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The copy rights of the articles published in Colombia Médica belong to the Universidad del Valle. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Colombia Médica without prior authorization for non-commercial use