Trends in cancer incidence in Uruguay:2002 - 2015
Abstract
Background: Uruguay is the southamerican country which has the highest cancer incidence and mortality rates. The National Cancer Registry collects data on cancer cases nationwide since 1989 and has reached high quality standards in the last decades. This is the first report on incidence trends.
Methods: Data from the National Cancer Registry of all new cases of invasive cancer from twelve sites diagnosed in 2002-2015 was analyzed. Age-standardized rates were calculated. Trends of incidence rates were analyzed using joinpoint regression models.
Results For both, men and women, incidence rates trends for all cancer sites, colo-rectal and bladder cancer remained stable. Esophageal and gastric cancers descend while Thyroid and kidney cancer incidence increased. In men lung cancer decreased; testicular cancer increased, and prostate cancer increased at the beginning of the period and decreased in the final years. In women; lung cancer increased, breast cancer remained stable and cervical cancer presented a significant decline from 2005 to 2010 and reached a plateau since then.
Conclusion: Cancer incidence dynamics are complex and affected not only by Public Health policies such as tobacco control, vaccination and screening programs, but also by environmental and life style changes and the attitude of the medical community towards the application of diagnostic and therapeutic tools. The aim of this paper is to analyze cancer incidence time trends in the country and provide possible explanations to them.
Authors
Downloads
Keywords
- Cancer
- Incidence trends
- Uruguay
- Urinary Bladder Neoplasms
- Incidence Stomach Neoplasms
- Tobacco
- Latin America
- Testicular Germ Cell Tumor
- Testicular Neoplasms
- Breast Neoplasms
- Uterine Cervical Neoplasms
- Noncommunicable Diseases
- Thyroid Gland Carcinoma
Author Biographies
, 1 Universidad de la República, Facultad de Medicina, Departamento de Métodos Cuantitativos. Montevideo, Uruguay, 2 Registro Nacional de Cáncer, Comisión Honoraria de lucha contra el Cáncer. Montevideo, Uruguay.
https://orcid.org/0000-0002-9632-7539, Registro Nacional de Cáncer, Comisión Honoraria de lucha contra el Cáncer. Montevideo, Uruguay.
https://orcid.org/0000-0002-1282-5590, Universidad de la República, Facultad de Medicina, Departamento de Métodos Cuantitativos. Montevideo, Uruguay
https://orcid.org/0000-0001-7414-3221, 1 Universidad de la República, Facultad de Medicina, Departamento de Métodos Cuantitativos. Montevideo, Uruguay, 2 Registro Nacional de Cáncer, Comisión Honoraria de lucha contra el Cáncer. Montevideo, Uruguay.
https://orcid.org/0000-0001-6608-8605References
Ferlay J, Ervik M, Lam F, Colombet M, Mery L. Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer; 2018. Cited: 2019 Jul 27. Available from: https://gco.iarc.fr/
Instituto Nacional de Estadística. Censo 2004 Fase I; 2005. Cited: 2016 Nov 8. Available from: http://www.ine.gub.uy/web/guest/censo-2004-fase-i
Instituto Nacional de Estadística. Censos 2011; 2012. Cited: 2016 Oct 5. Available from: http://www.ine.gub.uy/censos-2011
Comisión Honoraria de Lucha contra el cáncer. Registro Nacional de Cáncer; 2019. Cited: 2019 Apr 11. Available from: https://www.comisioncancer.org.uy/categoria/Registro-Nacional-de-Cancer-14
Ministerio de Salud. Estadísticas Vitales. cited: 2017 May 16. Available from: http://www.msp.gub.uy/EstVitales/#services
De Stefani E, Fierro L, Barrios E, Ronco A. Cancer mortality trends in Uruguay 1953-1991. Int J Cancer. 1994;56(5): 634-9. https://doi.org/10.1002/ijc.2910560505
Sierra MS, Soerjomataram I, Antoni S, Laversanne M, Piñeros M, de Vries E, et al. Cancer patterns and trends in Central and South America. Cancer Epidemiol. 2016;44:S23-42. https://doi.org/10.1016/j.canep.2016.07.013
Corral CF, Cueva AP, Yépez MJ, Tarupi MW. Trends in cancer incidence and mortality over three decades in Quito - Ecuador. Colomb Med (Cali). 2018;49(1):35-41. https://doi.org/10.25100/cm.v49i1.3785
Bravo LE, Collazos T, Collazos P, García LS, Correa P. Trends of cancer incidence and mortality in Cali, Colombia. 50 years experience. Colomb Med (Cali). 2012;43(4):246-55. https://doi.org/10.25100/cm.v43i4.1266
Fritz A, Percy C, Jack A, Shanmugaratnam K, Sobin L, Parkin DM et al. International Classification of Diseases for Oncology. 3rd ed. Geneva: World Health Organization; 2000.
Ferlay J, Burkhard C, Whelan S, Parkin DM. Check and conversion programs check and conversion programs. IARC Technical Report No. 42 Lyon; 2005. Cited: 2016 Jun 29; Available from: http://www.iacr.com.fr/index.php?option=com_content&view=article&id=72:iarccrgtools&catid=68&Itemid=445
Forman D, Bray F, Brewster DH, Gombe MC, Kohler B, Piñeros M, et al. Cancer Incidence in Five Continents, Vol. X. Lyon, France: International Agency for research on Cancer; 2014. IARC Scientific publication N°164.
Bray F, Colombet M, Mery L, Piñeros M, Znaor A, Zanetti R, et al. Cancer Incidence in Five Continents, Vol. XI. Lyon: International Agency for Research on Cancer.; 2017.
IARC-WHO. Globocan. Cancer today. Data Sources and methods; 2018. Cited 2019 Feb 6. Available from: http://gco.iarc.fr/today/data-sources-methods
Instituto Nacional de Estadística. Censos 1963-1996; 1997. Cited: 2016 Oct 3. Available from: http://www.ine.gub.uy/web/guest/censos-1963-1996
Segi M. Cancer mortality for selected sites in 24 countries (1950-57). Department of Public Health, Tohoku University of Medicine, Sendai, Japan. 1960.
Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med. 2000;19(3):335-51. https://doi.org/10.1002/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z
National Cancer Institute. Statistical Methodology and Applications Branch, Survilliance Research Program. Joinpoint Regression Program, Ver 4.7.0.0. Bethesda, Maryland, Estados Unidos; 2019.
Schnitt SJ, Lakhani SR. Breast cancer. In: Stewart BW, Wild C, editors. World cancer report 2014. Lyon, France: IARC-WHO; 2014. p. 362-73.
Ministerio de Salud Pública. Guía de práctica clínica de detección temprana del cáncer de mama. Uruguay: MSP; 2015. Cited: 2017 May 31. Available from: http://www.msp.gub.uy/sites/default/files/archivos_adjuntos/Iniciativas%20sanitarias%20%28guia%20deteccion%20cancer%20mama%29.pdf
Barrios E, Musetti C, Alonso R, Garau M. V Atlas de mortalidad por cáncer en el Uruguay 2009-2013. Montevideo: Comisión Honoraria de Lucha Contra el Cáncer; 2015.
Thun MJ, Henley S. Tobacco. In: Schottenfeld D, Fraumeni JF, editors. Cancer epidemiology and prevention.3era. Ed. Oxford University Press; 2006. p. 217-42. https://doi.org/10.1093/acprof:oso/9780195149616.003.0013
Bray F, Tyczynski JE, Parkin DM. Going up or coming down? The changing phases of the lung cancer epidemic from 1967 to 1999 in the 15 European Union countries. Eur J Cancer. 2004;40(1):96-125. https://doi.org/10.1016/j.ejca.2003.08.005
Bray F, Weiderpass EE. Lung cancer mortality trends in 36 European countries: secular trends and birth cohort patterns by sex and region 1970-2007. Int J Cancer. 2010;126(6):1454-66. https://doi.org/10.1002/ijc.24855
Barrios E, Garau M, Musetti C, Alonso R. A decade of tobacco control planning in Uruguay: analysis of the lung cancer epidemiological situation. 37th International Association of Cancer registries Annual Scientific Conference; 2015 Oct; Mumbai, India.
Alonso R, Piñeros M, Laversanne M, Musetti C, Garau M, Barrios E, et al. Lung cancer incidence trends in Uruguay 1990-2014: An age-period-cohort analysis. Cancer Epidemiol. 2018;55:17-22. https://doi.org/10.1016/j.canep.2018.04.012
Ministerio de Salud Pública. 1a Encuesta Nacional de Factores de Riesgo de Enfermedades Crónicas No Transmisibles. Montevideo; 2006. Available from: http://www.msp.gub.uy/sites/default/files/archivos_adjuntos/1er_enfrecnt_2006_1.pdf
Ministerio de Salud Publica. 2a Encuesta Nacional de Factores de Riesgo de Enfermedades No Transmisibles; 2013. Cited: 2018 Sep 18. Available from: http://www.msp.gub.uy/publicaci%C3%B3n/2%C2%AA-encuesta-nacional-de-factores-de-riesgo-de-enfermedades-no-transmisibles
Negoita S, Feuer EJ, Mariotto A, Cronin KA, Petkov VI, Hussey SK, et al. Annual report to the nation on the status of cancer, part II: Recent changes in prostate cancer trends and disease characteristics. Cancer. 2018;124(13):2801-14. https://doi.org/10.1002/cncr.31549
Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66(4):683-91. https://doi.org/10.1136/gutjnl-2015-310912
Shibata A, Parsonnet J. Stomach Cancer. In: Schottenfeld D, Fraumeni JF. Cancer epidemiology and prevention.3era. Ed. Oxford University Press; 2006. https://doi.org/10.1093/acprof:oso/9780195149616.003.0037
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. CA Cancer J Clin. 2018;68(6):394-424. https://doi.org/10.3322/caac.21492
Song W, Jeon HG. Incidence of kidney, bladder, and prostate cancers in Korea: An update. Korean J Urol. 2015;56(6):422-8. https://doi.org/10.4111/kju.2015.56.6.422
Chow W-H, Dong LM, Devesa SS. Epidemiology and risk factors for kidney cancer. Nat Rev Urol. 2010;7(5):245-57. https://doi.org/10.1038/nrurol.2010.46
De P, Otterstatter MC, Semenciw R, Ellison LF, Marrett LD, Dryer D. Trends in incidence, mortality, and survival for kidney cancer in Canada, 1986-2007. Cancer Causes Control. 2014;25(10):1271-81. https://doi.org/10.1007/s10552-014-0427-x
Znaor A, Laversanne M, Bray F. Less overdiagnosis of kidney cancer? an age-period-cohort analysis of incidence trends in 16 populations worldwide. Int J Cancer. 2017;141(5):925-32. https://doi.org/10.1002/ijc.30799
King SC, Pollack LA, Li J, King JB, Master VA. Continued increase in incidence of renal cell carcinoma, especially in young patients and high grade disease: United States 2001 to 2010. J Urol. 2014;191(6):1665-70. https://doi.org/10.1016/j.juro.2013.12.046
Bergström A, Pisani P, Tenet V, Wolk A, Adami HO. Overweight as an avoidable cause of cancer in Europe. Int J Cancer. 2001;91(3):421-30. https://doi.org/10.1002/1097-0215(200002)9999:9999<::AID-IJC1053>3.0.CO;2-T
WHO. Obesity and overweight; 2019. Cited: 2019 Jun 25. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Wong MCS, Fung FDH, Leung C, Cheung WWL, Goggins WB, Ng CF. The global epidemiology of bladder cancer: a joinpoint regression analysis of its incidence and mortality trends and projection. Sci Rep. 2018;8(1):1129. https://doi.org/10.1038/s41598-018-19199-z
Antoni S, Ferlay J, Soerjomataram I, Znaor A, Jemal A, Bray F. Bladder Cancer Incidence and Mortality: A Global Overview and Recent Trends. Eur Urol. 2017;71(1):96-108. https://doi.org/10.1016/j.eururo.2016.06.010
Park JS, Kim J, Elghiaty A, Ham WS. Recent global trends in testicular cancer incidence and mortality. Medicine (Baltimore). 2018;97(37):e12390. https://doi.org/10.1097/MD.0000000000012390
Ylönen O, Jyrkkiö S Pukkala E Syvänen K Boström PJ.Time trends and occupational variation in the incidence of testicular cancer in the Nordic countries. BJU Int. 2018; 122 (3), 384-393. https://doi.org/10.1111/bju.14148
Sengupta P, Dutta S, Krajewska-Kulak E. The disappearing sperms: analysis of reports published between 1980 and 2015. Am J Mens Health. 2017;11(4):1279-304. https://doi.org/10.1177/1557988316643383
Carlsen E, Giwercman A, Keiding N, Skakkeblek NE. Evidence for decreasing quality of semen during past 50 years. BMJ. 1992; 305(6854): 609-613. https://doi.org/10.1136/bmj.305.6854.609
Walsh TJ, Croughan MS, Schembri M, Chan JM, Turek PJ.Increased risk of testicular germ cell cancer among infertile men. Arch Intern Med. 2009;169(4):351-6. https://doi.org/10.1001/archinternmed.2008.562
Baker JA, Buck GM, Vena JE, Moysich KB. Fertility patterns prior to testicular cancer diagnosis. Cancer Causes Control. 2005;16(3):295-9. https://doi.org/10.1007/s10552-004-4024-2
worldbank. Indicators | Data; 2019. Cited: 2019 Jul 31. Available from: https://data.worldbank.org/indicator
Callaghan RC, Allebeck P, Akre O, McGlynn KA, Sidorchuk A. Cannabis use and incidence of testicular cancer: A 42-year follow-up of swedishmen between 1970 and 2011. Cancer Epidemiol Biomarkers Prev. 2017; 26(11):1644-52. https://doi.org/10.1158/1055-9965.EPI-17-0428
Gurney J, Shaw C, Stanley J, Signal V, Sarfati D. Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis. BMC Cancer. 2015;15(1):897. https://doi.org/10.1186/s12885-015-1905-6
Monitor Cannabis. Evolución del consumo de cannabis en Uruguay y mercados regulados; 2019. Cited: 2019 Jun 25. Available from: http://monitorcannabis.uy/evolucion-del-consumo-de-cannabis-en-uruguay-y-mercados-regulados/
Montgomery EA. Oesophageal cancer. In: Stewart BW, Wild C, editors. World cancer report 2014. Lyon: IARC-WHO; 2014. p. 374-82.
Holmes RS, Vaughan TL. Epidemiology and pathogenesis of esophageal cancer. Semin Radiat Oncol. 2007;17(1):2-9. https://doi.org/10.1016/j.semradonc.2006.09.003
Blackstock AW. Esophageal Cancer. Semin Radiat Oncol. 2007;17(1):1. https://doi.org/10.1016/j.semradonc.2006.11.001
Bosman FT, Carneiro F, Hruban RH, Theise ND, editors. Tumours of the Oesophagus Cap 1. In: WHO Classification of Tumours of the Digestive System Fourth Edition. Lyon: IARC; 2010
Chen Y, Tong Y, Yang C, Gan Y, Sun H, Bi H, et al. Consumption of hot beverages and foods and the risk of esophageal cancer: a meta-analysis of observational studies. BMC Cancer. 2015;15:449. https://doi.org/10.1186/s12885-015-1185-1
Vassallo A, Correa P, De Stéfani E, Cendán M, Zavala D, Chen V, et al. Esophageal cancer in Uruguay: a case-control study. J Natl Cancer Inst. 1985;75(6):1005-9.
International Agency for Research on Cancer, editor. Coffee, tea, mate, methylxanthines and methylglyoxal. Lyon; 1991.513 p. (IARC monographs on the evaluation of carcinogenic risks to humans).
Lubin JH, De Stefani E, Abnet CC, Acosta G, Boffetta P, Victora C, et al. Maté drinking and esophageal squamous cell carcinoma in South America: pooled results from two large multicenter case-control studies. Cancer Epidemiol Biomarkers Prev. 2014;23(1):107-16. https://doi.org/10.1158/1055-9965.EPI-13-0796
IARC Monographs on the evaluation of Carcinogenic Risks to Humans. Report of the Advisory Group to recommend Priorities for IARC Monographs during 2015-2019.Lyon; 2014. Internal Report 14/002.
Candreva EC, Keszenman DJ, Barrios E, Gelós U, Nunes E. Mutagenicity induced by hyperthermia, hot mate infusion, and hot caffeine in Saccharomyces cerevisiae. Cancer Res. 1993;53(23):5750-3.
De Stefani E, Moore M, Aune D, Deneo-Pellegrini H, Ronco AL, Boffetta P, et al. Maté consumption and risk of cancer: a multi-site case-control study in Uruguay. Asian Pac J Cancer Prev. 2011;12(4):1089-93.
Prabhu A, Obi KO, Rubenstein JH. The synergistic effects of alcohol and tobacco consumption on the risk of esophageal squamous cell carcinoma: a meta-analysis. Am J Gastroenterol. 2014;109(6):822-7. https://doi.org/10.1038/ajg.2014.71
Jemal A, Center MM, DeSantis C, Ward EM. Global patterns of cancer incidence and mortality rates and trends. Cancer Epidemiol Biomarkers Prev. 2010;19(8):1893-907. https://doi.org/10.1158/1055-9965.EPI-10-0437
Bosetti C, Levi F, Ferlay J, Garavello W, Lucchini F, Bertuccio P, et al. Trends in oesophageal cancer incidence and mortality in Europe. Int J Cancer. 2008;122(5):1118-29. https://doi.org/10.1002/ijc.23232
Prat J, Franceschi S. Cancers of the female reproductive organs. In: World cancer report 2014. Lyon, France: Stewart BW and Wild C IARC-WHO; 2014. p. 465-81.
Nozar DMF, Briozzo L. Cáncer de cuello uterino en Uruguay. Controversias en la prevención. Rev Med Uruguay. 2017;33(1):64-70.
Schiffman MH, Hildesheim A. Cervical Cancer. In: Schottenfeld D, Fraumeni JF. Cancer epidemiology and prevention.3era. Ed. Oxford University Press; 2006. https://doi.org/10.1093/acprof:oso/9780195149616.003.0054
The Word Bank. Fertility rate, total (births per woman) - Uruguay | Data; 2019. Cited: 2020 Feb 11. Available from: https://data.worldbank.org/indicator/SP.DYN.TFRT.IN?locations=UY
Schottenfeld D, Fraumeni JF. Cancer epidemiology and prevention.3era. Ed. Oxford University Press; 2006. https://doi.org/10.1093/acprof:oso/9780195149616.001.0001
Vaccarella S, Franceschi S, Bray F, Wild CP, Plummer M, Dal Maso L. Worldwide thyroid-cancer epidemic? The increasing impact of overdiagnosis. N Engl J Med. 2016;375(7):614-7. https://doi.org/10.1056/NEJMp1604412
Ahn HS, Welch HG. South Korea's Thyroid-Cancer "Epidemic" - Turning the Tide. N Engl J Med. 2015;373(24):2389-90. https://doi.org/10.1056/NEJMc1507622
Copyright (c) 2019 Universidad del Valle
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 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
