Artículos científicos

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Limited Education as a Risk Factor in Cervical Cancer
(Bull Pan Am Health Organ, 1996-12) Corral, Fabián; Cueva, Patricia; Yépez, José; Montes, Elizabeth
Evaluación externa de registros de cáncer de base poblacional: la Guía REDEPICAN para América Latina
(Rev Panam Salud Publica, 2013) Navarro, Carmen; Molina, José Antonio; Barrios, Enrique; Izarzugaza, Isabel; Loria, Dora; Cueva, Patricia; Sánchez, María José; Chirlaque, María Dolores; Fernández, Leticia
Objetivo. Evaluar la factibilidad y la adecuación de la Guía REDEPICAN (Red Ibero americana de Epidemiología y Sistemas de Información en Cáncer) a la situación actual de los Registros de Cáncer de Base Poblacional (RCBP) en América Latina y el Caribe como herramienta útil para mejorar dichos registros. Métodos. La Guía fue diseñada por expertos en registros de cáncer y auditorías sanitarias, y se establecieron siete dominios para evaluarla. Para cada dominio se eligieron varios criterios con sus correspondientes estándares. Se determinaron tres niveles de cumplimiento del estándar. Se organizaron dos cursos de formación de evaluadores externos y tres paneles de discusión con expertos. La Guía se probó en seis RCBP de América Latina y España. Resultados. La Guía contiene 68 criterios, 10 de ellos considerados esenciales para un RCBP. De acuerdo con la puntuación alcanzada, el registro se considera como aceptable (41–199), bueno (200–299) o excelente (300–350). El dominio sobre Métodos de registro representa el 25% de la puntuación, seguido por la Exhaustividad y validez (19%), la Difusión de resultados (19%), la Estructura (13%), la Confidencialidad y aspectos éticos (11%), la Comparabilidad (9%) y el Manual de procedimiento (3%). El proyecto piloto permitió: 1) perfeccionar criterios y estándares, 2) ampliar el concepto de calidad para incorporar las necesidades de los clientes y 3) potenciar la sección de Difusión de resultados. Dos registros latinoamericanos evaluados mejoraron su calidad hasta alcanzar el estándar de la Agencia Internacional de Investigación sobre el Cáncer. Conclusiones. La guía REDEPICAN se ha elaborado teniendo en cuenta el contexto de los registros en América Latina y constituye una herramienta útil y novedosa para la mejora de la calidad de los RCBP. Además está preparada para ser utilizada en otros países y registros.
Planning and Developing Population-Based Cancer Registration in Low- and Middle-Income Settings
(Agency for Research on Cancer, 2014) Bray, Freddie; Znaor, Ariana; Cueva, Patricia; Korir, Anne; Swaminathan, Rajaraman; Ullrich, Andreas; Wang, Susan A.; Parkin, Donald Maxwell
Cover Page Table of contents Contributors Acknowledgements, Foreword, Preface, Executive summary, Abbreviations Chapter 1 – Introduction Chapter 2 – The role and status of population-based cancer registration Chapter 3 – Planning and developing a population-based cancer registry Chapter 4 – Sources of information for the population-based cancer registry Chapter 5 – Quality control at the population-based cancer registry Chapter 6 – Making the population-based cancer registry heard – reporting the results References – References Annex 1. – CanReg5 Annex 2. – Selected data quality indicators by country or region List of corrections
Stomach cancer burden in Central and South America
(2016) Sierra, Monica S.; Cueva, Patricia; Bravo, Luis Eduardo; Forman, David
Rationale and objective: Stomach cancer mortality rates in Central and South America (CSA) are among the highest in the world. We describe the current burden of stomach cancer in CSA. Methods: We obtained regional and national-level cancer incidence data from 48 population-based registries (13 countries) and nation-wide cancer deaths from WHO’s mortality database (18 countries). We estimated world population age-standardized incidence (ASR) and mortality (ASMR) rates per 100,000 and estimated annual percent change to describe time trends. Results: Stomach cancer was among the 5 most frequently diagnosed cancers and a leading cause of cancer mortality. Between CSA countries, incidence varied by 6-fold and mortality by 5–6-fold. Males had up to 3-times higher rates than females. From 2003 to 2007, the highest ASRs were in Chile, Costa Rica, Colombia, Ecuador, Brazil and Peru (males: 19.2–29.1, females: 9.7–15.1). The highest ASMRs were in Chilean, Costa Rican, Colombian and Guatemalan males (17.4–24.6) and in Guatemalan, Ecuadorian and Peruvian females (10.5–17.1). From 1997 to 2008, incidence declined by 4% per year in Brazil, Chile and Costa Rica; mortality declined by 3–4% in Costa Rica and Chile. 60–96% of all the cancer cases wereunspecified in relation to gastric sub-site but, among those specified, non-cardia cancers occurred 2–13- times more frequently than cardia cancers. Conclusion: The variation in rates may reflect differences in the prevalence of Helicobacter pylori infectionand other risk factors. High mortality may additionally reflect deficiencies in healthcare access. The high proportion of unspecified cases calls for improving cancer registration processes. ã 2015 International Agency for Research on Cancer; Licensee Elsevier Ltd. This is an open access article under the CC BY-NC-ND IGO 3.0 license (https://creativecommons.org/licenses/by-nc-nd/3.0/igo/).
Etiology of stomach cancer (C16) in Central and South America
(2016) Cueva, Patricia; Sierra, Mónica S.; Bravo, Luis Eduardo; Forman, David
International Incidence of Childhood Cancer Volume III - Quito
(International Agency for Research on Cancer, 2017) International Incidence of Childhood Cancer
Tendencias en incidencia y mortalidad por cáncer durante tres decadas en Quito - Ecuador
(Colombia Médica, 2018) Corral Cordero, Fabián; Cueva Ayala, Patricia; Yépez Maldonado, José; Tarupi Montenegro, Wilmer
Introducción: El Registro Nacional de Tumores ha recolectado, procesado, analizado y divulgado regularmente la información de los casos nuevos de cáncer diagnosticados en la ciudad de Quito, Ecuador durante las últimas tres décadas. Objetivo: Analizar la tendencia de las tasas de incidencia y mortalidad por cáncer durante el periodo 1985-2013. Métodos: Se estimaron las tasas de incidencia y mortalidad estandarizadas por edad a través del método directo, utilizando la población estándar mundial. Para el análisis de la tendencia de las tasas, de localizaciones seleccionadas, se utilizó la regresión joinpoint. Resultados: Se documentó un descenso de las tasas de incidencia y mortalidad de los tipos de cáncer de cuello uterino y estómago. Existe incremento de las tasas de cánceres de mama y colon-recto. Es notorio el crecimiento de la tasa de incidencia de cáncer de tiroides en mujeres. El cáncer de pulmón se incrementó en las mujeres en tanto que en los varones sus valores se mantuvieron estables. Conclusión: Se evidencian importantes variaciones en la evolución del cáncer en Quito, la información presentada constituye un instrumento para el seguimiento y evaluación de las intervenciones que se desarrollen.
Stagnation in Decreasing Gastric Cancer Incidence and Mortality in Quito: Time Trend Analysis, 1985–2013
(Journal of Cancer Epidemiology, 2019) Tarupi Montenegro, Wilmer; De Vries, Esther; Cueva, Patricia; Yépez, José
Background: Despite the significant global decline in mortality and incidence, gastric cancer (GC) remains a very common cause of illness and death in the Latin American region. This article seeks to describe, in depth, the time trend of incidence and mortality of GC in the city of Quito, from 1985 to 2013. Methods: Using data from the Quito Cancer Registry, annual sex-specific age-standardized incidence and mortality rates were calculated. The analysis included all types of GC together, as well as by histological subtype. Joinpoint regression analysis was performed to estimate the annual percentage change (EAPC). To evaluate cohort and period effects, Age-Period-Cohort (APC) modeling was performed. Results: Over time, incidence rate decreased from 30.4 to 18.8 cases in men and from 20.1 to 12.9 cases in women. The mortality rate decreased from 17.5 to 14.4 deaths in men and from 14.2 to 10.9 deaths in women. The incidence trend was composed of a first period (1986-1999) of strong decline (EAPC Men= -2.6, 95% Confidence Interval [CI]: -4.2, -0.9; EAPC Women= -3.2, 95% CI: -4.6, -1.9), followed by a less important decrease in men (EAPC= -0.8, 95% CI:-2.5, 0.9) and a slight increase in women (EAPC= 0.7, 95% CI: -1.4; 2.8). Mortality rates were constantly decreasing in both men (EAPC= -0.5, 95% CI: -0.9, -0.1) and women (EAPC= -0.9, 95% CI: -1.7, -0.1) throughout the period of analysis. Conclusions: The declines in incidence and mortality rates are stagnating. It is important to take measures to further reduce the high burden of GC.
Global surveillance of trends in cancer survival 2000-14 (CONCORD-3)
(The Lancet, 2019-03) Allemani, Claudia; Matsuda, Tomohiro; Di Carlo, Veronica; Harewood, Rhea; Matz, Melissa; Nikšić, Maja; Bonaventure, Audrey; Valkov, Mikhail; Johnson, Christopher J; Estève, Jacques; Ogunbiyi, Olufemi J; Chen, Wan-Qing; Eser, Sultan; Engholm, Gerda; Stiller, Charles; Monnereau, Alain; Woods, Ryan; Visser, Otto; Hsiang Lim, Gek; Aitken, Joanne; Weir, Hannah K; Coleman Michel P.; CONCORD Working Group
Background—In 2015, the second cycle of the CONCORD programme established global surveillance of cancer survival, as a metric of the effectiveness of health systems and to inform global policy on cancer control. Methods—CONCORD-3 updates the world-wide surveillance of cancer survival to 2014, with individual data for 37.5 million patients diagnosed with cancer during the 15-year period 2000–2014. Data were provided by 322 population-based cancer registries in 71 countries and territories, of which 47 provided data with 100% population coverage. The study includes 18 cancers or groups of cancers: oesophagus, stomach, colon, rectum, liver, pancreas, lung, breast (women), cervix, ovary, prostate and melanoma of the skin in adults, and brain tumours, leukaemias and lymphomas in both adults and children. Standardised quality control procedures were applied; errors were rectified by the registry concerned. We estimated five-year net survival. Estimates were age-standardised with the International Cancer Survival Standard weights. Findings—For most cancers, five-year net survival remains among the highest in the world in the US and Canada, in Australia and New Zealand, and in Finland, Iceland, Norway and Sweden. For many cancers, Denmark is closing the survival gap with the other Nordic countries. Survival trends are generally increasing, even for some of the more lethal cancers: in some countries, survival has increased by up to 5% for cancers of the liver, pancreas and lung. For women diagnosed during 2010–2014, the predicted five-year survival for breast cancer is now close to 90% in the US and in Australia, but international differences remain very wide, with levels as low as 40% in South Africa. For gastrointestinal cancers, the highest levels of five-year survival are seen in South-East Asia, in Korea for cancers of the stomach (69%), colon (72%) and rectum (71%), in Japan for oesophageal cancer (36%) and in Taiwan for liver cancer (28%). By contrast, in the same world region, survival is generally lower than elsewhere for melanoma of the skin (60% in Korea, 52% in Taiwan, 50% in China), and for both lymphoid malignancies (53% in Korea, 51% in Taiwan, 38% in China) and myeloid malignancies (46% in Korea, 33% in Taiwan, 25% in China). For children diagnosed during 2010–2014, five-year survival for acute lymphoblastic leukaemia ranged from 66% in Thailand to 95% in Finland. Five-year survival from brain tumours in children is higher than for adults, and the global range is very wide (from 45% in Thailand to 80% in Sweden and Denmark). Interpretation—The CONCORD programme enables timely comparisons of the overall effectiveness of health systems in providing care for 18 cancers that collectively represent 75% of all cancers diagnosed world-wide every year. It contributes to the evidence base for global policy on cancer control. From 2017, the Organisation for Economic Co-operation and Development will use findings from the CONCORD programme as the official benchmark of cancer survival, among their indicators of the quality of health care in 48 countries world-wide. It is crucial for governments to recognise population-based cancer registries as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems for all patients diagnosed with cancer
Epidemiología del cáncer pancreático en Quito 1986-2016
(Revista Colombiana de Cancerología, 2021) Guzmán, David; Cueva, Patricia; Tarupi Montenegro, Wilmer
Introducción: El cáncer de páncreas se encuentra entre los tipos de cáncer más mortales en el mundo, con una tasa de supervivencia neta del 9 a los 5 años. Si bien ha mejorado la comprensión de la fsiopatología, las opciones de detección temprana y tratamiento siguen siendo un desafío importante para la Salud Pública mundial. Este artículo busca describir la tendencia temporal de incidencia y mortalidad en la ciudad de Quito, de 1986 a 2016, así como la evolución de su base diagnóstica. Metodología: Utilizando datos del Registro de Cáncer de Base Poblacional de Quito, se calcularon las tasas anuales de incidencia y mortalidad estandarizadas por edad según sexo. El análisis incluyó la distribución de los casos de acuerdo con la base diagnóstica. El análisis de regresión joinpoint se realizó para estimar el cambio porcentual anual promedio (CPAP). Resultados: Durante el período de análisis, la tasa de incidencia disminuyó de 3.8 a 3.1 casos en hombres (CPAP: -1.0 Intervalos de confanza al 95 (IC95 ): -1,9; -0.1) y se mantuvo estable en mujeres. La tasa de mortalidad se incrementó en mujeres (CPAP: 1.3 IC95 :0.2; 2.4) y se mantuvo estable en hombres. Con el tiempo, la proporción de verificación histológica de los casos se incrementó en un 109 en hombres y en un 76 en mujeres. Conclusiones: Se evidencia una mejora en la calidad de registro de la información; sin embargo, la proporción de verifcación histológica es aún baja en Quito comparado con las estimaciones a nivel regional. Se subraya la necesidad de intensificar los esfuerzos del diagnóstico oportuno y adecuado.
The histology of brain tumors for 67 331 children and 671 085 adults diagnosed in 60 countries during 2000- 2014: a global, population-based study (CONCORD-3)
(Neuro-Oncology, 2021) Girardi, Fabio; Rous, Brian; Stiller, Charles A.; Gatta, Gemma; Fersht Naomi; Storm, Hans H.; Rodrigues, Jessica R.; Herrmann, Christian; Marcos-Gragera, Rafael; Peris-Bonet, Rafael; Valkov, Mikhail; Weir, Hannah K.; Woods, Ryan R.; You, Hui; Cueva, Patricia A.; De, Prithwish; Di Carlo, Veronica; Børge Johannesen, Tom; Lima, Carlos A.; Lynch, Charles F.; Coleman, Michel P.; Allemani, Claudia; CONCORD Working Group
Background. Global variations in survival for brain tumors are very wide when all histological types are con sidered together. Appraisal of international differences should be informed by the distribution of histology, but little is known beyond Europe and North America. Methods. The source for the analysis was the CONCORD database, a program of global surveillance of cancer sur vival trends, which includes the tumor records of individual patients from more than 300 population-based cancer registries. We considered all patients aged 0-99 years who were diagnosed with a primary brain tumor during 2000-2014, whether malignant or nonmalignant. We presented the histology distribution of these tumors, for pa tients diagnosed during 2000-2004, 2005-2009, and 2010-2014. Results. Records were submitted from 60 countries on 5 continents, 67 331 for children and 671 085 for adults. After exclusion of irrelevant morphology codes, the final study population comprised 60 783 children and 602 112 adults. Only 59 of 60 countries covered in CONCORD-3 were included because none of the Mexican records were eligible. We defined 12 histology groups for children, and 11 for adults. In children (0-14 years), the proportion of low-grade astrocytomas ranged between 6% and 50%. Medulloblastoma was the most common subtype in coun tries where low-grade astrocytoma was less commonly reported. In adults (15-99 years), the proportion of glio blastomas varied between 9% and 69%. International comparisons were made difficult by wide differences in thproportion of tumors with unspecified histology, which accounted for up to 52% of diagnoses in children and up to 65% in adults. Conclusions. To our knowledge, this is the first account of the global histology distribution of brain tumors, in children and adults. Our findings provide insights into the practices and the quality of cancer registration worldwide.
Cancer Incidence in Five Continents Vol. XI
(IARC Scientific Publications, 2021) Bray, F.; Colombet, M.; Mery, L.; Piñeros, M.; Znaor, A.; Zanetti, R.; Ferlay, J.
Progress, challenges and ways forward supporting cancer surveillance in Latin America
(International Journal of Cancer, 2021) Piñeros, Marion; Abriata, María Graciela; Vries, Esther; Barrios, Enrique; Bravo, Luis Eduardo; Cueva, Patricia; De Camargo Cancela, Marianna; Fernández, Leticia; Gil, Enrique; Luciani, Silvana; Pardo, Constanza; Zoss, Walter; Bray, Freddie; Mery, Les
Population-based cancer registries (PBCRs) are the only means to provide reliable incidence and survival data as a basis for policy-making and resource allocations within cancer care. Yet, less than 3% and 10% of the respective populations of Cen tral America and South America are covered by high-quality cancer registries. The Global Initiative for Cancer Registry Development provides support to improve this situation via the International Agency for Research on Cancer Regional Hub for Latin America. In this paper, we summarize activities (advocacy, technical assistance, train ing and research) over the last 5 years, their impact and current challenges, including the implementation of new PBCR in four countries in the region. Despite the favor able political support to cancer registration in many countries, the sustainability of cancer registration remains vulnerable. Renewed efforts are needed to improve data quality in Latin America while ensuring maximum visibility of the data collected by disseminating and promoting their use in cancer control
Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries
(Lancet Child Adolesc Health, 2022) Ssenyonga, Naomi; Stiller, Charles; Nakata, Kayo; Shalkow, Jaime; Redmond, Shelagh; Bulliard, Jean-Luc; Girardi, Fabio; Fowler, Christine; Marcos-Gragera, Rafael; Bonaventure, Audrey; Nathalie Saint-Jacques; Minicozzi, Pamela; De, Prithwish; Rodríguez-Barranco, Miguel; Larønningen, Siri; Di Carlo, Veronica; Mägi Margit; Valkov, Mikhail; Seppä, Karri; Wyn Huws, Dyfed; Coleman, Michel P.; Allemani, Claudia; CONCORD Working Group
Background: Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0-14 years) and adults (aged 15-99 years) diagnosed with a haematological malignancy during 2000-14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0-24 years). Methods: We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0-14 years), adolescents (15-19 years), and young adults (20-24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. Findings: 164 563 young people were included in this analysis: 121 328 (73·7%) children, 22 963 (14·0%) adolescents, and 20 272 (12·3%) young adults. In 2010-14, the most common subtypes were lymphoid leukaemia (28 205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010-14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000-14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. Interpretation: This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group. Funding: Children with Cancer UK, the Institut National du Cancer, La Ligue Contre le Cancer, Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research foundation, Swiss Cancer League, Rossy Family Foundation, US National Cancer Institute, and the American Cancer Society.
Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000–2014 (CONCORD-3)
(2022) Girardi, Fabio; Matz, Melissa; Stiller, Charles; You, Hui; Gragera, Rafael Marcos; Valkov, Mikhail Y.; Bulliard, Jean-Luc; De, Prithwish; Morrison, David; Wanner, Miriam; O’Brian, David K.; Saint-Jacques, Nathalie; Coleman, Michel P.; Allemani, Claudia; CONCORD Working Group
Abstract Background. Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. Methods. We analyzed individual data for adults (15–99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000–2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. Results. The study included 556,237 adults. In 2010–2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%–38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000–2004 and 2005–2009. These improvements were more noticeable among adults diagnosed aged 40–70 years than among younger adults. Conclusions. To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
Global variations in lung cancer incidence by histological subtype in 2020: a population-based study.
(Lancet Oncol 2023, 2022) Zhang, Yanting; Vaccarella, Salvatore; Morgan, Eileen; Li, Mengmeng; Etxeberria, Jaione; Chokunonga, Eric; Manraj, Shyam Shunker; Kamate, Bakarou; Omonisi, Abidemi; Bray, Freddie
Background Lung cancer is the second most common cancer worldwide, yet the distribution by histological subtype remains unknown. We aimed to quantify the global, regional, and national burden of lung cancer incidence for the four main subtypes in 185 countries and territories. Methods In this population-based study, we used data from Cancer Incidence in Five Continents Volume XI and the African Cancer Registry Network to assess the proportions of adenocarcinoma, squamous cell carcinoma, small-cell carcinoma, and large-cell carcinoma among all lung cancers by country, sex, and age group and subsequently applied these data to corresponding national (GLOBOCAN) estimates of lung cancer incidence in 2020. Unspecified morphologies were reallocated to specified subtypes. Age-standardised incidence rates were calculated using the world standard population to compare subtype risks worldwide, adjusted for differences in age composition between populations by country. Findings In 2020, there were an estimated 2 206771 new cases of lung cancer, with 1 435943 in males and 770 828 in females worldwide. In males, 560 108 (39%) of all lung cancer cases were adenocarcinoma, 351 807 (25%) were squamous cell carcinoma, 163 862 (11%) were small-cell carcinoma, and 115322 (8%) were large-cell carcinoma cases. In females, 440510 (57%) of all lung cancer cases were adenocarcinoma, 91070 (12%) were squamous cell carcinoma, 68 224 (9%) were small-cell carcinoma, and 49 246 (6%) were large-cell carcinoma cases. Age-standardised incidence rates for adenocarcinoma, squamous cell carcinoma, small-cell carcinoma, and large-cell carcinoma, respectively, were estimated to be 12·4, 7·7, 3·6, and 2·6 per 100000 person-years in males and 8·3, 1·6, 1·3, and 0·9 per 100000 person-years in females worldwide. The incidence rates of adenocarcinoma exceeded those of squamous cell carcinoma in 150 of 185 countries in males and in all 185 countries in females. The highest age-standardised incidence rates per 100 000 person-years for adenocarcinoma, squamous cell carcinoma, small-cell carcinoma, and large-cell carcinoma, respectively, for males occurred in eastern Asia (23·5), central and eastern Europe (17·5), western Asia (7·2), and south-eastern Asia (11·0); and for females occurred in eastern Asia (16·0), northern America (5·4), northern America (4·7), and south-eastern Asia (3·4). The incidence of each subtype showed a clear gradient according to the Human Development Index for male and female individuals, with increased rates in high and very high Human Development Index countries. Interpretation Adenocarcinoma has become the most common subtype of lung cancer globally in 2020, with incidence rates in males exceeding those of squamous cell carcinoma in most countries, and in females in all countries. Our findings provide new insights into the nature of the global lung cancer burden and facilitates tailored national preventive actions within each world region.
Incidencia y mortalidad por cáncer en Quito: información para monitorear las políticas de control del cáncer
(Colombia Médica, 2022-02) Cueva, Patricia; Caballero, Henry; Tarupi Montenegro, Wilmer
El cáncer representa un desafío para la salud pública global, ya que requiere de una estrategia integral para su control. En este contexto los Registros de Cáncer de Base Poblacional (RCBP) son actores clave para la generación de políticas públicas que garanticen su implementación

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