Cáncer de colon en las fronteras de México / Colon cancer on the Mexican Border States

Resumen Introducción: Uno de los retos que se identifican para diseñar estrategias efectivas de control del cáncer de colon a escala global es el contar con instrumentos de monitoreo que permitan medir su evolución. Objetivo: Proveer evidencia para el monitoreo de la mortalidad por cáncer de colon en México integrando la dimensión espacial y temporal en un periodo de 17 años comprendido en 1998 y 2015. Metodología: Los microdatos analizados provienen de los registros de defunciones documentadas por los establecimientos de servicios médicos de las instituciones públicas del país. Este segmento representa la principal vía de atención médica en el país, por lo que el alcance de los resultados se acota al panorama que aporta el sector salud público en el país. Los datos se recopilan a través del Sistema Nacional de Información de Salud y el abordaje de la investigación es cuantitativo. Resultados: Se encontró un comportamiento diferenciado a escala regional en conjunto con desequilibrios en las capacidades de atención en las regiones de contraste, donde las entidades ubicadas de la frontera norte exhiben las mayores tasas de mortalidad en particular el caso de Chihuahua con una tasa de 68 para la población masculina y 49 para mujeres. Conclusiones: La evidencia encontrada es un insumo para orientar acciones de control en poblaciones específicas. La situación del sector privado no se aborda en el presente trabajo, por lo que se reconoce como una debilidad de la investigación.

Abstract Introduction: One of the challenges identified to design effective colon cancer control strategies on a global scale is to have monitoring instruments to measure its evolution. Objective: To provide evidence for the monitoring of mortality from colon cancer in Mexico, integrating the spatial and temporal dimension in a 17-year period from 1998 to 2015. Methodology: The micro data analyzed comes from the death records documented by the establishments of medical services of the country's public institutions, this segment represents the main health care provider in the country. Therefore, the scope of the results is limited to the population that receives health care by the public health sector in the country. The data collection is made through the National Health Information System and the research approach is quantitative. Results: Document a differentiated behavior at the regional scale, together with imbalances in the health care capacity for the border regions studied, where the states on the northern border exhibit the highest mortality rates, a particular high rate is found in Chihuahua State where a mortality rate of 68 Males and 49 for Females is found. Conclusions: The evidence found is a data driven source to guide control actions in specific populations, that may improve resource allocation. The private sector segment is not addressed by this study, a fact that represents a weakness of the research related to available data sources.

[Resources for the evaluation of public policy on lung cancer in MexicoRecursos para avaliação da política pública de câncer de pulmão no México]. / Recursos para la evaluación de la política pública en materia de cáncer de pulmón en México.

OBJECTIVES: To estimate lung cancer mortality rates adjusted by age distribution for the country's 32 states between 1998 and 2017; to contrast the territorial distribution of demand for oncological services with the availability of specialists to provide care; and to determine the predictive capacity of three different supervised classification algorithms in the context of automated learning techniques. METHODS: An exploratory analysis and data modeling were conducted, considering death records from the national health information system. RESULTS: Deaths from lung cancer in Mexico dropped by 14.5% between the period prior to implementation of the General Law on Tobacco Control and the subsequent period. A 22% reduction was observed in the male population by the end of the entire period. There is evidence of an imbalance between the demand for oncological services and the availability of specialists. The modeling phase demonstrated the usefulness of the country's electronic death records. CONCLUSIONS: Despite reductions in lung cancer mortality patterns in Mexico in the last two decades, the analysis showed persistent areas of opportunity for improvement, mainly in the female population of Guerrero, Oaxaca, and Puebla states. Based on this research, the main recommendation for focusing efforts to manage this oncological disease in Mexico is to determine whether these patterns are associated with smoking habits or with other social determinants.

OBJETIVOS: Estimar o índice de mortalidade por câncer de pulmão, ajustado pela estrutura etária, nos 32 estados do México no período entre 1998 e 2017, comparar a distribuição territorial da demanda por serviços oncológicos com a disponibilidade de especialistas e determinar a capacidade preditiva de 3 algoritmos utilizados na classificação supervisionada no contexto de técnicas de aprendizagem automatizada. MÉTODOS: Realizou-se uma análise exploratória e modelagem de dados dos registros de mortalidade cedidos pelo sistema nacional de informação em saúde. RESULTADOS: Houve uma redução de 14,5% no índice de mortalidade por câncer de pulmão no México entre o período pré-implementação da Lei Geral para o Controle do Tabaco e o período pós-implementação. Verificou-se uma redução de 22% da mortalidade na população masculina em todo o período considerado. Evidenciou-se desequilíbrio entre a demanda por serviços oncológicos e a disponibilidade de especialistas. A fase de modelagem permitiu demonstrar a utilidade dos registros eletrônicos de mortalidade existentes no país. CONCLUSÕES: Apesar da redução nos padrões de mortalidade por câncer de pulmão no México nas últimas duas décadas, a análise demonstrou que persistem áreas de oportunidade, sobretudo na população feminina nos estados de Guerrero, Oaxaca e Puebla. Determinar se estes padrões estão associados ao tabagismo ou a outros determinantes sociais é a principal recomendação desta pesquisa para guiar os esforços de atenção ao câncer no México.

Type 2 diabetes mortality at Mexican borders

Objective: To analyze type II diabetes mortality rates geographic distribution and evolution in time across both Mexican border regions during the period 1998-2013.Methods: The work is based on exploratory and inferential data analysis conducted using death reports from the national health information system. The analysis considers social determinants of health as a theoretical paradigm and includes microdata on consumption patterns at household level for the US-Mexico and Mexico- Guatemala border states.Results: A convergence path for type II diabetes mortality rates is found during the last 15 years between the studied border regions.Conclusions: The evidence presented indicates that the southern border states had been experiencing an epidemiologic transition towards mortality causes such as type II diabetes in the last decade. A trajectory that reflects a convergence pattern towards mortality rates found in the northern border states.

Objetivo: Analizar la distribución geográfica y evolución temporal de las tasas de mortalidad por diabetes tipo II en el periodo 1998-2013 para las regiones frontera sur y norte de México.Métodos: el trabajo se basa en el análisis exploratorio e inferencial de datos a partir de los registros de mortalidad reportados por el sistema nacional de información en salud SINAIS. El análisis retoma el paradigma teórico sobre determinantes sociales de salud por lo que se consideran microdatos sobre los patrones de consumo a nivel hogar en el contexto de la frontera México-Estados Unidos y México-Guatemala.Resultados: Se encuentra una trayectoria de convergencia durante los últimos 15 años en las tasas de mortalidad por diabetes tipo II entre las dos regiones fronterizas estudiadas.Conclusiones: La evidencia presentada indica que los estados de la frontera sur han experimentado en la última década una transición epidemiológica hacia causas de mortalidad como la diabetes tipo II, una trayectoria que muestra un patrón de convergencia con la población en la frontera norte.

Calidad de los recursos hídricos en el contexto de la actividad económica y patrones de salud en Sonora, México / Water resource quality as related to economic activity and health patterns in Sonora, Mexico

RESUMEN El objetivo del presente trabajo es analizar la distribución espacial de fuentes potenciales de contaminación de los recursos hídricos en el contexto de la actividad económica, y proponer una regionalización en relación con la ocurrencia de defunciones por cáncer en el estado fronterizo de Sonora, México. La metodología se basa en análisis exploratorio e inferencial de datos, en el que se utilizan dos fuentes de datos primarias: los aprovechamientos por descargas de agua residuales inscritos en el Registro Público de Derechos de Agua (REPDA) y los registros generados por el Sistema Nacional de Información en Salud (SINAIS) en el periodo 1998-2011 basado en la Clasificación Internacional de Enfermedades (CIE-10). El análisis de concentración espacial propuesto permite identificar causas específicas de defunción por cáncer a nivel regional. Los resultados indican que es de interés para la región el ajuste de los parámetros de calidad proyectados por la Norma Oficial Mexicana NOM-250-SSA1-2014 que consigna un subconjunto de contaminantes comunes en sitios con actividad minera.

ABSTRACT The aim of this work is to analyze the spatial distribution of potential pollution pathways of water resources given the economic activity in the Mexican border state of Sonora and propose a regional distribution in relation to cancer mortality rates across the state. The methodology is based in an exploratory and inferential data analysis using two sources of primary data: wastewater discharge concessions registered in the Public Registry on Water Rights [Registro Público de Derechos de Agua] (REPDA) and the records generated by the National Health Information System [Sistema Nacional de Información en Salud] (SINAIS) in the period 1998-2011 based on the International Classification of Disease (ICD-10). The spatial concentration analysis allows for the identification of specific cancer mortality causes at the regional level. Results indicate that the projected adjustments to the regulation NOM-250-SSA1-2014, which controls a subset of pollutants common in mining activity surroundings, is a matter of regional concern.

[Water resource quality as related to economic activity and health patterns in Sonora, Mexico]. / Calidad de los recursos hídricos en el contexto de la actividad económica y patrones de salud en Sonora, México.

The aim of this work is to analyze the spatial distribution of potential pollution pathways of water resources given the economic activity in the Mexican border state of Sonora and propose a regional distribution in relation to cancer mortality rates across the state. The methodology is based in an exploratory and inferential data analysis using two sources of primary data: wastewater discharge concessions registered in the Public Registry on Water Rights [Registro Público de Derechos de Agua] (REPDA) and the records generated by the National Health Information System [Sistema Nacional de Información en Salud] (SINAIS) in the period 1998-2011 based on the International Classification of Disease (ICD-10). The spatial concentration analysis allows for the identification of specific cancer mortality causes at the regional level. Results indicate that the projected adjustments to the regulation NOM-250-SSA1-2014, which controls a subset of pollutants common in mining activity surroundings, is a matter of regional concern.