Caracterización de la incidencia del cáncer de mama en un servicio público de salud chileno en el período 2006-2015 / Characterization of incidence rates of breast cancer in public health service, period 2006-2015

OBJETIVO: El cáncer de mama constituye la primera causa de muerte oncológica en mujeres chilenas. Las tasas de incidencia solo han sido estimadas según el registro 2003-2007. Nuestro objetivo fue estimar las tasas de incidencia en un período de 10 años en un servicio de salud y caracterizar dicha población. MÉTODO: Se calcularon las tasas de incidencia del período 2006-2015, por método directo, y se analizó la tendencia por Prais-Winsten. Se caracterizó la población según la edad y la etapa al diagnóstico. RESULTADOS: De 2862 casos, la tasa de incidencia estandarizada promedio fue de 66,6 por 100.000 mujeres. En el período hubo una tendencia al alza del diagnóstico de 0,63/100.000 anualmente (p = 0,5; intervalo de confianza del 95%: −1,73 a 2,99). La mayor tasa de incidencia bruta fue en el grupo de 70 y más años (154,8/100.000). El 49% correspondieron a casos diagnosticados de 50 a 69 años. El 56% se diagnosticó precozmente; la etapa I tuvo la más alta tasa (15,8/100.000). CONCLUSIONES: En este estudio, las tasas de incidencia son mayores que las reportadas en informes nacionales previos. El diagnóstico es mayoritariamente en etapas precoces, lo que difiere del resto de los países de la región. Nuestros datos pueden aportar a mejorar las políticas públicas.

OBJECTIVE: Breast cancer is the leading cause of cancer death in Chilean women. Incidence rates have only been estimated based on population records (2003-2007). Our objective was to estimate the incidence rates in a 10-year period in a health service and portray in words this cohort. METHOD: Incidence rates were calculated between 2006-2015 by direct method and trends were analyzed with the Prais-Winsten model. The population was defined according to age and stage at diagnosis. RESULTS: Of a total of 2862 cases, the average incidence rate was 66.6 out of 100,000 women. Between 2006-2015, the trend rose in breast cancer diagnosis of 0.63/100,000 annually (p = 0.5; 95% confidence interval: −1.73, 2.99). The highest crude rate of incidence was in the group aged 70 and over (154.8/100,000). 49% correspond to cases diagnosed between 50 and 69 years. 56% were in early stages, stage I, being the most frequent (15.8/100,000). CONCLUSIONS: On this research the incidence rates were higher than the ones reported on previous national reports. Diagnosis is mostly in early stages which differs from other countries in the region, our data can help improve public health policies.

Implementación del diagnóstico molecular del VPH: experiencia chilena en curso / Molecular diagnosis of human papillomavirus infection: the Chilean experience

Cervical Cancer (CaCu) has a heterogeneous epidemiological behavior throughout the planet, depending on regional socioeconomic development level. Some developed countries predict a potential eradication of this cancer in the next 100 years, while in Chile it still constitutes a pending challenge. Incidence rates show a slow but sustained downward prob, however, mortality has continued to fluctuate between 500-600 cases per year. A few years ago, vaccination against Human Papillomavirus (HPV), the main causal agent for this tumor, was consolidated as a public policy, both in girls and in boys. However, the technological leap in the screening prob was pending, from cytology to molecular diagnosis of the agent (HPV). In this report, we update our most recent data (2018) regarding CaCu mortality, then review global guidelines and experiences in HPV screening. Finally, we offer an account of the strategies that our health system is promoting to address the screening of the disease and whose molecular approach generates the widest worldwide scientific consensus. We also recognize the main barriers and future challenges, which, if overcome, would allow us to be in line with the mandate of WHO to control this women's health problema.

[Molecular diagnosis of human papillomavirus infection. The Chilean experience]. / Implementación del diagnóstico molecular del VPH: experiencia chilena en curso.

Cervical Cancer (CaCu) has a heterogeneous epidemiological behavior throughout the planet, depending on regional socioeconomic development level. Some developed countries predict a potential eradication of this cancer in the next 100 years, while in Chile it still constitutes a pending challenge. Incidence rates show a slow but sustained downward prob, however, mortality has continued to fluctuate between 500-600 cases per year. A few years ago, vaccination against Human Papillomavirus (HPV), the main causal agent for this tumor, was consolidated as a public policy, both in girls and in boys. However, the technological leap in the screening prob was pending, from cytology to molecular diagnosis of the agent (HPV). In this report, we update our most recent data (2018) regarding CaCu mortality, then review global guidelines and experiences in HPV screening. Finally, we offer an account of the strategies that our health system is promoting to address the screening of the disease and whose molecular approach generates the widest worldwide scientific consensus. We also recognize the main barriers and future challenges, which, if overcome, would allow us to be in line with the mandate of WHO to control this women's health problema.