[Trends in mortality from lung cancer in Mexico, 1980-2000]. / Tendencias de la mortalidad por cáncer pulmonar en México, 1980-2000.

OBJECTIVE: To analyze trends in age-adjusted lung cancer mortality rates in Mexico for the period of 1980 through 2000. METHOD: The trends were assessed using the adjusted rates of mortality from lung cancer, year of death, year of birth, age at death, state, and standard population. The standardized mortality rate and the index of potential years of life lost were used to compare incidence and premature deaths. The standardized mortality rate was analyzed by age groups according to the age at death (30-74 years), five-year observation period (1980-1999), and birth cohort (1910-1950). Nonparametric Spearman correlations were calculated for per capita tobacco consumption, social marginalization, and emigration. RESULTS: The adjusted mortality rate from lung cancer declined from 7.91 per 100 000 in 1989 to 5.96 per 100 000 in 2000. This pattern correlated with the reduction in per capita tobacco consumption, from 2.145 kg in 1959 to 0.451 kg in 1982. The latent period for the appearance of lung cancer in Mexico was 30 years. The male:female ratio was 2.4:1. The highest adjusted mortality rate was found in men who were 70-74 years old at the time of death. The adjusted mortality rates were low among the cohorts of persons born in 1945 or later, and those rates declined over the 1980-2000 period. The index of potential years of life lost and the incidence of premature death were greater among men. The mortality rates for the cohorts of men born between 1915 and 1940 showed a slight decline over the 1980-2000 period; beginning with men born in 1944 the rates increased slightly, mainly among men 30-34 and 35-39 years old at the time of death. For women the adjusted mortality rates were highest among those 75 or older; the rates gradually declined among the women born between 1945 and 1960, with the largest decrease among women 30-34 years old. The adjusted mortality rates varied according to the five-year observation period, the year of death, and birth cohort and gender. The correlation coefficient for the adjusted mortality rate by state and social marginalization was -0.70 (P = 0.00). There was no statistically significant correlation with the index of emigration (P = 0.56). CONCLUSIONS: Mortality from lung cancer has declined in Mexico. Morbidity and premature death due to lung cancer are greater in the states of northern Mexico.

Recent trends in mortality due to chronic obstructive pulmonary disease (COPD) in Mexico, 1980-2002.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. Changes in classification have a major impact on reported mortality rates. METHODS: Between 1980 and 2002, 230,463 COPD cases were studied (age group 35-94 years); 134,579 men; 95,884 women. RESULTS: The crude mortality rate varied from 37 (1980) to 61 per 100,000 men (2002), (increase: 65%). The crude mortality rate for females increased from 27 (1980) to 43 deaths per 100,000 women (2002), (increase: 56%). The trends of the absolute values by birth year and age groups are higher as age increases. As age of death comes down and the birth cohort increases, the absolute values decrease. The Mexican states located in the northern and central areas present a higher risk for dying. There is an increment coefficient of 93 cases per increment year in males (age group 35-74), and 61 cases per increment year in females (age group 35-74 years). For the age group 35-94 years, the annual increase for males is 288 cases. These results were statistically significant, and the regression model was validated by residual analysis. CONCLUSIONS: The oldest cohorts of the studied population showed the highest COPD mortality absolute values. The geographic risk of dying from COPD is concentrated in two regions: a) the three Mexican states of higher economic income at the northern frontier to the U.S. and b) those Mexican states surrounding the main producer of tobacco (Nayarit).

Geography of diabetes mellitus mortality in Mexico: an epidemiologic transition analysis.

BACKGROUND: The worldwide prevalence of diabetes mellitus (DM) will increase from 135 to 300 million cases by the year 2025. In Mexico, DM is the third cause of general mortality and the primary cause of mortality in the 55- to 64-year-old age group. The purpose of this study was to analyze the characteristics of DM mortality trends in Mexico from 1980 to 2000 in the context of this epidemiologic transition. METHODS: Age-adjusted mortality rates were estimated for DM as underlying cause of death using World Health Organization (WHO) reference population. To evaluate magnitude of risks, standardized mortality ratio (SMR) was calculated; prematurity of mortality was evaluated by means of potential lost life years index (PLLYI). Diabetes mortality trends in the U.S. were calculated with information from the Centers for Disease Control (CDC) public registry and were age-adjusted for comparison. RESULTS: Total number of deaths due to DM during the period was 582,826. Standardized mortality ratio by state showed higher mortality in the northern Mexican states; PLLYI was higher in the northern states. Mortality trends in Mexico showed a rapid increase during the 1980s followed by a less acute increment in the 1990s. Age-adjusted mortality rate trends in the U.S. were lower than those in Mexico. CONCLUSIONS: This study shows an increase in DM age-adjusted mortality trends during the years 1980-2000 in Mexico. The observed pattern of mortality varies widely throughout the country, probably due to differences in socioeconomic conditions and in access to healthcare.

AIDS mortality trends in Mexico, 1988-1997.

OBJECTIVE: To assess the geographic distribution and trends of AIDS deaths for the 1988-1997 period in Mexico. MATERIAL AND METHODS: Crude and adjusted mortality rates were estimated for the 1988-1997 period. A trend test was performed using the simple linear regression method. Standardized mortality ratios (SMR) and years of potential life lost (YPLL) were calculated for each Mexican state. RESULTS: During the study period (1988-1997), there were 26,999 AIDS deaths in Mexico; 86.5% (23,354) of them were among men. The mean age at the time of death was 38.4 years for men and 37.7 years for women (p > 0.05). The crude AIDS mortality rate for the period of study was 3.02 cases (95% CI: 2.94, 3.06) per 100,000 inhabitants. The adjusted rate was 3.13 (95% CI: 3.09, 3.17), with 5.22 (95% CI: 5.16-5.29) for men and 0.82 (95% CI: 0.79-0.84) for women. The states with the highest SMR were: Baja California (SMR: 248.69; 95% CI: 234.02-263.36), Mexico City (SMR: 220.74; 95% CI: 215.57-225.91), and Jalisco (SMR: 169.16; 95% CI: 162.88-175.44). Similarly, a Potential Lost Life Years Index (PLLYI) analysis by state showed a greater risk of premature AIDS mortality in the same states [Baja California (PLLYI index: 236.33; 95% CI: 233.97-238.68), Mexico City (PLLYI: 194.68; 95% CI: 193.88-195.48), and Jalisco (PLLYI: 170.69; 95% CI: 169.60-171.79)]. CONCLUSIONS: Mortality trends indicate that AIDS mortality in Mexico increased by an annual rate of 23% between 1988 and 1997. The adjusted AIDS mortality rate increased from 0.75 per 100,000 in 1988, to 4.20 per 100,000 in 1997, with the largest burden of mortality in men (male to female ratio of 6:1). We therefore expect that a decreasing effect on AIDS mortality trends will be observed in the next years. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.

[To smoke or not to smoke, in restaurants, hotels, and bars]. / Fumar o no fumar, en restoranes, hoteles y cantinas.

A MEDLINE search was conducted to identify relevant references, to review the information on adverse effects of tobacco smoking and environmental tobacco smoke (ETS). Occupational exposure to ETS causes significant damages to food industry workers. High levels of mutagenic substances have been demonstrated in restaurant air as well as in the urine samples from those workers. Exposition to 3-aminophenyl, a hemoglobin-associated carcinogen. The best way to protect these workers is the reduction of tobacco smoking in restaurants, hotels, bars and taverns. In restaurant workers, ETS attributable risk for lung cancer is evident.

[Mortality trends in cancer attributable to tobacco in Mexico]. / Tendencias de mortalidad por cánceres atribuibles al tabaco en México.

OBJECTIVE: To describe the mortality trends of cancer attributable to tobacco smoking, particularly lung cancer, for the 1980-1997 period in Mexico. MATERIAL AND METHODS: Mortality trends were analyzed for each type of cancer associated to tobacco smoking, according to the International Classification of Diseases (ICD). Crude and adjusted mortality rates were estimated for the period between 1980 and 1997, by age, gender, basic death cause, and year of death. The gender ratio and the relative proportion were estimated for cases in the 35-64 age group and for the entire study population. Age population projections by Consejo Nacional de Poblacion (National Population Council), were used as denominators (1970-2010). RESULTS: The gender ratio for mortality rates for lung, esophageal, oral cavity and pharyngeal cancer was 2.10:1.00 (male:female). The gender ratio for laryngeal cancer was striking: 4.21:1.00, probably due to the higher prevalence of male tobacco smokers. The estimated relative proportion, using the total mortality due to malignant cancers between 1980-1997, was 12.31% for lung cancer, 1.71% for larynx cancer, 1.55% for esophageal cancer, and 1.49% for oral cavity/pharyngeal cancer. Previous tobacco smoking was correlated with the mortality rate trends for lung cancer (beta: 0.910, IC 95%: 1.097-1.797, R2 0.827). For the poorest social groups by federal entity, the correlation was inverted (beta: -0.510, IC 95% -0.170, -0.039, R2: 0.260). CONCLUSIONS: In Mexico, increased tobacco smoking, improved cancer diagnosis, and the demographic transition, are probably the main factors determining cancer mortality rates. However, other lifestyle associated variables, such as urbanization, physical activity, carotenoid intake, and other dietary and toxic substances like alcohol, may also influence the morbidity and mortality rates. Although tobacco-related cancer is a fast-growing public health problem having a poor prognosis, tobacco smoking, the main risk factor, could be eliminated by health education and promotion, together with publicity regulation and healthy taxation policies.

AIDS mortality trends in Mexico, 1988-1997

Objective. To assess the geographic distribution and trends of AIDS deaths for the 1988-1997 period in Mexico. Material and Methods. Crude and adjusted mortality rates were estimated for the 1988-1997 period. A trend test was performed using the simple linear regression method. Standardized mortality ratios (SMR) and years of potential life lost (YPLL) were calculated for each Mexican state. Results. During the study period (1988-1997), there were 26,999 AIDS deaths in Mexico; 86.5 percent (23,354) of them were among men. The mean age at the time of death was 38.4 years for men and 37.7 years for women (p> 0.05). The crude AIDS mortality rate for the period of study was 3.02 cases (95 percent CI: 2.94, 3.06) per 100,000 inhabitants. The adjusted rate was 3.13 (95 percent CI: 3.09, 3.17), with 5.22 (95 percent CI: 5.16 - 5.29) for men and 0.82 (95 percent CI: 0.79-0.84) for women. The states with the highest SMR were: Baja California (SMR: 248.69; 95 percent CI: 234.02-263.36), Mexico City (SMR: 220.74; 95 percent CI: 215.57-225.91), and Jalisco (SMR: 169.16; 95 percent CI: 162.88-175.44). Similarly, a Potential Lost Life Years Index (PLLYI) analysis by state showed a greater risk of premature AIDS mortality in the same states [Baja California (PLLYI index: 236.33; 95 percent CI: 233.97-238.68), Mexico City (PLLYI: 194.68; 95 percent CI: 193.88 - 195.48), and Jalisco (PLLYI: 170.69; 95 percent CI: 169.60-171.79)]. Conclusions. Mortality trends indicate that AIDS mortality in Mexico increased by an annual rate of 23 percent between 1988 and 1997. The adjusted AIDS mortality rate increased from 0.75 per 100 000 in 1988, to 4.20 per 100 000 in 1997, with the largest burden of mortality in men (male to female ratio of 6:1). We therefore expect that a decreasing effect on AIDS mortality trends will be observed in the next years.

Objetivo. Determinar la distribución geográfica y la tendencia de mortalidad por SIDA durante el periodo 1988 a 1997, en México. Material y métodos. Se estimaron tasas de mortalidad por SIDA, cruda y ajustadas, para el periodo 1988-1997. Se realizó una prueba de tendencia utilizando regresión lineal simple. La razón de mortalidad estandarizada (RME) y los años de vida potencialmente perdidos (AVPP), fueron calculados para cada estado de la República. Resultados. Durante el periodo de estudio se reportaron 26 999 muertes por SIDA en México, 86.5 por ciento (23 354), fueron hombres. La media de edad al momento de la muerte por esta causa, fue 38.4 años para los hombres y 37.7 años para las mujeres (p> 0.05). La tasa cruda de mortalidad por SIDA para el periodo de estudio fue de 3.02 casos (IC 95 por ciento 2.94-3.06) por 100 000 habitantes. La tasa ajustada de mortalidad por SIDA para el periodo de estudio fue de 3.13 casos (IC 95 por ciento 3.09-3.17) por 100 000 habitantes. La tasa ajustada de mortalidad para hombres fue de 5.22 casos (IC 95 por ciento 5.16-5.29) por 100 000 habitantes; y para mujeres fue de 0.82 casos (IC 95 por ciento 0.79-0.84). Los estados con mayor RME fueron Baja California (RME: 248.69; IC 95 por ciento: 234.02-263.36), Distrito Federal (RME: 220.74; IC 95 por ciento: 215.57-225.91), y Jalisco (RME: 169.16; IC 95 por ciento: 162.88-175.44). También se calculó el índice de años de vida potencialmente perdidos (IAVPP), mostrando mayor prematurez en la mortalidad por SIDA, en los mismos estados [Baja California (IAVPP: 236.33; IC 95 por ciento: 233.97-238.68), Distrito Federal (IAVPP: 194.68; IC 95 por ciento: 193.88-195.48), y Jalisco (IAVPP: 170.69; IC 95 por ciento: 169.60-171.79)]. Conclusiones. La tendencia de mortalidad por SIDA en México muestra un incremento anual de 23 por ciento entre 1988 y 1997. La tasa ajustada de mortalidad por SIDA se incrementó de 0.75 por 100 000 habitantes en 1988, a 4.20 por...

Tendencias de mortalidad por cánceres atribuibles al tabaco en México / x

Objetivo. Describir la tendencia de la mortalidad por cáncer atribuible al consumo de tabaco, particularmente neoplasias del pulmón, en México, durante el periodo 1980-1997. Material y métodos. Se hizo un análisis de tendencias de mortalidad para cada tipo de cáncer asociado con el tabaco, según la Clasificación Internacional de Enfermedades. Las tasas cruda y ajustada de mortalidad fueron estimadas en términos de edad, género, causa básica de la muerte y año, entre 1980 y 1997. Se estimó la razón de género y proporción relativa para los casos que estaban en el grupo de edad entre 35 y 64 años y para toda la población estudiada. Como denominador se utilizaron las proyecciones por edad calculadas por el Consejo Nacional de Población (1970-2010). Resultados. La razón de género para las tasas de mortalidad por cáncer de laringe, esófago, cavidad oral y faringe fue de 2.10:1.00 (hombre: mujer). La razón de género para el cáncer de laringe es enorme: 4.21: 1.00, probablemente debida a la mayor prevalencia de hombres fumadores de tabaco. La proporción relativa estimada, usando la mortalidad total debida a tumores malignos, entre 1980 y 1997 fue la siguiente: cáncer de pulmón 12.31 por ciento, laringe 1.71 por ciento, esófago 1.55 por ciento y cavidad oral/faringe 1.49 por ciento. El antecedente de tabaquismo tiene correlación con la tendencia de la tasa de mortalidad por cáncer del pulmón (Beta: 0.910, IC 95 por ciento: 1.097-1.797; R² 0.827). Para los grupos sociales mas pobres, por entidad federativa, la correlación está invertida (Beta: -0.510, IC 95 por ciento: -0.170, -0.039, R²: 0.260). Conclusiones. En México, la mejoría en el diagnóstico, la transición demográfica y el incremento del consumo de tabaco son, probablemente, los principales factores a los que se atribuye la tasa de mortalidad por cáncer. No obstante, otras variables asociadas con el estilo de vida, como urbanización, actividad física, ingesta de carotenoides y otros componentes...

Objective. To describe the mortality trends of cancer attributable to tobacco smoking, particularly lung cancer, for the 1980-1997 period in Mexico. Material and Methods. Mortality trends were analyzed for each type of cancer associated to tobacco smoking, according to the International Classification of Diseases (ICD). Crude and adjusted mortality rates were estimated for the period between 1980 and 1997, by age, gender, basic death cause, and year of death. The gender ratio and the relative proportion were estimated for cases in the 35-64 age group and for the entire study population. Age population projections by Consejo Nacional de Poblacion (National Population Council), were used as denominators (1970-2010). Results. The gender ratio for mortality rates for lung, esophageal, oral cavity and pharyngeal cancer was 2.10:1.00 (male: female). The gender ratio for laryngeal cancer was striking: 4.21:1.00, probably due to the higher prevalence of male tobacco smokers. The estimated relative proportion, using the total mortality due to malignant cancers between 1980-1997, was 12.31 percent for lung cancer, 1.71 percent for larynx cancer, 1.55 percent for esophageal cancer, and 1.49 percent for oral cavity/pharyngeal cancer. Previous tobacco smoking was correlated with the mortality rate trends for lung cancer (beta: 0.910, IC 95 percent: 1.097-1.797, R² 0.827). For the poorest social groups by federal entity, the correlation was inverted (beta: -0.510, IC 95 percent -0.170, -0.039, R²: 0.260). Conclusions. In Mexico, increased tobacco smoking, improved cancer diagnosis, and the demographic transition, are probably the main factors determining cancer mortality rates. However, other lifestyle associated variables, such as urbanization, physical activity, carotenoid intake, and other dietary and toxic substances like alcohol, may also influence the morbidity and mortality rates. Although tobacco-related cancer is a fast-growing public health...

Fumar o no fumar, en restoranes, hoteles y cantinas / x

Con el objetivo de revisar la información sobre los efectos adversos de fumar tabaco y de la exposición al humo del tabaco en el ambiente (HTA), se revisó la base de MEDLINE para identificar citas relevantes. Los efectos adversos a la salud, de la exposición al HTA, son daños ocupacionales significativos para los trabajadores de los servicios de alimentación. Se han demostrado altos niveles de sustancias mutagénicas en el aire ambiental de restoranes y en la orina de los trabajadores, así como la exposición al 3-aminofenil, un carcinógeno asociado con la hemoglobina. La mejor manera de proteger a estos trabajadores es reducir el consumo de tabaco en restoranes, hoteles, cantinas y tabernas. En trabajadores de restoranes es evidente el incremento del riesgo de cáncer pulmonar atribuible a la exposición al HTA.

A MEDLINE search was conducted to identify relevant references, to review the information on adverse effects of tobacco smoking and environmental tobacco smoke (ETS). Occupational exposure to ETS causes significant damages to food industry workers. High levels of mutagenic substances have been demonstrated in restaurant air as well as in the urine samples from those workers. Exposition to 3-aminophenyl, a hemoglobine-associated carcinogen. The best way to protect these workers is the reduction of tobacco smoking in restaurants, hotels, bars and taverns. In restaurant workers, ETS attributable risk for lung cancer is evident.

Fumadores involuntarios: exposición pasiva al humo de tabaco en el ambiente / Involuntary smokers: passive exposure to environmental tobacco

Se definen los conceptos de fumador activo, fumador involuntario, exposición pasiva al humo de tabaco en el ambiente, HC=mezcla del humo resultante de la combustión del producto del tabaco (pipa, cigarrillo, cigarro puro o charuto), CHEA= corriente de humo exhalada por el fumador activo, HC + CHEA + biomasa en el aire=HTA, composición del HTA, medida de la exposición al HTA, riesgos de la exposición al HTA, efectos del HTA en la salud colectiva: en los adultos sanos, en el desarrollo de los niños (antes y después del nacimiento), en las mujeres grávidas y en los familiares. Además, se discuten el impacto de los fumadores activos en los ambientes de la casa, el trabajo, estudio y lugares públicos.

Breast cancer in mexican women: an epidemiological study with cervical cancer control

Objetivo: O câncer de mama (CM) é uma das principais causas de morte por câncer em mulheres no México, com aumento da incidência e da mortalidade nos últimos anos. O estudo realizado objetivou identificar possíveis fatores de risco relacionados ao CM. Métodos: Realizou-se um estudo epidemiológico de casos hospitalares de CM e de controles hospitalares com câncer cérvico-uterino (CACU) em oito hospitais de terceiro nível, na Cidade do México. Foram estudados 353 casos incidentes de CM e 630 controles com CACU, identificados entre mulheres com menos de 75 anos de idade, residentes na área metropolitana da Cidade do México pelo menos há um ano. O diagnóstico foi confirmado histologicamente em ambos os grupos. As variáveis foram analisadas de acordo com critérios aprovados biológica e estatisticamente. Foram efetuadas análises univariadas, bivariadas e multivariadas. Os casos e controles foram estratificados de acordo com o estado hormonal menopáusico (pré e pós-menopausa). Foi usado o odds ratio (OR) como método de associação com intervalos de confiança (IC) acima de 95 por cento. Resultados: Os fatores associados com o CM foram: nível socioeconômico alto (OR=2,77 IC 95 por cento 1,77-4,35); menarca prematura (OR=1,32 IC 95 por cento 0,88-2,00); idade acima de 31 anos quando da primeira gravidez (OR=5,49 IC 95 por cento 21,16-13,98) e um histórico familiar de CM (OR=4,76 IC 95 por cento 2,10-10,79). Por outro lado, um aumento na duração da amamentação foi um fator protetor (> 25 meses OR=0,38 IC 95 por cento 0,20-0,77). Conclusões: Os resultados contribuíram para a identificação de fatores de risco para o CM descritos na literatura internacional na população de mulheres mexicanas. A amamentação parece exercer importante papel na proteção do CM. Em virtude das mudanças no estilo de vida das mulheres, as mulheres jovens tendem a diminuir seu período de amamentação

Trends of lung cancer mortality in Mexico

Lung cancer (LC) is one of the most important public health problems in the world; 1,035,000 annual deaths are estimated each year and more than 80 percent of these are attributed to tobacco. The trend of lung cancer mortality in Mexico City from 1979 -1993 was determined, as was the rate ratio of lung cancer mortality in mexico City from 1979 - 1993 was determined, as was the rate ratio of lung cancer mortality in 31 states in mexico, taking Mexico City as a reference by means of a Poisson model. A strong linear regression model was used to evaluate the rate, where the dependent variable the year observed. In 15 years, 73,807 deaths from LC were reported LC were reported, with an increase in mortality from 5.01 - 7.25 per 100,000 ihabitants. Mortality increases significantly after 60 years if age (ß+0, p<.05) in men and in women. Mortality from LC was 70 percent in mend, and more than 60 percent of deaths were reported after 65 years of age. Mortality risk is higher in the northern states of the country (e.g., Sonora, RR=2.40) than in the southern region (e.g., Oaxaca RR=0.40). In Mexico, almost 10,000 deaths by LC are estimated for the year 2010. Therefore, changes in lifestyle should be encouraged in order to decrease the smoking habit. The governmental tax on cigarettes should be increased, smoking restricted in squares and public spaces, and the risks should be announced on cigarette packages, among other measures. With respect to other emergent risk factors, the sources of industrial pollution and toxic emissions should be regulated

La epidemia de cáncer de mama en México. ¿Consecuencia de la tarnsición demográfica? / Breast cancer epidemy in Mexico. Demographic transition consecuence?

Objetivo. Analizar la relación entre la disminución de la fecundidad y el aumento de la mortalidad por cáncer de mama, entre los estados de la República Mexicana, para periodo 1979-1994. Material y métodos. Se utilizaron las tasa específicas de fecundidad y las tasas de mortalidad por cáncer de mama de los estados del país. Para establecer de manera formal la relación, se utilizó el análisis de componentes principales y el análisis de clasificación. Resultados. La evolución de la fecundidad muestra una disminución importante, conservándose diferencias regionales: los estados del norte tienen niveles más bajos que los del sur. Estas diferencias regionales coinciden con las diferencias, en sentido inverso, que se observan en cuanto al aumento de la mortalidad por cáncer de mama entre los estados, es decir: los del norte presentan niveles más importantes que los del sur. Conclusiones. El aumento de la mortalidad debida al cáncer de mama y su relación con la disminución de la fecundidad ponen de manifiesto la importancia del aspecto preventivo de los servicios de salud, ya que en el futuro las mujeres mexicanas tedrán un comportamiento reproductivo similar al de las mujeres de países desarrollados

Cáncer de mama. Un hilo conductor histórico presente y futuro / Breast cancer: a historical account, present and future

Se describen los modelos que tradicionalmente han sido utilizados en la construcción teórica del conocimiento de cáncer de mama (CM); es decir, el biologicista, el higienista-preventivo y el epidemiológico. Se incluye además -en forma anecdótica- el modelo hipocrático. El CM se perfila como una amenaza letente en países como México a consecuencia del aumento importante de la esperanza de vida; de la reducción de la tasa de crecimiento total anual, al inicio de lo que hoy conocemos como el proceso de envejecimiento de la población; de cambios en los estilos de vida, particularmente la práctica cada vez menor de la lactancia y la disminución de tasas de fertilidad; así como de la escasa eficiencia y efectividad de los programas de detección oportuna del CM. En este contexto, uno de los principales retos en relación con este padecimiento es la práctica de la salud pública con fundamento multidisciplinario. Al final de este ejercicio, se propone el modelo sociomédico, que postula la integración de diversas áreas del conocimiento y permite dar una respuesta efectiva a uno de los principales desafíos en materia de enfermedades crónicas de los próximos años

This essay describes the different theoretical constructions of breast cancer models, such as the biological, hygienist-preventive and epidemiological. An anecdotical account of the Hippocratic model is also presented. This disease will be one of the major challenges posed by noncommunicable diseases in coming years, due to a significant increase of life expectancy and to a decrease of the overall annual growth rate -resulting in the ageing of the population-, as well as to lifestyle changes -particularly the considerable decrease of fertility rates and breastfeeding practices-, and to the poor efficiency and effectiveness of breast cancer screening programs. In this context, one of the main challenges for breast cancer control is to secure the multidisciplinary approach offered by public health. After analyzing the different models, we favor the sociomedical model as the one that incorporates several areas of knowledge to formulate an effective response to breast cancer.