Progress, challenges and ways forward supporting cancer surveillance in Latin America.

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 Central 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, training 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 favorable 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.

Interaction between polychlorinated biphenyls and dissolved organic matter of different molecular weights from natural and anthropic sources.

Polychlorinated biphenyls (PCBs) are compounds of significant interest due to high toxicity, persistence, long-range atmospheric transport, and bioaccumulation. These compounds can interact with components present in the environment, including dissolved organic matter (DOM) in soils and waters, thereby modifying its availability and movement. In this study, DOM was fractionated by ultrafiltration and characterized according to its hydrophobicity and hydrophilicity, then the interaction of a series of PCBs and different DOM fractions was evaluated. The DOM was collected from the surface waters of three sectors located along a river in the southern part of America. These sectors are subject to different anthropic activities, thus the DOM of sector 1, with the least anthropic influence, was mainly hydrophobic and with a high content of aromatic structures. In contrast, the DOM collected from sectors 2 and 3, where anthropic activity is highest, was slightly hydrophobic and hydrophilic, respectively. The DOM of these two sectors was mainly composed of low molecular weight macromolecules. These results revealed that more hydrophobic PCBs (i.e., 101, 118, 138, and 180) have a greater affinity to DOM with a higher molecular weight (i.e., >1 kDa). In turn, PCBs with lesser chlorination and hydrophobicity presented a greater affinity to DOM with a lower molecular weight. In conclusion, our study shows that the high molecular weight DOM is responsible for mobilizing PCBs with a high degree of chlorination.

Double Transfer Voltammetry in Two-Polarizable Interface Systems: Effects of the Lipophilicity and Charge of the Target and Compensating Ions.

Analytical expressions are obtained for the study of the net current and individual fluxes across macro- and micro-liquid/liquid interfaces in series as those found in ion sensing with solvent polymeric membranes and in ion-transfer batteries. The mathematical solutions deduced are applicable to any voltammetric technique, independently of the lipophilicity and charge number of the target and compensating ions. When supporting electrolytes of semihydrophilic ions are employed, the so-called double transfer voltammograms have a tendency to merge into a single signal, which complicates notably the modeling and analysis of the electrochemical response. The present theoretical results point out that the appearance of one or two voltammetric waves is highly dependent on the size of the interfaces and on the viscosity of the organic solution. Hence, the two latter can be adjusted experimentally in order to "split" the voltammograms and extract information about the ions involved. This has been illustrated in this work with the experimental study in water | 1,2-dichloroethane | water cells of the transfer of the monovalent tetraethylammonium cation compensated by anions of different lipophilicity, and also of the divalent hexachloroplatinate anion.

Theoretical Treatment of Ion Transfers in Two Polarizable Interface Systems When the Analyte Has Access to Both Interfaces.

A new theory is presented to tackle the study of transfer processes of hydrophilic ions in two polarizable interface systems when the analyte is initially present in both aqueous phases. The treatment is applied to macrointerfaces (linear diffusion) and microholes (highly convergent diffusion), obtaining analytical equations for the current response in any voltammetric technique. The novel equations predict two signals in the current-potential curves that are symmetric when the compositions of the aqueous phases are identical while asymmetries appear otherwise. The theoretical results show good agreement with the experimental behavior of the "double transfer voltammograms" reported by Dryfe et al. in cyclic voltammetry (CV) ( Anal. Chem. 2014 , 86 , 435 - 442 ) as well as with cyclic square wave voltammetry (cSWV) experiments performed in the current work. The theoretical treatment is also extended to the situation where the target ion is lipophilic and initially present in the organic phase. The theory predicts an opposite effect of the lipophilicity of the ion on the shape of the voltammograms, which is validated experimentally via both CV and cSWV. For the above two cases, simple and manageable expressions and diagnosis criteria are derived for the qualitative and quantitative study of ion lipophilicity. The ion-transfer potentials can be easily quantified from the separation between the two signals making use of explicit analytical equations.

GALNT9 gene expression is a prognostic marker in neuroblastoma patients.

BACKGROUND: The enzymes encoded by the GALNT [UDP-N-acetyl-α-d-galactosamine:polypeptide N-acetylgalactosaminyltransferase (GALNAC-T)] gene family catalyze the first step of O-glycosylation. Little is known about the link between expression of the genes encoding GALNAC-T enzymes and tumor progression in neuroblastoma, a pediatric cancer that can be classified as either low or high risk. We assessed the expression of genes in the GALNT family in a large cohort of neuroblastoma patients and characterized members of this family that might be used as new prognostic markers. METHODS: Reverse-transcription PCR analysis of 14 GALNT genes with a panel of neuroblastoma cell lines identified the GALNT9 gene as playing a potential role in disease progression. We used the log-rank test and the multivariable Cox proportional hazards model with a cohort of 122 neuroblastoma patients to analyze the relationship between GALNT9 expression and overall survival or disease-free survival. RESULTS: In the high-risk neuroblastoma experimental model IGR-N-91, GALNT9 expression was present in neuroblasts derived from primary tumors but not in neuroblasts from metastatic bone marrow. Moreover, GALNT9 in neuroblastoma cell lines was expressed in substrate adherent (S)-type cell lines but not in neuronal (N)-type lines. In the tumor cohort, GALNT9 expression was associated with high overall survival, independent of the standard risk-stratification covariates. GALNT9 expression was significantly associated with disease-free survival for patients currently classified as at low risk (P < 0.0007). CONCLUSIONS: GALNT9 expression correlates with both improved overall survival in low- and high-risk groups and an improved clinical outcome (overall and disease-free survival) in low-risk patients. Thus, the GALNT9 expression may be a prognostic marker for personalized therapy.

Meat, milk and risk of lymphoid malignancies: a case-control study in Uruguay.

In the time period 1996-2004, 697 cases with lymphoid neoplasms and 3606 controls with nonneoplastic conditions were included in a case-control study conducted in the Cancer Institute of Uruguay. They were administered a routine questionnaire that included 8 sections and a food frequency questionnaire focused on intakes of total meat, red meat, salted meat, barbecued meat, processed meat, milk, total vegetables and total fruits, and alcoholic beverages. Lymphoid cancers were analyzed by multiple polytomous regression. Red meat, salted meat, and milk were positively associated with risk of lymphoid cancers [odds ratios (OR) for the highest tertile vs. the lowest one of red meat = 1.68, 95% confidence interval (CI) 1.37-2.08, OR for whole milk = 2.92, 95% CI 2.63-3.63). On the other hand, plant foods, particularly total fruits, and alcoholic beverages (mainly red wine) were protective. We could conclude that these foods could play a significant role in the etiology of lymphoid malignancies.

Prevalence and distribution of high-risk human papillomavirus genotypes in invasive carcinoma of the uterine cervix in Uruguay.

OBJECTIVES: Persistent infection with specific genotypes of human papillomaviruses (HPVs) is the main cause of invasive cervical cancer (ICC). Only a few of the various HPV types account for most of the cases worldwide, and geographical differences in their distribution are evident. Data from locally prevalent genotypes are essential in view of introduction of HPV type-specific prophylactic vaccines. METHODS: In this work, we have investigated HPV type distribution in samples of ICC cases that occurred in Uruguayan women. DNA extracted from ICC treated in Centro Hospitalario Pereira Rossell of Montevideo between 1999 and 2007 were analyzed. Search and typing were performed by polymerase chain reaction using generic GP5+/GP6+ primers and specific primers for HPV types 16, 18, 33, and 45. Positive GP5+/GP6+ samples, which were negative for all 4 high-risk HPV-specific types screened were further analyzed by sequencing. RESULTS: Human papillomavirus DNA sequences were found in 163 (92.6%) of 176 cases. The most prevalent genotypes were HPV16 (67.6%) and HPV18 (8.5%) followed by HPV45 (6.8%) and HPV33 (3.4%), as single or mixed infection. Other less frequent genotypes were HPV31, HPV35, HPV39, HPV51, HPV52, HPV58, HPV66, and HPV73. The viral type could not be determined (HPV X) in 1 case (0.6%) of the HPV DNA-positive cervical cancers and double infections were found in 1.7% of the cases. The higher percentage of most aggressive HPV (16/18/45) genotypes was detected in cases diagnosed at younger than 60 years old, whereas these genotypes were less frequent in older patients. CONCLUSION: We conclude that HPV types 16, 18, and 45 have a very high prevalence in ICC of Uruguayan women. Results provide evidence that 16 of 18 infections are more aggressive, but most cancers could be vaccine preventable.

[External evaluation of population-based cancer registries: the REDEPICAN Guide for Latin America]. / Evaluación externa de registros de cáncer de base poblacional: la Guía REDEPICAN para América Latina.

OBJECTIVE: Evaluate the feasibility of the REDEPICAN Guide (Red Iberoamericana de Epidemiología y Sistemas de Información en Cáncer) and its adaptation to the current situation of population-based cancer registries (PBCRs) in Latin America and the Caribbean as a useful tool to improve these registries. METHODS: Experts in cancer registries and health audits designed the guide and developed seven domains to evaluate in PBCRs. Several criteria were selected for each domain, with corresponding standards, scored according to three levels of compliance. Two training courses for external evaluators and three discussion panels for experts were organized. The guide was tested in six PBCRs in Latin America and Spain. RESULTS: The guide contains 68 criteria, 10 of which are considered essential for a PBCR. Based on its score, a registry is regarded as acceptable (41-199), good (200-299), or excellent (300-350). The registry methods domain accounts for 25% of the score, followed by completeness and validity (19%), dissemination of outcomes (19%), structure (13%), confidentiality and ethical aspects (11%), comparability (9%), and the procedures manual (3%). The pilot project enabled (1) enhancement of criteria and standards, (2) expansion of the quality concept to include client needs, and (3) strengthening the dissemination of outcomes section. Two of the Latin American registries that were evaluated improved their quality, meeting the standards of the International Agency for Research on Cancer. CONCLUSIONS: Development of the REDEPICAN Guide has taken into account the context of the registries in Latin America and is a useful and innovative tool for improving the quality of PBCRs. Furthermore, it is ready for use in other countries and registries.

Cancer incidence and mortality in Uruguay: 2013-2017.

Background: Uruguay has the highest cancer incidence and mortality rates in Latin America. The National Cancer Registry of Uruguay, which has been in operation since 1992, provides epidemiological information on incidence and mortality at the country level. Objective: The objective of this article is to update the incidence and mortality figures by reporting the information for the period 2013-2017. Methods: All incident cases of invasive neoplasias except non melanoma of the skin and all cancer deaths occurred in from 2013 to 2017 were analyzed. Age standardized rates were calculated by the direct method, using the world standard population. Complementary, incidence (2002-2017) and mortality (1990-2017) trends were studied for the leading sites. Results: Among females, the most common cancers are breast, colon and rectum, lung, cervix and thyroid. The most frequent cancers in males are prostate, lung, colon and rectum, bladder and kidney. Lung, prostate and colorectal cancer are the leading causes of cancer death in males while breast cancer is the first cause of cancer death among females. Conclusions: Although cancer mortality has declined monotonously since 1990, cancer control is a challenge for Uruguay, wherein breast, lung and prostate cancer have very high incidence while the country must still make an effort to reduce other cancers that are very common in economically less favored countries.

Antecedentes: Uruguay tiene las mayores tasas de incidencia y mortalidad por cáncer en América Latina. El Registro Nacional de Cáncer de Uruguay, que ha estado en funcionamiento desde 1992 provee información epidemiológica sobre incidencia y mortalidad de todo el país. Objetivo: El objetivo de este artículo es actualizar las cifras de incidencia y mortalidad reportando la información para el período 2013-2017. Métodos: Se analizaron todos los casos incidentes de neoplasias invasivas excluyendo el cáncer de piel no melanoma y todas las muertes por cáncer del período 2013-2017. Se calcularon las tasas estandarizadas por edad según el método directo, utilizando como estándar la población mundial. En forma complementaria, se estudiaron las tendencias de incidencia (2002-2017) y de mortalidad (1990-2017) para los sitios más frecuentes. Resultados: Entre las mujeres, los cánceres más frecuentes son mama, colorrecto, pulmón, cérvix y tiroides. Los cánceres más frecuentes en hombres son próstata, pulmón colorrecto, vejiga y riñón. Los cánceres de pulmón, próstata y colorrecto ocupan los primeros lugares en las muertes por cáncer en hombres, mientras que en mujeres el cáncer de mama ocupa el primer lugar. Conclusiones: Si bien la mortalidad por cáncer ha disminuído de manera monótona desde 1990, el control del cáncer es un desafío para Uruguay dónde los cánceres de mama, pulmón y próstata tienen una incidencia muy alta, a la vez que aún se debe hacer un esfuerzo para reducir otros cánceres que son muy comunes en los países económicamente menos favorecidos.

A scientific methodology course for advanced medical students: an eight-year perspective.

Background: Exponential increases in the development of medical knowledge, the expansion of areas where medicine develops its activities, the emergence of new pathologies ( e.g., COVID-19), novel diagnostic methods and therapeutic strategies, together with the appearance of multiple communication and information technologies, determined that the education of future physicians required targeted training in scientific methodology. Methods: The design and execution of a course in scientific methodology in the curriculum of Facultad de Medicina, Universidad de la República, Uruguay, is described. The course is carried out at an advanced stage of the medical studies for all the students, in which they develop a 10-month research project supervised by the medical school faculty. Students undergo all stages of a research endeavor: generation of hypothesis, elaboration of a research protocol, submission to the Research Ethics and Animal Welfare Committees, data recollection, analysis, interpretation and publication of the results. Results: The course is undertaken at the Facultad de Medicina, Universidad de la República, Uruguay, the main university of the country, with high numbers of students enrolled. The course involves the participation of 600 students and up to 300 professors per year, which implies a huge institutional effort Conclusions: The scientific methodology course resulted in one of the most important incorporations of the current 2008 curriculum. Local students, faculty and international evaluators have qualified this activity as an educational breakthrough, being a gratifying and productive experience. The course represented the first exposure of medical students to the research methodology, scientific literature and publication rules, and emphasized the dynamic nature of medical knowledge within modern medical education. Moreover, for some students it constituted the onset of academic research careers. An additional positive outcome was the reactivation of some faculty research projects, in a way that largely exceeded the boundaries of the course.

An updated profile of the cancer burden, patterns and trends in Latin America and the Caribbean.

Background: Cancer is a leading cause of disease and death in Latin America and the Caribbean (LAC). Contemporary data on the cancer burden aims to inform effective cancer policies; this article provides an update and benchmarking of national cancer incidence and mortality estimates for the year 2020, alongside recent mortality trends in the region. Methods: The number of new cancer cases and deaths were extracted from the GLOBOCAN 2020 database developed by the International Agency for Research on Cancer (IARC), and mortality data over time from IARC's cancer mortality database, New cancer cases, deaths and corresponding age-standardized rates per 100,000 person-years are presented. Random fluctuations in mortality trends by country, sex and cancer site were smoothed using LOWESS regression. Findings: An estimated total of 1.5 million new cancer cases and 700,000 deaths occur annually in LAC, with corresponding incidence and mortality rates of 186.5 and 86.6 per 100,000. The most common cancers in 2020 were prostate (15%), breast (14%), colorectal (9%), lung (7%) and stomach (5%). Lung cancer remained the leading cause of cancer death (12%), though rates varied substantially between countries. The mortality trends of infectious-related cancers tended to decline in most countries, while rates of cancer types linked to westernization were mainly increasing. Assuming rates remain unchanged, the cancer burden in LAC will increase by 67% reaching 2.4 million new cases annually by 2040. Interpretation: The cancer patterns reflect important underlying sociodemographic changes occurring over the last decades. With an increasing burden anticipated over the next decades in this region, there is a need to plan oncological service provision accordingly. Funding: No external funds received.

Colorectal Cancer in Young and Older Adults in Uruguay: Changes in Recent Incidence and Mortality Trends.

Uruguay has the highest colorectal cancer incidence rates in Latin America. Previous studies reported a stable incidence and a slight increase in mortality among males. We aimed to assess colorectal cancer incidence (2002-2017) and mortality trends (1990-2017) by age groups and sex, using data from the National Cancer Registry. Annual percent changes (APCs) were estimated using joinpoint regression models. We included 27,561 colorectal cancer cases and 25,403 deaths. We found an increasing incidence among both males and females aged 40-49, with annual increases of 3.1% (95%CI: 1.21-5.03) and 2.1% (95%CI: 0.49-3.66), respectively, and an increasein the rate in older males (70+) of 0.60% (95%CI: 0.02-1.20) per year between 2002 and 2017. Mortality remained stable among those younger than 50, whereas it decreased for older females aged 50-69 and 70+ (APC: -0.61% (-1.07-0.14) and -0.68% (-1.02-0.34), respectively), and increased for the oldest males (70+; APC: 0.74 (0.47-1.01)). In conclusion, we found rising colorectal cancer incidence accompanied by stable mortality in young adults. Sex disparities were also found among the older adults, with a more favorable pattern for females. Exposures to dietary and lifestyle risk factors, and inequalities in access to and awareness of screening programs, are probably among the main underlying causes and deserve further investigation.

Prognostic Factors in De Novo Metastatic Renal Cell Carcinoma: A Report From the Latin American Renal Cancer Group.

PURPOSE: To assess the effect of clinical and pathological variables on cancer-specific and overall survival (OS) in de novo metastatic patients from a collaborative of primarily Latin American countries. PATIENTS AND METHODS: Of 4,060 patients with renal cell carcinoma diagnosed between 1990 and 2015, a total of 530 (14.5%) had metastasis at clinical presentation. Relationships between clinical and pathological parameters and treatment-related outcomes were analyzed by Cox regression and the log-rank method. RESULTS: Of 530 patients, 184 (90.6%) had died of renal cell carcinoma. The median OS of the entire cohort was 24 months. American Society of Anesthesiology classification 3-4 (hazard ratio [HR]: 1.64), perirenal fat invasion (HR: 2.02), and ≥ 2 metastatic organ sites (HR: 2.19) were independent prognostic factors for 5-year OS in multivariable analyses. We created a risk group stratification with these variables: no adverse risk factors (favorable group), median OS not reached; one adverse factor (intermediate group), median OS 33 months (HR: 2.04); and two or three adverse factors (poor risk group), median OS 14 months (HR: 3.58). CONCLUSION: Our study defines novel prognostic factors that are relevant to a Latin American cohort. With external validation, these easily discerned clinical variables can be used to offer prognostic information across low- and middle-income countries.

Electrochemistry of undoped diamond nanoparticles: accessing surface redox states.

The electrochemical response of an electrode-immobilized layer of undoped, insulating diamond nanoparticles is reported, which we attribute to the oxidation and reduction of surface states. The potentials of these surface states are pH-dependent; moreover they are able to interact with solution redox species. The voltammetric response of redox couples Fe(CN)(6)(3-/4-) and IrCl(6)(3-/2-) are compared at bare boron-doped diamond electrodes and electrodes modified with a layer of nanodiamond (ND). In all cases the presence of ND modifies the CV response at slow scan rates if low concentrations of redox couple are used. Enhancements of oxidation currents are noted at potentials at which the ND surface states can also undergo oxidation, and enhancements of reduction currents are likewise observed where ND is also reducible. We attribute these observations to electron transfer occurring between the species generated at the underlying electrode during CV and the ND immobilized in the interfacial region, leading to regeneration of the starting species and hence enhancement in currents due to a feedback mechanism. The magnitude of current enhancement thus depends on the standard potential of the redox couple relative to those of the ND surface states.

Trends in cancer incidence in Uruguay: 2002 -2015.

BACKGROUND: Uruguay is the south American 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 descended 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.

INTRODUCCIÓN: Uruguay es el país de Sudamerica que tiene las mayores tasas de incidencia y mortalidad por cáncer. El Registro Nacional de Cáncer recoge los datos de cáncer de todo el país desde 1989 y en las últimas décadas ha alcanzado los más altos estándares de calidad. Este es el primer reporte de tendencias de incidencia de cáncer de Uruguay. MÉTODOS: Se analizaron los datos de todos los casos de cáncer invasivo diagnosticados entre 2002 y 2015 incluidos en el Registro Nacional de Cáncer y los de once topografías en particular. Se calcularon las tasas de incidencia estandarizada y se analizaron las tendencias utilizando los modelos de regresión de Joinpoint. RESULTADOS: Las tasas de incidencia de cáncer colorrectal, vejiga y todos los sitios reunidos se mantuvieron estables tanto en hombres como en mujeres. La tasa de incidencia de cáncer de estómago y esófago disminuyeron mientras que las de tiroides y riñón aumentaron. En los hombres, el cáncer de pulmón disminuyó, el cáncer de testículo aumentó y el de próstata aumentó en un lapso inicial y decreció en los últimos años. En las mujeres el cáncer de pulmón aumentó y el de mama se mantuvo estable mientras que el cáncer de cérvix presentó un descenso significativo entre 2005 y 2010 alcanzando una meseta desde entonces. CONCLUSIÓN: La dinámica de la incidencia de cáncer es compleja y está afectada no sólo por las políticas de Salud Pública como las campañas de control de tabaco, vacunación y programas de tamizaje sino por los cambios ambientales y de los estilos de vida y la actitud de los médicos respecto a la aplicación de técnicas diagnósticas y terapéuticas. En este trabajo se analizan las tendencias de incidencia en el país y se plantean posibles explicaciones para los cambios.

Estadio, perfil biológico y tendencias de incidencia y mortalidad de cáncer de mama en Uruguay: análisis por franjas etarias

Introducción: el cáncer de mama es el tumor maligno más frecuente y la primera causa de muerte por cáncer en mujeres en Uruguay y en el mundo. La evidencia epidemiológica sugiere que el cáncer de mama en diferentes grupos de edades se comportaría como patologías distintas. El objetivo de este trabajo es caracterizar el cáncer de mama en Uruguay para diferentes estratos de edades. Material y método: se analizaron las tendencias temporales de la incidencia de cáncer de mama en mujeres en Uruguay en el período 2002-2019, y de la mortalidad por esta causa en 1990-2020. Para el quinquenio 2015-2019, se analiza además la distribución de estadios al diagnóstico y de perfiles biológicos (luminales, triple negativos y HER2 positivos). Se analizan tres segmentos de edades: mujeres de 20 a 44 años, de 45 a 69 y de 70 y más años. Resultados: las tasas de incidencia para el conjunto de edades se presentaron estables en el período 2002-2019, mientras que la mortalidad presenta una tendencia decreciente en el período 1990-2020. En las mujeres menores de 45 años se encuentra un aumento en la incidencia, con mortalidad que decrece hasta el 2010, seguido de una estabilización de las tasas; en las mujeres de 45 a 69 años la incidencia se mantiene estable y la mortalidad decrece; en las mayores de 70 años, la incidencia decrece mientras la mortalidad se mantiene estable. Más del 70% de los casos se diagnostican en estadios I y II. Los tumores luminales (receptores hormonales positivos, HER2 negativos) son el subtipo más frecuente para todos los grupos, la proporción de tumores con estas características aumenta con la edad, mientras decrece la proporción de HER2 positivo y triple negativo. Conclusión: en las mujeres uruguayas el cáncer de mama presenta características diferenciales para las tres franjas de edades analizadas.

Introduction: Breast cancer is the most common malignant tumor and the leading cause of cancer death in women in Uruguay and worldwide. Epidemiological evidence suggests that breast cancer in different age groups behaves as distinct pathologies. The objective of this work is to characterize breast cancer in Uruguay for different age groups. Method: Temporal trends in the incidence of breast cancer in women in Uruguay are analyzed for the period 2002-2019, along with mortality trends for this cause from 1990 to 2020. For the five-year period 2015-2019, the distribution of stages at diagnosis and biological profiles (Luminal, Triple-negative, and Her2 positive) is also analyzed. Three age segments are analyzed: women aged 20 to 44 years, 45 to 69 years, and 70 years and older. Results: The incidence rates for all age groups remained stable during the period 2002-2019, while mortality showed a decreasing trend in the period 1990-2020. In women under 45, there is an increase in incidence, with mortality decreasing until 2010, followed by a stabilization of rates; in women aged 45 to 69, incidence remains stable and mortality decreases; in those over 70, incidence decreases while mortality remains stable. More than 70% of cases are diagnosed at stages I and II. Luminal tumors (hormone receptor positive, Her2 negative) are the most frequent subtype for all age groups. The proportion of tumors with these characteristics increases with age, while the proportion of Her2 positive and triple-negative tumors decreases. Conclusions: In Uruguayan women, breast cancer presents differential characteristics for the three age groups analyzed.

Introdução: O câncer de mama é o tumor maligno mais comum e a principal causa de morte por câncer em mulheres no Uruguai e no mundo. Evidências epidemiológicas sugerem que o câncer de mama se comportaria como patologias distintas em diferentes faixas etárias. O objetivo deste trabalho é caracterizar o câncer de mama no Uruguai para diferentes faixas etárias. Materiais e Métodos: São analisadas as tendências temporais da incidência de câncer de mama em mulheres no Uruguai no período 2002-2019 e a mortalidade por esta causa no período 1990-2020. Para o quinquénio 2015-2019 são também analisadas a distribuição dos estádios ao diagnóstico e os perfis biológicos (Luminal, Triplo negativo e Her2 positivo). São analisados três segmentos etários: mulheres dos 20 aos 44 anos, dos 45 aos 69 anos e dos 70 anos ou mais. Resultados: As taxas de incidência para todas as idades permaneceram estáveis no período 2002-2019 enquanto a mortalidade apresentou tendência decrescente no período 1990-2020. Nas mulheres com menos de 45 anos verifica-se um aumento da incidência, com uma redução da mortalidade até 2010, seguida de uma estabilização das taxas; nas mulheres de 45 a 69 anos, a incidência permanece estável e a mortalidade diminui; nas pessoas com mais de 70 anos, a incidência diminui enquanto a mortalidade permanece estável. Mais de 70% dos casos são diagnosticados nos estágios I e II. Os tumores luminais (receptor hormonal positivo, Her2 negativo) são o subtipo mais comum para todos os grupos sem do que a proporção de tumores com essas características aumenta com a idade, enquanto a proporção de (Her2 positivo e triplo negativo) diminui. Conclusão: Nas mulheres uruguaias, o câncer de mama apresenta características diferenciadas para as três faixas etárias analisadas.

[Production systems of Spondias purpurea (Anacardiaceae) in Central West Mexico]. / Sistemas de producción de Spondias purpurea (Anacardiaceae) en el centro-occidente de México.

Morphological, physical and chemical traits related with fruit quality characteristics of Spondias purpurea L. agroecosystems were studied in Central-West Mexico for wild and cultivated populations. Spondias purpurea regularly thrive in shallow, rocky infertile soils unsuitable for conventional crops. The weight, axial and radial length, pH, total soluble solids (SST), reducing sugars, proteins and mineral content in fruits were recorded. The mean fresh fruit weight was superior in the cultivated varieties (20 g) than in the wild (16 g). Similarly the highest values of pH, SST, reducing sugars and protein content (3.3, 12.15 degrees Brix, 0.38 g/100 g and 1.18 g/100 g, respectively) were observed in the cultivated plantations compared with wild populations (3.0, 8.31 degrees Brix, 0.24 g/100 g and 0.14 g/100 g, respectively). In cultivated plantations, productivity ranged from 0.15 ton ha(-1) to 5.0 ton ha(-1), and must be considered satisfactory, considering the low inputs of fertilizers and pesticides applied to orchards. The fruits of S. purpurea are similar in nutrimental content to more important commercial fruit species; it produces fresh fruits during the dry months of spring, when few fresh fruits are available in the local markets. In addition, S. purpurea is a source of water and food for domestic animals and wild fauna. These traits emphasize their agronomical and ecological importance for tropical and subtropical environments, where it can also be used in reforestation programs because it can grow in infertile rocky soils, and in agroecosystems inhabited by low income farmers that practice subsistence agriculture. In fact, the cultivation of Spondias has helped convert marginal lands into productive lands.

Polypeptide-GalNAc-T6 expression predicts better overall survival in patients with colon cancer.

Colorectal carcinoma (CRC) is the second leading cause of cancer mortality worldwide. O-glycosylated mucins at the cell surface of colonic mucosa exhibit alterations in cancer and are involved in fundamental biological processes, including invasion and metastasis. Certain members of the GalNAc-transferase family may be responsible for these changes and are being investigated as novel biomarkers of cancer. In the present study the prognostic significance of GalNAc-T6 was investigated in patients with CRC patients. GalNAc-T6 expression was observed in all three colon cancer cell lines analyzed by reverse transcription-polymerase chain reaction, immunofluorescence and flow cytometry. A cohort of 81 colon cancer specimens was analyzed by immunohistochemical staining using MAb T6.3. It was demonstrated that GalNAc-T6 was expressed in 35/81 (43%) cases of colon cancer but not in the normal colonic mucosa. No association was observed with the clinical-pathologic parameters. However, patients expressing GalNAc-T6 had a significantly increased overall survival (median, 58 months; P<0.001) compared with GalNAc-T6 negative patients, especially those with advanced disease. These results suggest that GalNAc-T6 expression predicts an improved outcome in patients with CRC. The molecular mechanism underlying the less aggressive behavior of colon cancer cells expressing GalNAc-T6 remains to be elucidated.

Lung cancer incidence trends in Uruguay 1990-2014: An age-period-cohort analysis.

BACKGROUND: Uruguay, a country with one of the highest lung cancer rates worldwide, initiated a series of comprehensive anti-smoking measures in 2005. We assess the tobacco control policies in the context of cohort-driven lung cancer incidence trends over a 25-year period, providing baseline predictions to 2035. METHODS: Using data from the National Cancer Registry of Uruguay, an age-period-cohort analysis of trends 1990-2014 was performed. The NORDPRED package was used to predict the annual number of new cases of lung cancer and incidence rates up to 2035. RESULTS: In men, age-standardised (world) rates declined from a peak of 165.6 in 1995 to 103.1 by 2014, translating to a 70% reduction in the risk of lung cancer in men born in 1970 relative to the early-1940s. In females, rates increased steadily from 18.3 in 1991 to 30.0 by 2014, with successive increases in risk among generations of women born 1940-1960. There is however evidence of a decline in observed rates in women born recently. Extrapolations of the trends indicate an 8% reduction in the mean number of new lung cancer cases in men by 2035, but a 69% increase in women. CONCLUSION: Despite observed and predicted reductions in lung cancer incidence in Uruguayan men, rates among women are set to continue to increase, with a large rise in the annual number of female lung cancer diagnoses expected before 2035. There are signals of a diminishing risk among recent generations of women born after 1960. The current analysis provides important baseline information in assessing the future impact of the recent tobacco control initiatives in Uruguay.