[Trends and social indicators of both mortality breast cancer and cervical cancer in Antioquia, Colombia, 2000-2007]. / Tendencias e indicadores sociales de la mortalidad por cáncer de mama y cuello uterino: Antioquia, Colombia, 2000-2007.

OBJECTIVE: To estimate the mortality age-standardized rates (ASR) for breast and cervical cancer from 2000-2007 and explore social indicators that explain the variability of rates in Antioquia. MATERIAL AND METHODS: The ASR was estimated by the direct method and linear regression was used to relate social indicators with rates by subregion. RESULTS: Breast and cervical cancer mortality ASRs in Antioquia were 11.3 and 9.1 per 100 000 woman-years respectively. In Medellin, the breast cancer mortality ASR was 12.5, 1.8 times the rate of cervical cancer. A decrease of cervical cancer ASR between 2000 and 2007 was observed in Medellin (p-value=0.03) but not in the rest of Antioquia. Cervical cancer mortality ASR was related to the percentage of poverty (p-value=0.0003). CONCLUSIONS: Mortality due to these neoplasms has remained constant in Antioquia. The wide variation in mortality from cervical cancer between regions seems to be associated with poverty.

[Perceived urgency of medical condition and use of health care services in Medellín, Colombia, 2005-2006]. / Morbilidad sentida de las urgencias médicas y la utilización de los servicios de salud en Medellín, Colombia, 2005-2006.

INTRODUCTION: Medellín has a population of 2.1 million and has 47 acute care hospitals that provide emergency health care services. Perceived seriousness of a medical condition in addition to accessibility and availability of care may influence the use of health care services in the region. OBJECTIVES: A broad-spectrum survey was conducted to rate the urgency of a health condition as perceived by the patient and how that patient proceeded to make use of health care services. MATERIALS AND METHODS: The cross sectional survey was conducted, using door-to-door personal interviews in 1,442 homes from 70 neighborhoods. RESULTS: Of the 612,689 individuals interviewed, 533,718 (87,11%) reported that they have had a medical emergency. Respiratory difficulties were the most frequent reason for visiting a health care facility as reported by 113,153 (21.2%) of the participants. Of the 532,718 visits reported, 501,558 (93.97%) led to a hospital admission. Of the 21,042 visits not leading to an admission, 42.0% were considered as non-urgent by the hospital staff. Visits admissions reports were missing, 11.118 (2.08%). CONCLUSIONS: In Medellín, the incidence of medical emergencies leading to a health care facility visit is high. The high prevalence of respiratory emergencies and other conditions that can be managed outside the emergency service indicates the need for a pre-hospital emergency service.

Tendencias e indicadores sociales de la mortalidad por cáncer de mama y cuello uterino: Antioquia, Colombia, 2000-2007 / Trends and social indicators of both mortality breast cancer and cervical cancer in Antioquia, Colombia, 2000-2007

OBJETIVO: Estimar tasas estandarizadas por edad (TEE) de mortalidad por cáncer de mama y cérvix 2000-2007 y explorar indicadores sociales que expliquen la variabilidad de las tasas. MATERIAL Y MÉTODOS: Las TEE de mortalidad se estimaron por el método directo y mediante regresión lineal se relacionaron con indicadores sociales por subregión. RESULTADOS: La TEE de cáncer de mama en Antioquia fue 11.3 por 100 000 mujeres-año y para cáncer cervical 9.1. En Medellín, la TEE de cáncer de mama fue 12.5, 1.8 veces la tasa de cáncer cervical. Se observó una disminución del cáncer cervical en Medellín (valor-p=0.03) entre 2000 y 2007, pero no en el resto de Antioquia. La mortalidad de cáncer cervical se relacionó con el porcentaje de miseria (valor-p=0.0003). CONCLUSIONES: La mortalidad por estas neoplasias ha permanecido constante en Antioquia, con una amplia variación de la mortalidad por cáncer cervical por subregión asociada con niveles de pobreza.

OBJECTIVE: To estimate the mortality age-standardized rates (ASR) for breast and cervical cancer from 2000-2007 and explore social indicators that explain the variability of rates in Antioquia. MATERIAL AND METHODS: The ASR was estimated by the direct method and linear regression was used to relate social indicators with rates by subregion. RESULTS: Breast and cervical cancer mortality ASRs in Antioquia were 11.3 and 9.1 per 100 000 woman-years respectively. In Medellin, the breast cancer mortality ASR was 12.5, 1.8 times the rate of cervical cancer. A decrease of cervical cancer ASR between 2000 and 2007 was observed in Medellin (p-value=0.03) but not in the rest of Antioquia. Cervical cancer mortality ASR was related to the percentage of poverty (p-value=0.0003). CONCLUSIONS: Mortality due to these neoplasms has remained constant in Antioquia. The wide variation in mortality from cervical cancer between regions seems to be associated with poverty.