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.

Planificación sanitaria a partir de los datos ómicos: ¿es posible esta idea para Chile? / The contribution of omic sciences for the management of cancer in Chile

With or without a COVID19 pandemic, cancer is and will continue to be one of the greatest health challenges on the planet. In Chile, during 2016, this disease was the second cause of death in the country and during 2019, it was the first cause in seven Chilean regions, surpassing cardiovascular diseases. With the advent of precision medicine as a powerful tool for cancer control, it is necessary to have genomic, proteomic, and molecular data in general, ideally on a population scale. This is essential for decision-making, for example in public and private oncology, to be as cost-effective as possible. Chile has a mass of high-quality researchers in cancer. However, until today the investment in research and development is far below the peers in the OECD. In this work we put into perspective the role of precision medicine and omic sciences as essential tools for public health. We offer a brief national diagnosis of the knowledge collected to date by the local scientific community regarding onco-genomic data from our own population. We finally discuss the potential behind the strengthening of this scientific knowledge, aiming to optimize the comprehensive management of cancer.

[The contribution of omic sciences for the management of cancer in Chile]. / Planificación sanitaria a partir de los datos ómicos: ¿es posible esta idea para Chile?

With or without a COVID19 pandemic, cancer is and will continue to be one of the greatest health challenges on the planet. In Chile, during 2016, this disease was the second cause of death in the country and during 2019, it was the first cause in seven Chilean regions, surpassing cardiovascular diseases. With the advent of precision medicine as a powerful tool for cancer control, it is necessary to have genomic, proteomic, and molecular data in general, ideally on a population scale. This is essential for decision-making, for example in public and private oncology, to be as cost-effective as possible. Chile has a mass of high-quality researchers in cancer. However, until today the investment in research and development is far below the peers in the OECD. In this work we put into perspective the role of precision medicine and omic sciences as essential tools for public health. We offer a brief national diagnosis of the knowledge collected to date by the local scientific community regarding onco-genomic data from our own population. We finally discuss the potential behind the strengthening of this scientific knowledge, aiming to optimize the comprehensive management of cancer.

Realidad de la investigación en salud en Chile: participación de los médicos en el Fondo Nacional de Investigación (FONIS) en la última década / Reality of health research in Chile: participation of doctors in the National Research Fund (FONIS) in the last decade

Chile es uno de los países de la OCDE que menos invierte en ciencia y tecnología, y la investigación en salud no está exenta de este problema. Existe evidencia reportada en publicaciones nacionales de que la participación de médicos en la investigación ha experimentado un marcado retroceso en las últimas décadas. El objetivo de este artículo es analizar específicamente la participación de los médicos como investigadores responsables en proyectos financiados por el Fondo Nacional de Investigación en Salud (FONIS). Este programa fue diseñado para promover investigaciones que resuelvan problemas prioritarios de salud y de esa manera entregar enfoques diagnósticos y terapéuticos a la medida del fenotipo local. Nuestros análisis muestran un estancamiento real y una disminución porcentual, misma tendencia que estudios previos. La implementación de recomendaciones internacionales en el campo de la medicina rasnacional en las políticas de salud nacionales podría revertir el aparente proceso de retirada de los médicos de las actividades de I+D, lo que beneficiaría la salud de los pacientes y reduciría los costos para el sistema, de, por ejemplo, la importación de la terapéutica.(AU)

Chile is one of the OECD countries that invests less in science and technology, and health research is not exempt from this problem. Evidence reported in national publications shows that the participation of physicians in research has experienced a marked decline in recent decades. The objective of this article is to specifically analyze the participation of physicians as responsible researchers in projects funded by the National Fund for Health Research (FONIS). This program was designed to promote research that addresses priority health issues and thereby delivers diagnostic and therapeutic approaches tailored to the local phenotype. Our analyzes show a real stagnation and a percentage decrease, same trend as previous studies. The implementation of international recommendations in the field of translational medicine in national health policies could reverse the apparent process of withdrawal of physicians from R&D activities, which would benefit the health of patients and reduce the costs for the system, for instance, in the ones implied of importing therapeutics.(AU)