Incidence of childhood cancer in Latin America and the Caribbean: coverage, patterns, and time trends / Incidencia del cáncer infantil en América Latina y el Caribe: cobertura de los registros, patrones y tendencias a lo largo del tiempo / Incidência de câncer infantil na América Latina e no Caribe: cobertura, padrões e tendências temporais

[ABSTRACT]. Objective. To provide a comprehensive overview of geographical patterns (2001–2010) and time trends (1993–2012) of cancer incidence in children aged 0–19 years in Latin America and the Caribbean (LAC) and interpret the findings in the context of global patterns. Methods. Geographical variations in 2001–2010 and incidence trends over 1993–2012 in the population of LAC younger than 20 years were described using the database of the third volume of the International Incidence of Childhood Cancer study containing comparable data. Age-specific incidence per million person-years (ASR) was calculated for population subgroups and age-standardized (WSR) using the world standard population. Results. Overall, 36 744 unique cases were included in this study. In 2001–2010 the overall WSR in age 0–14 years was 132.6. The most frequent were leukemia (WSR 48.7), central nervous system neoplasms (WSR 23.0), and lymphoma (WSR 16.6). The overall ASR in age group 15–19 years was 152.3 with lymphoma rank- ing first (ASR 30.2). Incidence was higher in males than in females, and higher in South America than in Central America and the Caribbean. Compared with global data LAC incidence was lower overall, except for leukemia and lymphoma at age 0–14 years and the other and unspecified tumors at any age. Overall incidence at age 0–19 years increased by 1.0% per year (95% CI [0.6, 1.3]) over 1993–2012. The included registries covered 16% of population aged 0–14 years and 10% of population aged 15–19 years. Conclusions. The observed patterns provide a baseline to assess the status and evolution of childhood can- cer occurrence in the region. Extended and sustained support of cancer registration is required to improve representativeness and timeliness of data for childhood cancer control in LAC.

[RESUMEN]. Objetivo. Presentar un panorama integral de los patrones geográficos (2001 a 2010) y las tendencias a lo largo del tiempo (1993 a 2012) de la incidencia de cáncer en la población infantil de 0 a 19 años en América Latina y el Caribe e interpretar los resultados en el contexto de los patrones mundiales. Métodos. Se describen las diferencias geográficas en el período 2001-2010 y las tendencias de la incidencia entre 1993 y el 2012 correspondientes a la población menor de 20 años de América Latina y el Caribe, mediante el empleo de la base de datos del tercer volumen del estudio de Incidencia Internacional del Cáncer Infantil, (IICC, por su sigla en inglés), que contiene datos comparables. Se calculó la tasa de incidencia específica para la edad (TEE) por millón de años-persona para los diversos subgrupos poblacionales y la tasa de incidencia mundial estandarizada según la edad (TEM) utilizando la población estándar mundial. Resultados. El estudio incluyó un total de 36 744 casos únicos. En el período del 2001 al 2010, la TEM general en la franja etaria de 0 a 14 años fue de 132,6. Los cánceres más frecuentes fueron la leucemia (TEM 48,7), las neoplasias del sistema nervioso central (TEM 23,0) y el linfoma (TEM 16,6). La TEE general en la franja etaria de 15 a 19 años fue de 152,3, con el linfoma como cáncer más frecuente (TEE 30,2). La incidencia fue mayor en el sexo masculino que en el femenino, y fue más alta en América del Sur que en Centroamérica y el Caribe. En comparación con los datos mundiales, en América Latina y el Caribe la incidencia fue, en general, menor, excepto en el caso de leucemia y el linfoma en la franja etaria de 0–14 años y los cánceres classificados como otros tumores y tumores sin especificar en todas las edades. La incidencia general en la franja etaria de 0-19 años aumentó en un 1,0 % al año (IC del 95 % [0,6, 1,3]) entre 1993 y el 2012. La cobertura de los registros incluidos fue de un 16% de la población de 0 a 14 años y de un 10% de la de 15 a 19 años. Conclusiones. Los patrones observados proporcionan un valor de referencia para evaluar el estado y la evolución de la incidencia del cáncer infantil en la Región. Es necesario contar con un apoyo mayor y más sostenido para el registro del cáncer a fin de mejorar la representatividad y la oportunidad de los datos relativos al control del cáncer infantil en América Latina y el Caribe.

[RESUMO]. Objetivo. Apresentar uma visão abrangente dos padrões geográficos (2001 a 2010) e das tendências temporais (1993 a 2012) da incidência de câncer em crianças e jovens de 0 a 19 anos na América Latina e no Caribe (ALC) e interpretar os resultados no contexto de padrões mundiais. Métodos. Foram descritas variações geográficas de 2001 a 2010 e tendências de incidência de 1993 a 2012 na população com menos de 20 anos da ALC usando informações comparáveis da base de dados do terceiro volume do estudo International Incidence of Childhood Cancer. Foram calculadas taxas de incidência específica por idade por milhão de pessoas-ano (ASR, na sigla em inglês) para subgrupos populacionais e taxas padronizadas por idade usando a população padrão mundial (WSR, na sigla em inglês). Resultados. No total, foram incluídos 36 744 casos únicos. No período de 2001 a 2010, a WSR para todos os tumores combinados na faixa etária de 0 a 14 anos foi de 132,6. Os diagnósticos mais frequentes foram leucemia (WSR de 48,7), neoplasias do sistema nervoso central (WSR de 23,0) e linfoma (WSR de 16,6). A ASR para todos os tumores combinados na faixa etária de 15 a 19 anos foi de 152,3, e a maior taxa foi a de linfoma (ASR de 30,2). A incidência foi maior no sexo masculino do que no sexo feminino e maior na América do Sul do que na América Central e no Caribe. De modo geral, em comparação com as estimativas mundiais, a incidência na ALC foi menor, exceto para leucemia e linfoma entre 0 e 14 anos e para outros tumores e tumores não especificados em qualquer idade. A taxa de incidência na faixa etária de 0 a 19 anos aumentou em 1,0% ao ano (IC de 95% [0,6, 1,3]) entre 1993 e 2012. Os registros incluídos cobriam 16% da população de 0 a 14 anos e 10% da população de 15 a 19 anos. Conclusões. Os padrões observados servem de referência para avaliar o status e a evolução da ocorrência de câncer infantil na região. É necessário garantir um apoio ampliado e consistente aos registros de câncer para aprimorar a representatividade e a disponibilidade das informações em tempo adequado para o controle do câncer infantil na ALC.

Incidence of childhood cancer in Latin America and the Caribbean: coverage, patterns, and time trends / Incidencia del cáncer infantil en América Latina y el Caribe: cobertura de los registros, patrones y tendencias a lo largo del tiempo / Incidência de câncer infantil na América Latina e no Caribe: cobertura, padrões e tendências temporais

ABSTRACT Objective. To provide a comprehensive overview of geographical patterns (2001-2010) and time trends (1993-2012) of cancer incidence in children aged 0-19 years in Latin America and the Caribbean (LAC) and interpret the findings in the context of global patterns. Methods. Geographical variations in 2001-2010 and incidence trends over 1993-2012 in the population of LAC younger than 20 years were described using the database of the third volume of the International Incidence of Childhood Cancer study containing comparable data. Age-specific incidence per million person-years (ASR) was calculated for population subgroups and age-standardized (WSR) using the world standard population. Results. Overall, 36 744 unique cases were included in this study. In 2001-2010 the overall WSR in age 0-14 years was 132.6. The most frequent were leukemia (WSR 48.7), central nervous system neoplasms (WSR 23.0), and lymphoma (WSR 16.6). The overall ASR in age group 15-19 years was 152.3 with lymphoma ranking first (ASR 30.2). Incidence was higher in males than in females, and higher in South America than in Central America and the Caribbean. Compared with global data LAC incidence was lower overall, except for leukemia and lymphoma at age 0-14 years and the other and unspecified tumors at any age. Overall incidence at age 0-19 years increased by 1.0% per year (95% CI [0.6, 1.3]) over 1993-2012. The included registries covered 16% of population aged 0-14 years and 10% of population aged 15-19 years. Conclusions. The observed patterns provide a baseline to assess the status and evolution of childhood cancer occurrence in the region. Extended and sustained support of cancer registration is required to improve representativeness and timeliness of data for childhood cancer control in LAC.

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RESUMO Objetivo. Apresentar uma visão abrangente dos padrões geográficos (2001 a 2010) e das tendências temporais (1993 a 2012) da incidência de câncer em crianças e jovens de 0 a 19 anos na América Latina e no Caribe (ALC) e interpretar os resultados no contexto de padrões mundiais. Métodos. Foram descritas variações geográficas de 2001 a 2010 e tendências de incidência de 1993 a 2012 na população com menos de 20 anos da ALC usando informações comparáveis da base de dados do terceiro volume do estudo International Incidence of Childhood Cancer. Foram calculadas taxas de incidência específica por idade por milhão de pessoas-ano (ASR, na sigla em inglês) para subgrupos populacionais e taxas padronizadas por idade usando a população padrão mundial (WSR, na sigla em inglês). Resultados. No total, foram incluídos 36 744 casos únicos. No período de 2001 a 2010, a WSR para todos os tumores combinados na faixa etária de 0 a 14 anos foi de 132,6. Os diagnósticos mais frequentes foram leucemia (WSR de 48,7), neoplasias do sistema nervoso central (WSR de 23,0) e linfoma (WSR de 16,6). A ASR para todos os tumores combinados na faixa etária de 15 a 19 anos foi de 152,3, e a maior taxa foi a de linfoma (ASR de 30,2). A incidência foi maior no sexo masculino do que no sexo feminino e maior na América do Sul do que na América Central e no Caribe. De modo geral, em comparação com as estimativas mundiais, a incidência na ALC foi menor, exceto para leucemia e linfoma entre 0 e 14 anos e para outros tumores e tumores não especificados em qualquer idade. A taxa de incidência na faixa etária de 0 a 19 anos aumentou em 1,0% ao ano (IC de 95% [0,6, 1,3]) entre 1993 e 2012. Os registros incluídos cobriam 16% da população de 0 a 14 anos e 10% da população de 15 a 19 anos. Conclusões. Os padrões observados servem de referência para avaliar o status e a evolução da ocorrência de câncer infantil na região. É necessário garantir um apoio ampliado e consistente aos registros de câncer para aprimorar a representatividade e a disponibilidade das informações em tempo adequado para o controle do câncer infantil na ALC.

Implementation of a population-based cancer registry network in Mexico 2017-2020.

The growing cancer burden particularly among less developed countries requires local data to plan and evaluate cancer control measures. This article describes the development of a population-based cancer registry network (PBCRN) in Mexico that took place between 2017 and 2020 and present related data. The PBCRN, led by the National Cancer Institute (Incan), included nine registries representing 11.3% of the Mexican population. Definitions, coding, and operative processes were based on international standards. All cities were visited to set up local structure; personnel were hired by Incan and trained in basic cancer registration in Merida. A specific software was developed. Regular virtual meetings took place for data verification and quality control. Data collection included institutions of the public and private health system. Personnel included 34 registrars, nine local leaders, and 12 staff members at the Incan. A total of 13 517 cases were recorded between 2017-2020, 64% percent of them were among females. Breast cancer was the more frequent malignancy (23.3%), followed by digestive organs with (18.4%) and female genital cancers (13.5%). Childhood (0-14 years) and adolescents cancer represented 4.4% of the total new cancer cases. The network was suspended in 2020. The present effort lacked sustainability and data were only partial. However, the experience provides valuable insights to be considered for the renewed cancer registration efforts that are currently ongoing in Mexico.

Geographic variations in cancer incidence and mortality in the State of São Paulo, Brazil 2001-17.

BACKGROUND: Cancer is a leading cause of morbidity and mortality in Brazil and the burden is rising. To better inform tailored cancer actions, we compare incidence and mortality profiles according to small areas in the capital and northeast region of the State of São Paulo for the leading cancer types. METHODS: New cancer cases were obtained from cancer registries covering the department of Barretos (2003-2017) and the municipality of São Paulo (2001-2015). Cancer deaths for the same period were obtained from a Brazilian public government database. Age-standardized rates per 100,000 persons-years by cancer and sex are presented as thematic maps, by municipality for Barretos region, and by district for São Paulo. RESULTS: Prostate and breast cancer were the leading forms of cancer incidence in Barretos, with lung cancer leading in terms of cancer mortality in both regions. The highest incidence and mortality rates were seen in municipalities from the northeast of Barretos region in both sexes, while elevated incidence rates were mainly found in São Paulo districts with high and very high socioeconomic status (SES), with mortality rates more dispersed. Breast cancer incidence rates in São Paulo were 30 % higher than Barretos, notably in high and very high SES districts, while corresponding rates of cervical cancer conveyed the opposite profile, with elevated rates in low and medium SES districts. CONCLUSIONS: There is substantial diversity in the cancer profiles in the two regions, by cancer type and sex, with a clear relation between the cancer incidence and mortality patterns observed at the district level and corresponding SES in the capital.

Cancer Incidence in Merida, Mexico 2015-2018: First Report from the Population-based Cancer Registry.

BACKGROUND: Cancer registries are essential for monitoring cancer burden and patterns, and document changes in time for cancer control. Hereby, we present the first results of four years of the Merida population-based cancer registry in Mexico. METHODS: The registry collects data on all new cancers diagnosed since 2015 using both active and passive methods including a total of 104 information sources. Definitions and coding follow international standards. Using CanReg5 software, age-standardized incidence rates (ASR/100,000 person years) were computed by direct method using the world standard population. RESULTS: A total of 5684 new cancer cases were registered during 2015-2018, 2321 in males and 3363 in females corresponding to age-adjusted incidence rates (ASR per 100,000) of 128.5, and 153.1, respectively. Most frequent cancers among males were prostate cancer (ASR 29.8), lymphomas (ASR 10.9) and colorectal cancer (ASR 9.7) while among females it was breast cancer (ASR 49.3), cervical cancer (ASR 17.5) and corpus uteri (ASR 11.5). Childhood cancers (0-14 year) represented 2.9% of all cancers, with leukemias accounting for 52% of the new cases. Overall, 87.6% of new cases were microscopically verified. CONCLUSIONS: The data reported provide information on the cancer profile in Merida. Prostate and breast cancer are the main incident cancers. Cervical cancers present high rates among women, while lymphomas and liver cancer data merit further exploration. Efforts to support the Merida cancer registry as well as other registries in Mexico need to be pursued in order to have locally recorded data to support cancer control measures.

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.

Implementation of the population-based cancer registry in the city of Mérida, Mexico: process and early results / Implementación del registro de cáncer de base poblacional de la ciudad de Mérida en México: procesos y resultados preliminares

Abstract: Objective: To briefly describe the process of establishment and preliminary results of the Mérida Population-based Cancer Registry (Mérida-PBCR) Materials and methods: Mérida-PBCR started in 2016 as a research project in the IMSS, with a gradual increase in its information sources. It covers a population of 908 536 inhabitants. Data collection is active and passive, international standards are used; CanReg5 software enables data entry, storage and analysis. Results: Current data include 71.5% of sources. For the period 2015-2016, a total of 2 623 new cancer cases were registered, the majority of these (60.1%) among females. 81.5% of the cases had morphological verification. Prostate (17.4%), colorectal (8.5%) and stomach (8.1%) cancers were the most common among males, and breast (31.6%), cervix (12%) and corpus uteri (7.6%) cancers, the most common among females. Age-adjusted cancer incidence rates (per 100 000) for all sites combined were 114.9 among males and 145.1 among females. Conclusion: The implementation of the Mérida-PBCR has followed particular parameters, with important efforts to include new information sources. Although the data are still preliminary and must be interpreted with great caution, the main cancers follow a similar pattern to that of the national and regional estimates.

Resumen: Objetivo: Describir brevemente el proceso de implementación y resultados preliminares del Registro de Cáncer de Base Poblacional (RCBP) de Mérida. Material y métodos: RCBP-Mérida inició en 2016 como un proyecto de investigación del IMSS, con cobertura poblacional de 908 536 habitantes. El número de fuentes de información ha incrementado gradualmente. Se realizó colección de datos de forma pasiva y activa en software CanReg5 utilizando estándares internacionales. Resultados: Se han incluido al RCBP-Mérida 71.5% de las fuentes de información. Durante 2015-2016 se registraron 2 623 casos nuevos, la mayoría (60.1%) mujeres. El 81.5% de los casos tuvo verificación morfológica. En hombres, el cáncer de próstata (17.4%), colorrectal (8.5%) y estómago (8.1%) son los más comunes; en mujeres, mama (31.6%), cérvix (12.0%) y cuerpo-uterino (7.6%). Las tasas de incidencia ajustadas por edad (100 000 habitantes) para todos los sitios combinados son 114.9 hombres y 145.1 mujeres. Conclusión: La implementación del RCBP-Mérida ha seguido parámetros particulares, con importante esfuerzo para incluir fuentes de información. Aunque los datos son preliminares y se deben interpretar con precaución; los principales tipos de cáncer siguen un patrón similar a las estimaciones nacionales y regionales

Gallbladder and extrahepatic bile duct cancers in the Americas: Incidence and mortality patterns and trends.

Trends in gallbladder cancer incidence and mortality in populations across the Americas can provide insight into shifting epidemiologic patterns and the current and potential impact of preventative and curative programs. Estimates of gallbladder and extrahepatic bile duct cancer incidence and mortality for the year 2018 were extracted from International Agency for Research on Cancer (IARC) GLOBOCAN database for 185 countries. Recorded registry-based incidence from 13 countries was extracted from IARCs Cancer Incidence in Five Continents series and corresponding national deaths from the WHO mortality database. Among females, the highest estimated incidence for gallbladder and extrahepatic bile duct cancer in the Americas were found in Bolivia (21.0 per 100,000), Chile (11.7) and Peru (6.0). In the US, the highest incidence rates were observed among Hispanics (1.8). In the Chilean population, gallbladder cancer rates declined in both females and males between 1998 and 2012. Rates dropped slightly in Canada, Costa Rica, US Whites and Hispanics in Los Angeles. Gallbladder cancer mortality rates also decreased across the studied countries, although rising trends were observed in Colombia and Canada after 2010. Countries within Southern and Central America tended to have a higher proportion of unspecified biliary tract cancers. In public health terms, the decline in gallbladder cancer incidence and mortality rates is encouraging. However, the slight increase in mortality rates during recent years in Colombia and Canada warrant further attention. Higher proportions of unspecified biliary tract cancers (with correspondingly higher mortality rates) suggest more rigorous pathology procedures may be needed after surgery.

Improving Data Validity at Population-Based Cancer Registry through Trace-Back of Death Certificates: A Concrete Experience in Argentina.

The validity of data provided by population-based cancer registries (PBCRs) is a key aspect in cancer surveillance. Tracing back cases initially reported by death certificate or death-certificate-notified (DCN) cases, improves data quality and has an especially significant impact on survival estimates. The present study performed in the Mendoza PBCR describes the trace-back procedure of cancer cases notified by death certificate for selected cancers (liver, lung, and stomach cancers) with the aim of reducing the percentage of cases diagnosed by death certificate only (DCO). The study was performed in 2018 using cancers diagnosed between 2006 and 2012 in the framework of a survival project (SURVCAN-3). Among the 822 cases that have been traced back, only 32.1% had an identified source of information. Of these, 70.3% had medical records available for review. Of the reviewed medical records, 86.9% of cancer diagnoses were confirmed. The DCN and DCO cases were much higher among older age groups. With the trace-back, the overall percentage of DCO was reduced from 23.8% to 19.9%. We conclude that DCN trace-back could improve data quality by reducing DCO diagnoses, which directly impacts survival estimates. Trace-back should be performed routinely and in a timely manner.

Implementation of the population-based cancer registry in the city of Mérida, Mexico: process and early results.

OBJECTIVE: To briefly describe the process of establishment and preliminary results of the Mérida Population-based Cancer Registry (Mérida-PBCR). MATERIALS AND METHODS: Mérida-PBCR started in 2016 as a research project in the IMSS, with a gradual increase in its information sources. It covers a population of 908 536 inhabitants. Data collection is active and passive, international standards are used; CanReg5 software enables data entry, storage and analysis. RESULTS: Current data include 71.5% of sources. For the period 2015- 2016, a total of 2 623 new cancer cases were registered, the majority of these (60.1%) among females. 81.5% of the cases had morphological verification. Prostate (17.4%), colorectal (8.5%) and stomach (8.1%) cancers were the most common among males, and breast (31.6%), cervix (12%) and corpus uteri (7.6%) cancers, the most common among females. Ageadjusted cancer incidence rates (per 100 000) for all sites combined were 114.9 among males and 145.1 among females. CONCLUSIONS: The implementation of the Mérida-PBCR has followed particular parameters, with important efforts to include new information sources. Although the data are still preliminary and must be interpreted with great caution, the main cancers follow a similar pattern to that of the national and regional estimates.

OBJETIVO: Describir brevemente el proceso de implementación y resultados preliminares del Registro de Cáncer de Base Poblacional (RCBP) de Mérida. MATERIAL Y MÉTODOS: RCBP-Mérida inició en 2016 como un proyecto de investigación del IMSS, con cobertura poblacional de 908 536 habitantes. El número de fuentes de información ha incrementado gradualmente. Se realizó colección de datos de forma pasiva y activa en software CanReg5 utilizando estándares internacionales. RESULTADOS: Se han incluido al RCBP-Mérida 71.5% de las fuentes de información. Durante 2015-2016 se registraron 2 623 casos nuevos, la mayoría (60.1%) mujeres. El 81.5% de los casos tuvo verificación morfológica. En hombres, el cáncer de próstata (17.4%), colorrectal (8.5%) y estómago (8.1%) son los más comunes; en mujeres, mama (31.6%), cérvix (12.0%) y cuerpo-uterino (7.6%). Las tasas de incidencia ajustadas por edad (100 000 habitantes) para todos los sitios combinados son 114.9 hombres y 145.1 mujeres. CONCLUSIONES: La implementación del RCBP-Mérida ha seguido parámetros particulares, con importante esfuerzo para incluir fuentes de información. Aunque los datos son preliminares y se deben interpretar con precaución; los principales tipos de cáncer siguen un patrón similar a las estimaciones nacionales y regionales.

The descriptive epidemiology of lung cancer and tobacco control: a global overview 2018.

OBJECTIVE: To present the most recent national estimates of lung cancer burden globally in 185 countries and tobacco smoking prevalence (%) by sex. MATERIALS AND METHODS: Estimates of lung cancer incidence and mortality for 2018 were extracted from the Globocan database; observed incidence, from the last volume of Cancer Incidence in Five Continents, and tobacco prevalence, from the World Health Observatory/WHO database. RESULTS: In 2018, over two million new lung cancer cases and 1.7 million deaths were estimated to occur worldwide, representing 14% of the new cancer cases and 20% of the cancer deaths. Incidence rates showed marked variation between countries. Stable or decreasing incidence rates were predominant among males, while among females increasing rates were common. CONCLUSIONS: The continuing rise in lung cancer among women reinforces the need for strengthening implementation of the preventive actions committed to by governments in the WHO Framework Convention for Tobacco Control.

OBJETIVO: Presentar las estimaciones nacionales más recientes de la carga del cáncer de pulmón a nivel mundial en 185 países y de prevalencia de tabaquismo (%) por sexo. MATERIAL Y MÉTODOS: Las estimaciones de incidencia y mortalidad por cáncer de pulmón para el año 2018 se extrajeron de la base de datos Globocan, la incidencia observada del último volumen de Incidencia de Cáncer en Cinco Continentes y la prevalencia de tabaquismo del Observatorio Mundial de la Salud/OMS. RESULTADOS: En 2018, se estimaron más de dos millones de nuevos casos de cáncer de pulmón y 1.7 millones de muertes a nivel mundial, que representan 14% de los casos nuevos y 20% de las muertes por cáncer. Las tasas de incidencia mostraron grandes variaciones entre países. En hombres, se observaron principalmente tasas de incidencia estables o decrecientes, mientras que en mujeres se observó con frecuencia un incremento. CONCLUSIONES: Los resultados en mujeres refuerzan la necesidad de fortalecer las acciones preventivas de los gobiernos en el Convenio Marco de la OMS para el Control del Tabaco.

The descriptive epidemiology of lung cancer and tobacco control: a global overview 2018 / Epidemiología descriptiva del cáncer de pulmón y control de tabaco en 2018: una visión global

Abstract: Objective: To present the most recent national estimates of lung cancer burden globally in 185 countries and tobacco smoking prevalence (%) by sex. Materials and methods: Estimates of lung cancer incidence and mortality for 2018 were extracted from the Globocan database; observed incidence, from the last volume of Cancer Incidence in Five Continents, and tobacco prevalence, from the World Health Observatory/WHO database. Results: In 2018, over two million new lung cancer cases and 1.7 million deaths were estimated to occur worldwide, representing 14% of the new cancer cases and 20% of the cancer deaths. Incidence rates showed marked variation between countries. Stable or decreasing incidence rates were predominant among males, while among females increasing rates were common. Conclusion: The continuing rise in lung cancer among women reinforces the need for strengthening implementation of the preventive actions committed to by governments in the WHO Framework Convention for Tobacco Control.

Resumen: Objetivo: Presentar las estimaciones nacionales más recientes de la carga del cáncer de pulmón a nivel mundial en 185 países y de prevalencia de tabaquismo (%) por sexo. Material y métodos: Las estimaciones de incidencia y mortalidad por cáncer de pulmón para el año 2018 se extrajeron de la base de datos Globocan, la incidencia observada del último volumen de Incidencia de Cáncer en Cinco Continentes y la prevalencia de tabaquismo del Observatorio Mundial de la Salud/OMS. Resultados: En 2018, se estimaron más de dos millones de nuevos casos de cáncer de pulmón y 1.7 millones de muertes a nivel mundial, que representan 14% de los casos nuevos y 20% de las muertes por cáncer. Las tasas de incidencia mostraron grandes variaciones entre países. En hombres, se observaron principalmente tasas de incidencia estables o decrecientes, mientras que en mujeres se observó con frecuencia un incremento. Conclusión: Los resultados en mujeres refuerzan la necesidad de fortalecer las acciones preventivas de los gobiernos en el Convenio Marco de la OMS para el Control del Tabaco.

Advancing Reliable Data for Cancer Control in the Central America Four Region.

The Central America Four (CA-4) region, comprising Guatemala, Honduras, El Salvador, and Nicaragua, is the largest low- and middle-income country region in the Western Hemisphere, with over 36 million inhabitants. The CA-4 nations share a common geography, history, language, and development indices, and unified with open borders in 2006. The growing CA-4 cancer burden among the noncommunicable diseases is expected to increase 73% by 2030, which argues for a regional approach to cancer control. This has driven efforts to establish population-based cancer registries as a central component of the cancer control plans. The involvement of international and academic partners in an array of initiatives to improve cancer information and control in the CA-4 has accelerated over the past several years. Existing data underscore that the infectious cancers (cervical, stomach, and liver) are a particular burden. All four countries have committed to establishing regional population-based cancer registries and have advanced significantly in pediatric cancer registration. The challenges common to each nation include the lack of national cancer control plans and departments, competing health priorities, lack of trained personnel, and sustainability strategies. General recommendations to address these challenges are outlined. The ongoing regional, international, and academic cooperation has proven helpful and is expected to continue to be a powerful instrument to contribute to the design and implementation of long-term national cancer control plans.

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.

Cancer patterns, trends, and transitions in Peru: a regional perspective.

Peru, like several other South American countries, is experiencing remarkable population growth, ageing, and urbanisation, which has given rise to profound changes in its epidemiological profile. Prostate and breast cancer are the most frequent cancers in men and women, respectively, in Lima and Arequipa, the two areas with population-based cancer registries. However, infection-associated cancers (cervix and stomach) are also common, and rank highest in the national cancer mortality profile. Although a foundation of surveillance informs cancer-control initiatives in Peru, improvements in the vital statistics system, and the quality and use of incidence data for the planning and assessment of cancer prevention and control actions, are needed. Existing population-based cancer registries in Lima and Arequipa, and linkages to the established national mandatory cancer reporting system, are crucial for the collection of high-quality data on national cancer incidence. The delivery of effective cancer prevention and control measures requires sustained investment in the collection of high-quality data capable of informing policies and driving research programmes.

Cancer registration for cancer control in Latin America: a status and progress report / Registros de cáncer para el control de la enfermedad en América Latina: informe de situación y progreso

Cancer incidence by type has been included as a core indicator in the World Health Organization (WHO) Global Monitoring Framework for the Prevention and Control of Noncommunicable Diseases. The Global Initiative for Cancer Registry Development (GICR), coordinated by the International Agency for Research on Cancer (IARC), supports low- and middle-income countries to reduce disparities in cancer information for cancer control by increasing the coverage and quality of cancer registration. A baseline assessment has been performed at the IARC Regional Hub for Latin America using secondary and public information sources. Countries have been categorized according to the following criteria for population-based cancer registries (PBCRs): 1) “has no established PBCR (but some registration activity),” 2) “has established PBCR(s) but none of high-quality,” and 3)“has established, high-quality PBCR(s) (regional or national).” Currently, in LatinAmerica, most countries have cancer control plans in place; PBCRs cover approximately20% of the region’s population, though only 7% are deemed as having high-quality information. No information is available on the extent of use of the information generated byPBCRs for cancer control purposes. Though there are important advances in cancer registration in the region, there is still much to be done. This report also outlines key elementsfor improving cancer surveillance in the region, including 1) involvement of local stakeholders and experts, 2) integration of cancer registries into existing surveillance systems(accounting for the complexities and particularities of cancer surveillance), 3) improvementin data availability and quality, 4) enhanced communication and dissemination, and5)better linkages between cancer registries and cancer planning and cancer research.

La incidencia del cáncer por tipo se ha incluido como indicador central del Marco mundial de vigilancia integral para la prevención y el control de las enfermedades no transmisibles de la Organización Mundial de la Salud (OMS). La Iniciativa Mundial para el Desarrollo de Registros de Cáncer (GICR por su sigla en inglés), bajo la coordinación del Centro Internacional de Investigaciones sobre el Cáncer (CIIC), brinda apoyo a los países de ingresos bajos y medianos para reducir las disparidades de información sobre el cáncer para el control de esta enfermedad mediante el aumento de la cobertura y la calidad de los registros de cáncer. El Núcleo Regional del CIIC para América Latina (Buenos Aires) realizó una evaluación de valores de referencia y comparación usando fuentes secundarias y de información pública. Los países se han clasificado según los siguientes criterios relativos a los registros de cáncer basados en la población: 1) “no tiene ningún registro”; 2) “ha establecido uno o varios registros, pero ninguno es de alta calidad”; y 3) “tiene un registro de alta calidad (regional o nacional)”. En América Latina, la mayor parte de los países ya han implantado planes de control del cáncer; los registros cubren aproximadamente 20% de la población de la región, aunque se considera que solo 7% tiene información de alta calidad. No hay ninguna información disponible sobre el grado de utilización de la información generada por estos registros para fines de control del cáncer. Si bien se observan adelantos importantes en cuanto a los registros de cáncer en la región, hay todavía mucho por hacer. En este informe también se describen los elementos principales para mejorar la vigilancia del cáncer en la región como: 1) la participación de interesados directos y expertos locales; 2) la integración de los registros de cáncer a los sistemas de vigilancia existentes (para tomar en cuenta las complejidades y particularidades de la vigilancia del cáncer); 3) el mejoramiento de la disponibilidad y la calidad de los datos; 4) el mejoramiento de la comunicación y la difusión; y 5) mejores vínculos entre los registros de cáncer y la planificación e investigación en materia de cáncer.

Cancers of the brain and CNS: global patterns and trends in incidence.

Background: Cancers of the brain and CNS constitute a group of rare and heterogeneous tumors. Increasing incidence in Western populations has been linked to improvements in diagnostic technology, although interpretation is hampered by changes in diagnosis and reporting. The present study examines geographic and temporal variations in incidence rates of brain and CNS cancers worldwide. Methods: Data from successive volumes of Cancer Incidence in Five Continents were used, including 96 registries in 39 countries. We used Joinpoint regression to estimate the average annual percentage change and its 95% CI. Results: Globally, a large variability in the magnitude of the diagnosis of new cases of brain and CNS cancer was found, with a 5-fold difference between the highest rates (mainly in Europe) and the lowest (mainly in Asia). Increasing rates of brain and CNS cancer were found in South America, namely in Ecuador, Brazil, and Colombia; in eastern Europe (Czech Republic and Russia), in southern Europe (Slovenia), and in the 3 Baltic countries. Trends were similar between sexes, although decreasing trends in men and women were seen in Japan and New Zealand. Conclusions: Important regional variations in brain and CNS cancers exist, and given an increasing burden and risk worldwide, there is a need for further etiological research that focuses on the elucidation of environmental risk. The trends are sufficiently complex and diffuse, however, to warrant a cautious approach to interpretation.

Cancer registration for cancer control in Latin America: a status and progress report / Registros de cáncer para el control de la enfermedad en América Latina: informe de situación y progreso

ABSTRACT Cancer incidence by type has been included as a core indicator in the World Health Organization (WHO) Global Monitoring Framework for the Prevention and Control of Noncommunicable Diseases. The Global Initiative for Cancer Registry Development (GICR), coordinated by the International Agency for Research on Cancer (IARC), supports low- and middle-income countries to reduce disparities in cancer information for cancer control by increasing the coverage and quality of cancer registration. A baseline assessment has been performed at the IARC Regional Hub for Latin America using secondary and public information sources. Countries have been categorized according to the following criteria for population-based cancer registries (PBCRs): 1) "has no established PBCR (but some registration activity)," 2) "has established PBCR(s) but none of high-quality," and 3) "has established, high-quality PBCR(s) (regional or national)." Currently, in Latin America, most countries have cancer control plans in place; PBCRs cover approximately 20% of the region's population, though only 7% are deemed as having high-quality information. No information is available on the extent of use of the information generated by PBCRs for cancer control purposes. Though there are important advances in cancer registration in the region, there is still much to be done. This report also outlines key elements for improving cancer surveillance in the region, including 1) involvement of local stakeholders and experts, 2) integration of cancer registries into existing surveillance systems (accounting for the complexities and particularities of cancer surveillance), 3) improvement in data availability and quality, 4) enhanced communication and dissemination, and 5) better linkages between cancer registries and cancer planning and cancer research.(AU)

RESUMEN La incidencia del cáncer por tipo se ha incluido como indicador central del Marco mundial de vigilancia integral para la prevención y el control de las enfermedades no transmisibles de la Organización Mundial de la Salud (OMS). La Iniciativa Mundial para el Desarrollo de Registros de Cáncer (GICR por su sigla en inglés), bajo la coordinación del Centro Internacional de Investigaciones sobre el Cáncer (CIIC), brinda apoyo a los países de ingresos bajos y medianos para reducir las disparidades de información sobre el cáncer para el control de esta enfermedad mediante el aumento de la cobertura y la calidad de los registros de cáncer. El Núcleo Regional del CIIC para América Latina (Buenos Aires) realizó una evaluación de valores de referencia y comparación usando fuentes secundarias y de información pública. Los países se han clasificado según los siguientes criterios relativos a los registros de cáncer basados en la población: 1) "no tiene ningún registro"; 2) "ha establecido uno o varios registros, pero ninguno es de alta calidad"; y 3) "tiene un registro de alta calidad (regional o nacional)". En América Latina, la mayor parte de los países ya han implantado planes de control del cáncer; los registros cubren aproximadamente 20% de la población de la región, aunque se considera que solo 7% tiene información de alta calidad. No hay ninguna información disponible sobre el grado de utilización de la información generada por estos registros para fines de control del cáncer. Si bien se observan adelantos importantes en cuanto a los registros de cáncer en la región, hay todavía mucho por hacer. En este informe también se describen los elementos principales para mejorar la vigilancia del cáncer en la región como: 1) la participación de interesados directos y expertos locales; 2) la integración de los registros de cáncer a los sistemas de vigilancia existentes (para tomar en cuenta las complejidades y particularidades de la vigilancia del cáncer); 3) el mejoramiento de la disponibilidad y la calidad de los datos; 4) el mejoramiento de la comunicación y la difusión; y 5) mejores vínculos entre los registros de cáncer y la planificación e investigación en materia de cáncer.(AU)