Epidemiology of Eye Cancer in Cali, Colombia: A 55-Year Study.

PURPOSE: To describe the epidemiology, incidence, mortality and survival of ocular cancer in Cali between 1962 and 2019. METHODS: Ecological population-based study analyzing data of incidence, mortality, and 5-years survival of malignant ocular tumors from the Populational Cancer Registry of Cali between 1962 and 2019. RESULTS: Between 1962 and 2019, 586 ocular tumors were found, 50.5% occurred in females, the mean age at diagnosis was 45 years (standard deviation = 25), 70.3% of ocular malignancies occurred in >14 years. The average annual incidence rate was 7.8 per million for male and 6.9 per million for females. Retinoblastoma (21%), squamous cell carcinoma (20%), melanoma (16%) and lymphoma (8%) were the most common neoplasm. In those <15 years, the most frequent malignant tumors were retinoblastomas (85.7%), followed by non-specified malignant neoplasm (NOS, 7.9%), and rhabdomyosarcoma (3.6%). In those >14 years, there were NOS (30%), followed by squamous cell carcinomas (28%), melanomas (23%), and lymphomas (9.7%). Conjunctiva (38.2%), retina (21%) and orbit (10%) constituted the majority of anatomical sites of ocular tumors. The survival rate was about 83.2% and mortality did not show a decreasing trend over time (p > .05). CONCLUSIONS: The incidence of ocular cancer in Cali has a slightly increasing trend, with stable behavior in the last decades. Squamous cell carcinoma, retinoblastoma, melanoma and lymphoma are the most frequent ocular cancers, with being retinoblastoma more frequent than melanoma. In general, ocular cancer had good survival rates in Cali.

Trends in long-term cancer survival in Cali, Colombia: 1998-2017.

Background: Population-based cancer survival is an indicator of the effectiveness of cancer services that reflects the survival of all cancer patients in the population, regardless of socioeconomic status and disease characteristics. Aim: Provision of an up-to-date survival estimate of patients recorded within Cali Population Cancer Registry (RPCC) in 1998-2017. As a second objective, results will be compared with those reported by the CONCORD study for cancers prioritized by the current Ten-Year Cancer Control Plan of Colombia, 2012-2021. Methods: Adult cancer cases (aged 15 to 99 years) for nine cancer types diagnosed between 1998 and 2017, with follow-up to 2018, were obtained from the RPCC. The 5-year age-standardized net survival estimates (NS) were estimated using the Pohar-Perme. The results for the period 1995- 2014 were compared with those reported by the CONCORD study for the following locations: stomach (C16), breast (C50), cervix (C53), prostate (C61), and lung (C33-34). Results: Five-year survival estimates for breast and prostate cancers improved ten percentage points through 2007 (70.8 to 81.1 for breast and 79.9 to 90.2 for prostate) and remained stable during 2008-2017. For cervical cancer, survival estimates has remained stable for the last two decades at 53%. For stomach cancer and lung cancer, five-year NS was lower than 25% over the study period. For colorectal cancer, survival estimates increased from 37.9% in 1998-2002 to 54.8% in 2013-2017. Compared to previous 5-year survival estimates of cases diagnosed in 2010-2014, the estimates in this study are significantly higher than those obtained by CONCORD. Survival estimates of patients diagnosed in 1995-2009 showed no difference to CONCORD study. Conclusions: Periodic update of vital status and date of last contact reduces bias in survival estimates in population-based cancer registries with passive follow-up.

Antecedentes: La supervivencia del cáncer es un indicador de la eficacia de los servicios oncológicos que refleja la supervivencia de todos los pacientes con cáncer de la población, independientemente del nivel socioeconómico y las características de la enfermedad. Objetivo: Realizar una estimación actualizada de la supervivencia de los pacientes registrados en el Registro Poblacional de Cáncer de Cali durante 1998-2017. Como segundo objetivo, los resultados se compararán con los reportados por el estudio CONCORD para los cánceres priorizados por el actual Plan Decenal de Control del Cáncer de Colombia, 2012-2021. Métodos: Los casos de cáncer en adultos (15 a 99 años) para nueve tipos de cáncer diagnosticados entre 1998 y 2017, con seguimiento hasta 2018, se obtuvieron del RPCC. Las estimaciones de supervivencia neta (NS) estandarizada por edad a 5 años se estimaron utilizando el método de Pohar-Perme. Los resultados del periodo 1995-2014 se compararon con los obtenidas por el estudio CONCORD para las siguientes localizaciones: estómago (C16), mama (C50), cuello uterino (C53), próstata (C61) y pulmón (C33-34). Resultados: La SN-5a para los cánceres de mama y próstata mejoró diez puntos porcentuales hasta 2007 (SN=70.8 a 81.1 para mama y NS=79.9 a 90.2 para próstata) y se mantuvo estable durante 2008-2017. Para el cáncer de cuello uterino fue 53% y permaneció estable durante dos décadas. Para el cáncer de estómago y el cáncer de pulmón, la SN-5años fue inferior al 25%. Para cáncer colorrectal las estimaciones de supervivencia aumentaron de 37.9% en 1998-2002 a 54.8% en 2013-2017. En comparación con estimaciones anteriores de supervivencia a 5 años de casos diagnosticados en 2010-2014, las estimaciones de este estudio son significativamente más altas que las obtenidas por CONCORD-3. Para la década 1995-2009 no hubo diferencia. Conclusión: La actualización periódica del estado vital y la fecha de último contacto reduce el sesgo en las estimaciones de supervivencia en los registros de cáncer de base poblacional que hacen seguimiento pasivo.

Survival in stomach cancer: analysis of a national cancer information system and a population-based cancer registry in Colombia

Background: Stomach cancer is among the most frequent, is a leading cause of mortality in low- and middle-income countries. Assessing its survival is important to guide evidence-based health policies. Aims: To estimate stomach cancer survival in Colombia (2014-2019) with data from the National Cancer Information System (NCIS) and in Cali with data from the Cali Population Cancer Registry (RPCC) (1998-2017). Methods: NCIS estimated the overall 3-year net survival for 8,549 people, while RPCC estimated 5-year net survival for 6,776 people. Results: The 3-year net survival was 36.8% (95% CI: 35.5-38.1). Net survival was higher in people with special insurance (61.7%; 95% CI: 44.8-74.8) or third payer (40.5%; 95% CI: 38.7-42.3) than state insurance (30.7%; 95% CI: 28.7-32.8). It was also higher in women and people diagnosed at early stages. Multivariable analysis showed consistency with survival estimations with a higher risk of death in men, people with state insurance, and diagnosed at advanced stages. In Cali, the 5-year net survival remained stable in men during the last 20 years. In women the 5-year net survival in women increased 8.60 percentage points, equivalent to a 50% increase compared to the 1998-2002 period. For 2013-17, it was 19.1% (95%CI: 16.2-22.2) in men, and 24.8% (95% CI: 20.4-29.3) in women. Conclusions: Population survival estimates from the RPCC were lower than those observed in the NCIS. The differences in their methods and scope can explain variability. Nevertheless, our findings could be complementary to improve cancer control planning in the country.

Antecedentes: El cáncer de estómago se encuentra entre los más frecuentes y es una de las principales causas de mortalidad en los países de ingresos bajos y medianos. Evaluar su supervivencia es importante para orientar las políticas de salud basadas en la evidencia. Objetivos: Estimar la supervivencia del cáncer de estómago en Colombia (2014-2019) con datos del Sistema Nacional de Información del Cáncer (NCIS) y en Cali con datos del Registro Poblacional de Cáncer de Cali (RPCC) (1998-2017). Métodos: El NCIS estimó la supervivencia neta a tres años para 8,549 personas y el RPCC la calculó a 5 años para 6,776 personas registradas en sus bases de datos. Resultados: La supervivencia neta a tres años en Colombia fue del 36.8% (IC 95%: 35.5-38.1). La supervivencia neta fue mayor en personas con seguro especial (61.7%; IC 95%: 44.8-74.8) o tercer pagador (40.5%; IC 95%: 38.7-42.3) que el seguro estatal (30.7%; IC 95%: 28.7-32.8). También fue mayor en mujeres y personas diagnosticadas en etapas tempranas. El análisis multivariable mostró consistencia con la estimación de supervivencia con mayor riesgo de muerte en hombres, personas con seguro estatal y diagnosticados en estadios avanzados. En Cali, la supervivencia neta a 5 años se mantuvo estable en los hombres durante los últimos 20 años. En las mujeres aumentó 8.60 puntos porcentuales, equivalente a un aumento del 50% en comparación con el período 1998-2002. Para el período 2013-17 fue 19.1% (IC 95%: 16.2-22.2) en los hombres y 24.8% (IC 95%: 20.4-29.3) en las mujeres. Conclusiones: Las estimaciones de supervivencia del RPCC fueron más bajas que las obtenidas por el NCIS. Las diferencias en sus métodos y alcance pueden explicar la variabilidad. Sin embargo, nuestros hallazgos pueden ser complementarios para mejorar la planificación del control del cáncer en el país..

Cancer epidemiology in Cali, 60 years of experience.

Background: The population-based Cancer Registry of Cali Colombia operates continuously since 1962, disseminating incidence information in the XI volumes of Cancer Incidence in Five Continents. Aim: To describe the incidence and mortality rates for the period 2011-2020 and the changes in the trend of incidence rates (1962-2017) and mortality rates from cancer (1986-2020). Methods: The Joinpoint model and the annual percentage change (APC) were used as summary measures of the changes in the trends of incidence rates (ASR-I) and mortality (ASR-M) standardized by age with the direct method. Results: Trough 1988-2017 the ASR-I for all locations increased 0.4% annually (95% CI: 0.2, 0.6) in men and decreased annually 0.2% (95% CI: -0.3; -0.1) in women. The ASR-Is of cancers related to opportunity screening activities (prostate and breast) increased until the early 21st century and then decreased. The ASR-I of cancers related to infectious agents continue to decrease (cervix, vulva, and stomach). There is evidence of control of cancer related to tobacco consumption (lung, oral cavity, bladder). In both sexes, the ASR-I of thyroid, colorectal and lymphoma cancers increased and those of ovarian cancer decreased. Between 1984-2020 the ASR-M for all locations decreased annually 0.7% (95% CI: -0.9, -0.5) in men and 1.1% (95% CI: -1.3, -0.9) in women. For both sexes, ASR-M decreased for cancers of the esophagus, stomach, lung, bladder, lymphomas, and leukemias; and increased in colorectal cancer. The ASR-M for cervical and prostate cancer decreased annually by 3.5% (95% CI: -3.9, -3.2) and 0.1% (95% CI: -0.5, -0.3), respectively. Comment: This information allows the construction of some indicators to monitor the City Cancer Challenge initiative and the current 10-year plan for cancer control in Colombia, 2011-2021.

Antecedentes: El registro poblacional de Cáncer de Cali-Colombia, opera desde 1962 divulgando continuamente la información de incidencia en los XI volúmenes de Cancer Incidence in Five Continents. Objetivo: Describir las tasas de incidencia y mortalidad del periodo 2011-2020 y los cambios en la tendencia de las tasas de incidencia (1962-2017) y mortalidad por cáncer (1986-2020). Métodos: Se utilizó el modelo de Joinpoint y el cambio porcentual anual (APC) como medidas de resumen de los cambios en las tendencias de las tasas de incidencia (ASR-I) y mortalidad (ASR-M) estandarizadas por edad con el método directo. Resultados: Durante el periodo 1988-2017 las ASR-I para todas las localizaciones aumentaron anualmente 0.4% (IC 95%: 0.2; 0.6) en los hombres y disminuyeron anualmente 0.2% (IC 95%: -0.3; -0.1) en las mujeres. Las ASR-I de los cánceres relacionados con actividades de tamización de oportunidad (próstata y mama) aumentaron hasta principios del siglo XXI y luego descendieron. Las ASR-I de los canceres relacionados con agentes infecciosos continúan disminuyendo (cérvix, vulva y estómago). Hay evidencias de control de los cánceres relacionados al consumo de tabaco (pulmón, cavidad oral, vejiga). En ambos sexos aumentaron las ASR-I de los cánceres de tiroides, colorrectal y linfomas y disminuyeron las de cáncer de ovario. Entre 1984-2020 las ASR-M para todas las localizaciones disminuyeron anualmente 0.7% (IC 95%: -0.9; -0.5) en los hombres y 1.1% (IC 95%: -1.3; -0.9) en las mujeres. Para ambos sexos, disminuyeron las ASR-M para los cánceres de esófago, estómago, pulmón, vejiga, linfomas y leucemias; y aumentaron en cáncer colorrectal. Las ASR-M por cáncer de cérvix y próstata disminuyeron anualmente 3.5% (IC 95%: -3.9; -3.2) y 0.1% (IC 95%: -0.5; -0.3), respectivamente. Comentario: Esta información permite construir algunos indicadores para monitorear la iniciativa City Cancer Challenge y el actual Plan Decenal para el Control del Cáncer en Colombia, 2011-2021.

Complex Congenital Heart Disease and Neurodevelopment. A Case Study of Fraternal Twins.

Congenital heart defects have been associated with adverse neurodevelopmental outcomes due to factors that result in a hypoxic-ischemic cerebral cumulative effect. We present a pair of fraternal twins: the first twin was healthy, and the second was born with a complex congenital heart defect (CCHD). They were followed for growth and neurodevelopmental outcomes to determine the comparative effect of exposure to a CCHD. Results show that exposure to a CCHD could be related to a persistent motor deficiency with hypotonia and concurrent height for age delay. CCHD requires a comprehensive neurodevelopmental approach; the pathophysiology and the surrounding stimuli are influential.

Neurodevelopmental outcome of infants without central nervous system anomalies born to symptomatic RT-PCR ZIKV positive women.

An epidemic of Zika virus (ZIKV) infection began in Colombia in October 2015. Previous studies have identified a cause-effect relationship between fetal exposure to the ZIKV and the development of microcephaly and other central nervous system (CNS) anomalies with variable degrees of neurodevelopmental delay. Less is known about the neurodevelopmental outcome of infants without CNS anomalies born to symptomatic ZIKV RT-PCR-positive women. We aimed to compare the neurodevelopmental outcome of these infants to a control group of infants without CNS anomalies born to asymptomatic ZIKV RT-PCR negative women who did not seroconvert during pregnancy. Participating infants were categorized according to ZIKV maternal exposure. Women with symptomatology suggestive of ZIKV infection and a positive RT-PCR for ZIKV were categorized as ZIKV-exposed. Maternal controls (ZIKV unexposed) from the same geographic area were subsequently captured during the tail end of the epidemic through a partner project, the ZIKAlliance, whose aim was to determine the prevalence of ZIKV in pregnant women. Infant survivors from these two groups of pregnant women had a neurodevelopmental evaluation at 12, 18, and 24 months corrected age (CA). The ZIKV-exposed women were found to be older, had less subsidized health care, had a higher percentage of women in middle-class socioeconomic strata, had higher technical and university education, were less likely to be living with a partner, and had higher rates of pregnancy comorbidity and premature births than ZIKV unexposed women. Compared to infants born to ZIKV unexposed women (unexposed), infants born to ZIKV exposed women (exposed) were of lower gestational age and required more speech and occupational therapy services. No differences between groups were observed in the proportion of cut-off scores <70 on the Bayley-III Scale at 12, 18, and 24 months for motor, language, and cognitive domains. When a cut-off of <85 was used, a higher percentage of motor and cognitive impairment was observed in unexposed infants at 12 and 24 months CA, respectively. Median and IQR score on the Bayley-III scale showed higher scores in favor of exposed infants for motor development at 12 and 18 months CA, language at 12 months, and cognitive domain at 12, 18, and 24 months. The adjusted median and IQR compound score of the difference between exposed and unexposed was higher in favor of exposed infants at 12 to 24 months CA for motor (3.8 [95% CI 1.0 to 6.7]) and cognitive domains (10.6 [95% CI 7.3 to 13.9]). We observed no differences in the language domain (1.9 [95% CI -1.2 to 5.0]). We conclude that infants with no evidence of microcephaly or other CNS anomalies born to ZIKV-exposed women had normal neurodevelopment up to 24 months of CA, supporting an all-or-nothing effect with maternal ZIKV exposure. Long-term follow-up to evaluate school performance is required. Clinical Trial Registration: www.clinicaltrials.gov, NCT02943304.

Trends in long-term cancer survival in Cali, Colombia: 1998-2017 / Tendencias en la supervivencia al cáncer a largo plazo en Cali, Colombia: 1998-2017

Abstract Background: Population-based cancer survival is an indicator of the effectiveness of cancer services that reflects the survival of all cancer patients in the population, regardless of socioeconomic status and disease characteristics. Aim: Provision of an up-to-date survival estimate of patients recorded within Cali Population Cancer Registry (RPCC) in 1998-2017. As a second objective, results will be compared with those reported by the CONCORD study for cancers prioritized by the current Ten-Year Cancer Control Plan of Colombia, 2012-2021. Methods: Adult cancer cases (aged 15 to 99 years) for nine cancer types diagnosed between 1998 and 2017, with follow-up to 2018, were obtained from the RPCC. The 5-year age-standardized net survival estimates (NS) were estimated using the Pohar-Perme. The results for the period 1995- 2014 were compared with those reported by the CONCORD study for the following locations: stomach (C16), breast (C50), cervix (C53), prostate (C61), and lung (C33-34). Results: Five-year survival estimates for breast and prostate cancers improved ten percentage points through 2007 (70.8 to 81.1 for breast and 79.9 to 90.2 for prostate) and remained stable during 2008-2017. For cervical cancer, survival estimates has remained stable for the last two decades at 53%. For stomach cancer and lung cancer, five-year NS was lower than 25% over the study period. For colorectal cancer, survival estimates increased from 37.9% in 1998-2002 to 54.8% in 2013-2017. Compared to previous 5-year survival estimates of cases diagnosed in 2010-2014, the estimates in this study are significantly higher than those obtained by CONCORD. Survival estimates of patients diagnosed in 1995-2009 showed no difference to CONCORD study. Conclusions: Periodic update of vital status and date of last contact reduces bias in survival estimates in population-based cancer registries with passive follow-up.

Resumen Antecedentes: La supervivencia del cáncer es un indicador de la eficacia de los servicios oncológicos que refleja la supervivencia de todos los pacientes con cáncer de la población, independientemente del nivel socioeconómico y las características de la enfermedad. Objetivo: Realizar una estimación actualizada de la supervivencia de los pacientes registrados en el Registro Poblacional de Cáncer de Cali durante 1998-2017. Como segundo objetivo, los resultados se compararán con los reportados por el estudio CONCORD para los cánceres priorizados por el actual Plan Decenal de Control del Cáncer de Colombia, 2012-2021. Métodos: Los casos de cáncer en adultos (15 a 99 años) para nueve tipos de cáncer diagnosticados entre 1998 y 2017, con seguimiento hasta 2018, se obtuvieron del RPCC. Las estimaciones de supervivencia neta (NS) estandarizada por edad a 5 años se estimaron utilizando el método de Pohar-Perme. Los resultados del periodo 1995-2014 se compararon con los obtenidas por el estudio CONCORD para las siguientes localizaciones: estómago (C16), mama (C50), cuello uterino (C53), próstata (C61) y pulmón (C33-34). Resultados: La SN-5a para los cánceres de mama y próstata mejoró diez puntos porcentuales hasta 2007 (SN=70.8 a 81.1 para mama y NS=79.9 a 90.2 para próstata) y se mantuvo estable durante 2008-2017. Para el cáncer de cuello uterino fue 53% y permaneció estable durante dos décadas. Para el cáncer de estómago y el cáncer de pulmón, la SN-5años fue inferior al 25%. Para cáncer colorrectal las estimaciones de supervivencia aumentaron de 37.9% en 1998-2002 a 54.8% en 2013-2017. En comparación con estimaciones anteriores de supervivencia a 5 años de casos diagnosticados en 2010-2014, las estimaciones de este estudio son significativamente más altas que las obtenidas por CONCORD-3. Para la década 1995-2009 no hubo diferencia. Conclusión: La actualización periódica del estado vital y la fecha de último contacto reduce el sesgo en las estimaciones de supervivencia en los registros de cáncer de base poblacional que hacen seguimiento pasivo.

Head and neck cancer in Cali, Colombia: Population-based study.

INTRODUCTION: Head and neck cancer (HNC) is the seventh most common type of cancer in the world. In Latin America, data on HCN are limited by the scarcity of population-based cancer registries. OBJECTIVE: To describe survival and changes in the time trends of incidence and mortality rates of HCN with data from the Cali Cancer Population Registry (Colombia) during 1962-2018. METHOD: Males and females of any age residing in Cali were included. The trends in incidence rates (1962-2016) and mortality (1984-2018) were analysed by calculating the mean annual percentage change (APC). Five-year net survival was estimated for the four 5-year periods of 1996-2015 using the Pohar-Perme method. RESULTS: During 1962-2015, 5,110 new cases of HNC were recorded: 1,506 in the larynx, 1,377 in the oral cavity, 487 in the nose and paranasal sinuses, 643 in the oropharynx, 603 in the salivary glands and 360 in Naso-Hypopharynx region. The incidence rates of HNC decreased significantly at all subsites, except in those associated with the human papillomavirus. Between 1984 and 2018, there were 1,941 deaths attributed to HNC, and the mortality rate decreased significantly. The 5-year age-standardized net survival was 43.2% in 1996-2000, remained stable during the following decade, and for 2011-2015 it was 50.9%. CONCLUSION: The incidence and mortality of HNC in Cali decreased significantly during the study period in both sexes.

Fetal central nervous system anomalies according to RT-PCR and trimester of maternal infection with Zika virus: A prospective cohort study.

INTRODUCTION: In October 2015, an epidemic of Zika began in Colombia's geographic areas with a high population of mosquitoes of the genus Aedes. We aimed to describe the fetal brain ultrasound findings in pregnant women with active symptoms or a history of symptoms suggestive of Zika virus (ZIKV) infection. MATERIAL AND METHODS: Eligible pregnant women were tested with reverse transcriptase-polymerase chain reaction (RT-PCR) for ZIKV and followed prospectively using detailed anatomic ultrasound and transvaginal neurosonography to detect structural anomalies of the fetal central nervous system (CNS). RESULTS: A total of 115 symptomatic women with a positive ZIKV RT-PCR and 55 with a negative ZIKV RT-PCR were enrolled in the study; CNS compromise of the fetus occurred in 22% and 17%, respectively (p = 0.255). Callosal dysgenesis (14.5%) was the most frequent anomaly of the CNS, followed by microcephaly (13.6%) and neuronal migration disorders (8.3%). When symptomatic ZIKV RT-PCR-positive women were categorized by trimester of infection, CNS anomalies were present in 40% of first-trimester infections, compared with 21% and 7% in second- and third-trimester infections (p = 0.002). CNS anomalies were also more severe in first-trimester-infected fetuses than in second- and third-trimester-infected fetuses. The high prevalence of CNS anomalies in fetuses of symptomatic ZIKV RT-PCR negative women suggests a high rate of false-negative cases and an even higher prevalence of CNS anomalies than observed in this study. CONCLUSIONS: The prevalence of fetal CNS anomalies was higher than previously reported in the literature for both symptomatic RT-PCR-positive and -negative pregnant women. Corpus callosum anomalies, microcephaly, neuronal migration disorders, and brain parenchymal hyperechogenicities were the most frequent CNS anomalies detected. In addition, CNS anomalies were more frequent and severe in infected fetuses during the first trimester of pregnancy than during the second or third trimester.

Survival in stomach cancer: analysis of a national cancer information system and a population-based cancer registry in Colombia.

Background: Stomach cancer is among the most frequent, is a leading cause of mortality in low- and middle-income countries. Assessing its survival is important to guide evidence-based health policies. Aims: To estimate stomach cancer survival in Colombia (2014-2019) with data from the National Cancer Information System (NCIS) and in Cali with data from the Cali Population Cancer Registry (RPCC) (1998-2017). Methods: NCIS estimated the overall 3-year net survival for 8,549 people, while RPCC estimated 5-year net survival for 6,776 people. Results: The 3-year net survival was 36.8% (95% CI: 35.5-38.1). Net survival was higher in people with special insurance (61.7%; 95% CI: 44.8-74.8) or third payer (40.5%; 95% CI: 38.7-42.3) than state insurance (30.7%; 95% CI: 28.7-32.8). It was also higher in women and people diagnosed at early stages. Multivariable analysis showed consistency with survival estimations with a higher risk of death in men, people with state insurance, and diagnosed at advanced stages. In Cali, the 5-year net survival remained stable in men during the last 20 years. In women the 5-year net survival in women increased 8.60 percentage points, equivalent to a 50% increase compared to the 1998-2002 period. For 2013-17, it was 19.1% (95%CI: 16.2-22.2) in men, and 24.8% (95% CI: 20.4-29.3) in women. Conclusions: Population survival estimates from the RPCC were lower than those observed in the NCIS. The differences in their methods and scope can explain variability. Nevertheless, our findings could be complementary to improve cancer control planning in the country.

Antecedentes: El cáncer de estómago se encuentra entre los más frecuentes y es una de las principales causas de mortalidad en los países de ingresos bajos y medianos. Evaluar su supervivencia es importante para orientar las políticas de salud basadas en la evidencia. Objetivos: Estimar la supervivencia del cáncer de estómago en Colombia (2014-2019) con datos del Sistema Nacional de Información del Cáncer (NCIS) y en Cali con datos del Registro Poblacional de Cáncer de Cali (RPCC) (1998-2017). Métodos: El NCIS estimó la supervivencia neta a tres años para 8,549 personas y el RPCC la calculó a 5 años para 6,776 personas registradas en sus bases de datos. Resultados: La supervivencia neta a tres años en Colombia fue del 36.8% (IC 95%: 35.5-38.1). La supervivencia neta fue mayor en personas con seguro especial (61.7%; IC 95%: 44.8-74.8) o tercer pagador (40.5%; IC 95%: 38.7-42.3) que el seguro estatal (30.7%; IC 95%: 28.7-32.8). También fue mayor en mujeres y personas diagnosticadas en etapas tempranas. El análisis multivariable mostró consistencia con la estimación de supervivencia con mayor riesgo de muerte en hombres, personas con seguro estatal y diagnosticados en estadios avanzados. En Cali, la supervivencia neta a 5 años se mantuvo estable en los hombres durante los últimos 20 años. En las mujeres aumentó 8.60 puntos porcentuales, equivalente a un aumento del 50% en comparación con el período 1998-2002. Para el período 2013-17 fue 19.1% (IC 95%: 16.2-22.2) en los hombres y 24.8% (IC 95%: 20.4-29.3) en las mujeres. Conclusiones: Las estimaciones de supervivencia del RPCC fueron más bajas que las obtenidas por el NCIS. Las diferencias en sus métodos y alcance pueden explicar la variabilidad. Sin embargo, nuestros hallazgos pueden ser complementarios para mejorar la planificación del control del cáncer en el país..

Incidence, Mortality, and Survival Trends of Primary CNS Tumors in Cali, Colombia, From 1962 to 2019.

PURPOSE: Global studies have shown varying trends of CNS tumors within geographic regions. In Colombia, the epidemiologic characteristics of CNS neoplasms are not well elucidated. We aimed to provide a summary of the descriptive epidemiology of primary CNS tumors among the urban population of Cali, Colombia. METHODS: We conducted a time-trend study from 1962 to 2019 using the Population-Based Cali Cancer Registry. The age-standardized rates per 100,000 person-years were obtained by direct method using the world standard population. Results were stratified by sex, age group at diagnosis, and histologic subtype. We used Joinpoint regression analysis to detect trends and obtain annual percentage change (APC) with 95% CIs. We estimated 5-year net survival using the Pohar-Perme method. RESULTS: During 1962 to 2016, 4,732 new cases of CNS tumors were reported. From 1985 to 2019, a total of 2,475 deaths from malignant CNS tumors were registered. A statistically significant increase in the trends of incidence (APC, 2.8; 95% CI, 2.1 to 3.5) and mortality (APC, 1.5; 95% CI, 1.1 to 2.0) rates was observed during the study. The most common malignant CNS tumor was glioblastoma (17.8% of all tumors), and the most frequent benign tumor was meningioma (17.2%). Malignancy was more common in males than in females. Unspecified malignant neoplasms represented 32% of all cases. The highest 5-year net survival was 31.4% during 2012 to 2016. CONCLUSION: Our findings demonstrate an increasing burden of primary CNS tumors for the last 60 years, with a steady rate from the early 2010s. There was an improvement of 5-year net survival for the last decade. Males had higher mortality than did females. Additional efforts are needed to fully explore the geographic, environmental, and genetic contributors of CNS malignancies within the region.

Mortality from respiratory infections and chronic non-communicable diseases before the COVID-19 pandemic in Cali, Colombia.

INTRODUCTION: The COVID-19 disease pandemic is a health emergency. Older people and those with chronic noncommunicable diseases are more likely to develop serious illnesses, require ventilatory support, and die from complications. OBJECTIVE: To establish deaths from respiratory infections and some chronic non-communicable diseases that occurred in Cali, before the SARS-CoV-2 disease pandemic. METHODS: During the 2003-2019 period, 207,261 deaths were registered according to the general mortality database of the Municipal Secretary of Health of Cali. Deaths were coded with the International Classification of Diseases and causes of death were grouped according to WHO guidelines. Rates were standardized by age and are expressed per 100,000 people-year. RESULTS: A direct relationship was observed between aging and mortality from respiratory infections and chronic non-communicable diseases. Age-specific mortality rates were highest in those older than 80 years for all diseases evaluated. Seasonal variation was evident in respiratory diseases in the elderly. COMMENTS: Estimates of mortality rates from respiratory infections and chronic non-communicable diseases in Cali provide the baseline that will serve as a comparison to estimate the excess mortality caused by the COVID-19 pandemic. Health authorities and decision makers should be guided by reliable estimates of mortality and of the proportion of infected people who die from SARS-CoV-2 virus infection.

INTRODUCCIÓN: La pandemia de la enfermedad COVID-19 es una emergencia sanitaria. Las personas mayores y aquellos con enfermedades crónicas no trasmisibles tienen más probabilidades de desarrollar enfermedades graves, requerir soporte ventilatorio y morir a causa de las complicaciones. OBJETIVO: Establecer las defunciones por infecciones respiratorias y por algunas enfermedades crónicas no trasmisibles ocurridas en Cali, antes de la pandemia de la enfermedad por el SARS-CoV-2. MÉTODOS: Durante el periodo 2003-2019, se registraron 207,261 defunciones información obtenida de la base de datos de mortalidad general de la Secretaria de Salud Municipal de Cali. Las defunciones se codificaron con la Clasificación Internacional de Enfermedades y las causas de muerte se agruparon según las guías de la OMS. Las tasas se estandarizaron por edad, son expresadas por 100,000 personas-año. RESULTADOS: Se observó una relación directa entre envejecimiento y la mortalidad por infecciones respiratorias y enfermedades crónicas no trasmisibles. Las tasas de mortalidad específicas por edad fueron más altas en los mayores de 80 años para todas las enfermedades evaluadas. En las enfermedades respiratorias fue evidente una variación estacional en los ancianos. COMENTARIO: Las estimaciones de las tasas de mortalidad por infecciones respiratorias y enfermedades crónicas no trasmisibles para Cali proporcionan la línea de base que servirá de comparación para estimar el exceso de mortalidad que ocasionará la pandemia de COVID-19. Las autoridades sanitarias y los tomadores de decisiones deben guiarse por estimaciones fiables de la mortalidad y de la proporción de infectados que mueren por la infección del virus SARS-CoV-2.

Mortality from respiratory infections and chronic non-communicable diseases before the COVID-19 pandemic in Cali, Colombia / Mortalidad por infecciones respiratorias y enfermedades crónicas no trasmisibles antes de la pandemia por COVID-19 en Cali, Colombia

Abstract Introduction: The COVID-19 disease pandemic is a health emergency. Older people and those with chronic noncommunicable diseases are more likely to develop serious illnesses, require ventilatory support, and die from complications. Objective: To establish deaths from respiratory infections and some chronic non-communicable diseases that occurred in Cali, before the SARS-CoV-2 disease pandemic. Methods: During the 2003-2019 period, 207,261 deaths were registered according to the general mortality database of the Municipal Secretary of Health of Cali. Deaths were coded with the International Classification of Diseases and causes of death were grouped according to WHO guidelines. Rates were standardized by age and are expressed per 100,000 people-year. Results: A direct relationship was observed between aging and mortality from respiratory infections and chronic non-communicable diseases. Age-specific mortality rates were highest in those older than 80 years for all diseases evaluated. Seasonal variation was evident in respiratory diseases in the elderly. Comments: Estimates of mortality rates from respiratory infections and chronic non-communicable diseases in Cali provide the baseline that will serve as a comparison to estimate the excess mortality caused by the COVID-19 pandemic. Health authorities and decision makers should be guided by reliable estimates of mortality and of the proportion of infected people who die from SARS-CoV-2 virus infection.

Resumen Introducción: La pandemia de la enfermedad COVID-19 es una emergencia sanitaria. Las personas mayores y aquellos con enfermedades crónicas no trasmisibles tienen más probabilidades de desarrollar enfermedades graves, requerir soporte ventilatorio y morir a causa de las complicaciones. Objetivo: Establecer las defunciones por infecciones respiratorias y por algunas enfermedades crónicas no trasmisibles ocurridas en Cali, antes de la pandemia de la enfermedad por el SARS-CoV-2. Métodos: Durante el periodo 2003-2019, se registraron 207,261 defunciones información obtenida de la base de datos de mortalidad general de la Secretaria de Salud Municipal de Cali. Las defunciones se codificaron con la Clasificación Internacional de Enfermedades y las causas de muerte se agruparon según las guías de la OMS. Las tasas se estandarizaron por edad, son expresadas por 100,000 personas-año. Resultados: Se observó una relación directa entre envejecimiento y la mortalidad por infecciones respiratorias y enfermedades crónicas no trasmisibles. Las tasas de mortalidad específicas por edad fueron más altas en los mayores de 80 años para todas las enfermedades evaluadas. En las enfermedades respiratorias fue evidente una variación estacional en los ancianos. Comentario: Las estimaciones de las tasas de mortalidad por infecciones respiratorias y enfermedades crónicas no trasmisibles para Cali proporcionan la línea de base que servirá de comparación para estimar el exceso de mortalidad que ocasionará la pandemia de COVID-19. Las autoridades sanitarias y los tomadores de decisiones deben guiarse por estimaciones fiables de la mortalidad y de la proporción de infectados que mueren por la infección del virus SARS-CoV-2.

Reliable information for cancer control in Cali, Colombia.

BACKGROUND: The Cali Population Cancer Registry (RPCC) has been in continuous operation since 1962 with the objective of producing valid statistics on the incidence of cancer, its patterns, trends and survival rates. METHODS: During the period 2008-2012, 23,046 new cases were registered and during 2011-2015 there were 12,761 cancer deaths. The trend of the rates was described with the APC average annual change rate and with the Joinpoint analysis. We analyzed the individual data of 38,671 adults (15-99 years) diagnosed with cancer between 1995-2009, and we calculated the standardized net survival by age for the 14 most common cancer body sites, using the Pohar-Perme method. RESULTS: Prostate and breast cancer were the first cause of cancer morbidity. The incidence rates in these were susceptible to early detection, tumors stabilized after decades of growth, while an increase in the incidence of colon cancer and papillary thyroid carcinoma was observed. The incidence rates of cervical and stomach cancer and conditions related to infectious agents decreased, although the number of absolute cases increased, due to the growth and aging of the population. Gastric cancer was responsible for the highest number of cancer related deaths. The types of cancer related to tobacco consumption (lung, oral cavity, esophagus, pancreas, urinary bladder) showed low numbers and a tendency to decrease. During the period 2000-2004, the 5-year net survival improved for cancers of the breast, cervix, prostate, melanoma and thyroid, although in the period 2005-2009 a stagnation was observed. In stomach, liver and lung cancer, the 5-year net survival was less than 15%. The 5-year overall survival in children was 51.0% (95% CI: 47.5, 54.3) and in adolescents 44.6% (95% CI: 36.0, 52.8). COMMENT: RPCC has been an advisor to the Colombian government in the evaluation of CPRs in the country and its data has contributed significantly to different aspects of cancer control in Colombia.

ANTECEDENTES: El Registro Poblacional de Cáncer de Cali (RPCC) está en operación continua desde 1962 con el objetivo de producir estadísticas válidas sobre la incidencia de cáncer, sus patrones, tendencias y supervivencia. MÉTODOS: Durante el periodo 2008-2012, se registraron 23,046 casos nuevos y durante 2011-2015 se registraron 12,761 defunciones por cáncer. La tendencia de las tasas se describió con el porcentaje de cambio medio anual APC y con el análisis de Joinpoint. Se analizaron los datos individuales de 38,671 adultos (15-99 años) con diagnóstico de cáncer entre 1995-2009, y se calculó la supervivencia neta estandarizada por edad para las 14 localizaciones más comunes de cáncer, con el método de Pohar-Perme. RESULTADOS: Próstata y mama fueron la primera causa de morbilidad por cáncer. Las tasas de incidencia en estos tumores susceptibles de detección temprana se estabilizaron tras décadas de crecimiento, mientras que se observó un incremento de la incidencia de cáncer de colon y carcinoma papilar de tiroides. Las tasas de incidencia de cáncer de cuello uterino y estómago, afecciones relacionados con agentes infecciosos, disminuyeron, aunque el número de los casos absolutos aumentó, debido al crecimiento y envejecimiento de la población. El cáncer gástrico fue responsable del mayor número de muertes por cáncer. Los tipos de cáncer relacionados con el consumo de tabaco (pulmón, cavidad oral, esófago, páncreas, vejiga urinaria) mostraron cifras bajas y con tendencia al descenso. Durante el periodo 2000-2004, la supervivencia neta a 5 años mejoró para los cánceres de mama, cuello uterino, próstata, melanoma y tiroides, aunque en el periodo 2005-2009 se observó un estancamiento. En cáncer de estómago, hígado y pulmón, la supervivencia neta a 5 años fue inferior al 15%. La supervivencia global a 5 años en niños fue de 51.0% (IC 95%: 47.5, 54.3) y en adolescentes de 44.6% (IC 95%: 36.0, 52.8). COMENTARIO: El RPCC ha sido asesor del gobierno colombiano en la evaluación de RPCs en el país y sus datos han contribuido significativamente a diferentes aspectos del control del cáncer en Colombia.

Cali cancer registry methods.

BACKGROUND: The Population Cancer Registry of Cali (RPCC) has operated since 1962, disseminating high quality information to provide a framework to assess and control the burden of cancer in Cali. METHODS: The collection of new cancer cases in permanent residents of Cali is done through active search in and notification from hospitals, and public and private laboratories. The Secretary of Municipal Public Health provides individual information on general mortality and death from cancer. Tumors are coded with ICDO-3 and mortality with ICD-10. Presented rates are standardized by age and trends are assessed by estimating the percentage annual change using the regression analysis in JoinPoint. The 5-year net survival was analyzed with the Pohar-Perme estimator. RESULTS: The 88.5% of the registered cancers had morphological verification (MV). The proportion of unknown primary site represented 5% and the death certificate only cases (DCO) varied between 0 to3% depending on the cancer site. All deaths were certified by a physician, 94.2% of cancer deaths were correctly certified. The ill-defined site proportion was 5.3% and that of uterine cancer not specified (C55) was 0.5%. For survival analysis, existing data collection procedure and infrastructure ensures assessment of the patient's vital status and follow-up, with an average lost to follow-up of 13.2%. COMMENT: The information has been published in the eleven volumes of "Cancer Incidence in Five Continents" confirming high quality of the collected data. The RPCC PCRC has also participated in the Concord Study and is participating in SURVCAN-3.

ANTECEDENTES: El Registro Poblacional de Cáncer de Cali (RPCC) opera de manera continua desde 1962 divulgando información de calidad para proporcionar un marco para valorar y controlar el impacto del cáncer en Cali. MÉTODOS: La recolección de los casos nuevos de cáncer en residentes permanentes de Cali se hace mediante búsqueda activa y por notificación en los hospitales y laboratorios públicos y privados. La Secretaria de Salud Pública Municipal proporciona la información individual de mortalidad general y por cáncer. Los tumores se codifican con la CIO-3 y la mortalidad con la CIE-10. Las tasas se estandarizan por edad y la tendencia se estudia con el porcentaje de cambio anual y con la regresión de JoinPoint. La supervivencia neta a 5 años se analizó con el estimador de Pohar-Perme. RESULTADOS: El 88.5% de los canceres tuvieron verificación morfológica (VM). La proporción de los casos codificada como de sitio mal definido representó el 5% y el certificado de defunción como única evidencia del diagnóstico de cáncer (DCO) varió entre 0-3% dependiendo de la localización. Todas las defunciones fueron certificadas por un médico, el 94.2% de las muertes por cáncer fueron bien certificadas. La proporción de sitio mal definido fue 5.3% y la de cáncer de útero no especificado (C55) fue 0.5%. En todos los casos de supervivencia fue posible el seguimiento y la proporción de censuras fue 13.2. COMENTARIO: La información ha sido publicada en los once volúmenes de "Cancer Incidence in Five Continents". El RPCC participó en el Estudio Concord y está participando en SURVCAN-3.

Reliable information for cancer control in Cali, Colombia / Información fiable para el control del cáncer en Cali, Colombia

Abstract Background: The Cali Population Cancer Registry (RPCC) has been in continuous operation since 1962 with the objective of producing valid statistics on the incidence of cancer, its patterns, trends and survival rates. Methods: During the period 2008-2012, 23,046 new cases were registered and during 2011-2015 there were 12,761 cancer deaths. The trend of the rates was described with the APC average annual change rate and with the Joinpoint analysis. We analyzed the individual data of 38,671 adults (15-99 years) diagnosed with cancer between 1995-2009, and we calculated the standardized net survival by age for the 14 most common cancer body sites, using the Pohar-Perme method. Results: Prostate and breast cancer were the first cause of cancer morbidity. The incidence rates in these were susceptible to early detection, tumors stabilized after decades of growth, while an increase in the incidence of colon cancer and papillary thyroid carcinoma was observed. The incidence rates of cervical and stomach cancer and conditions related to infectious agents decreased, although the number of absolute cases increased, due to the growth and aging of the population. Gastric cancer was responsible for the highest number of cancer related deaths. The types of cancer related to tobacco consumption (lung, oral cavity, esophagus, pancreas, urinary bladder) showed low numbers and a tendency to decrease. During the period 2000-2004, the 5-year net survival improved for cancers of the breast, cervix, prostate, melanoma and thyroid, although in the period 2005-2009 a stagnation was observed. In stomach, liver and lung cancer, the 5-year net survival was less than 15%. The 5-year overall survival in children was 51.0% (95% CI: 47.5, 54.3) and in adolescents 44.6% (95% CI: 36.0, 52.8). Comment: RPCC has been an advisor to the Colombian government in the evaluation of CPRs in the country and its data has contributed significantly to different aspects of cancer control in Colombia.

Resumen Antecedentes: El Registro Poblacional de Cáncer de Cali (RPCC) está en operación continua desde 1962 con el objetivo de producir estadísticas válidas sobre la incidencia de cáncer, sus patrones, tendencias y supervivencia. Métodos: Durante el periodo 2008-2012, se registraron 23,046 casos nuevos y durante 2011-2015 se registraron 12,761 defunciones por cáncer. La tendencia de las tasas se describió con el porcentaje de cambio medio anual APC y con el análisis de Joinpoint. Se analizaron los datos individuales de 38,671 adultos (15-99 años) con diagnóstico de cáncer entre 1995-2009, y se calculó la supervivencia neta estandarizada por edad para las 14 localizaciones más comunes de cáncer, con el método de Pohar-Perme. Resultados: Próstata y mama fueron la primera causa de morbilidad por cáncer. Las tasas de incidencia en estos tumores susceptibles de detección temprana se estabilizaron tras décadas de crecimiento, mientras que se observó un incremento de la incidencia de cáncer de colon y carcinoma papilar de tiroides. Las tasas de incidencia de cáncer de cuello uterino y estómago, afecciones relacionados con agentes infecciosos, disminuyeron, aunque el número de los casos absolutos aumentó, debido al crecimiento y envejecimiento de la población. El cáncer gástrico fue responsable del mayor número de muertes por cáncer. Los tipos de cáncer relacionados con el consumo de tabaco (pulmón, cavidad oral, esófago, páncreas, vejiga urinaria) mostraron cifras bajas y con tendencia al descenso. Durante el periodo 2000-2004, la supervivencia neta a 5 años mejoró para los cánceres de mama, cuello uterino, próstata, melanoma y tiroides, aunque en el periodo 2005-2009 se observó un estancamiento. En cáncer de estómago, hígado y pulmón, la supervivencia neta a 5 años fue inferior al 15%. La supervivencia global a 5 años en niños fue de 51.0% (IC 95%: 47.5, 54.3) y en adolescentes de 44.6% (IC 95%: 36.0, 52.8). Comentario: El RPCC ha sido asesor del gobierno colombiano en la evaluación de RPCs en el país y sus datos han contribuido significativamente a diferentes aspectos del control del cáncer en Colombia.

Cali cancer registry methods / Métodos del Registro de Cáncer en Cali, Colombia

Abstract Background: The Population Cancer Registry of Cali (RPCC) has operated since 1962, disseminating high quality information to provide a framework to assess and control the burden of cancer in Cali. Methods: The collection of new cancer cases in permanent residents of Cali is done through active search in and notification from hospitals, and public and private laboratories. The Secretary of Municipal Public Health provides individual information on general mortality and death from cancer. Tumors are coded with ICDO-3 and mortality with ICD-10. Presented rates are standardized by age and trends are assessed by estimating the percentage annual change using the regression analysis in JoinPoint. The 5-year net survival was analyzed with the Pohar-Perme estimator. Results: The 88.5% of the registered cancers had morphological verification (MV). The proportion of unknown primary site represented 5% and the death certificate only cases (DCO) varied between 0 to3% depending on the cancer site. All deaths were certified by a physician, 94.2% of cancer deaths were correctly certified. The ill-defined site proportion was 5.3% and that of uterine cancer not specified (C55) was 0.5%. For survival analysis, existing data collection procedure and infrastructure ensures assessment of the patient's vital status and follow-up, with an average lost to follow-up of 13.2%. Comment: The information has been published in the eleven volumes of "Cancer Incidence in Five Continents" confirming high quality of the collected data. The RPCC PCRC has also participated in the Concord Study and is participating in SURVCAN-3.

Resumen Antecedentes: El Registro Poblacional de Cáncer de Cali (RPCC) opera de manera continua desde 1962 divulgando información de calidad para proporcionar un marco para valorar y controlar el impacto del cáncer en Cali. Métodos: La recolección de los casos nuevos de cáncer en residentes permanentes de Cali se hace mediante búsqueda activa y por notificación en los hospitales y laboratorios públicos y privados. La Secretaria de Salud Pública Municipal proporciona la información individual de mortalidad general y por cáncer. Los tumores se codifican con la CIO-3 y la mortalidad con la CIE-10. Las tasas se estandarizan por edad y la tendencia se estudia con el porcentaje de cambio anual y con la regresión de JoinPoint. La supervivencia neta a 5 años se analizó con el estimador de Pohar-Perme. Resultados: El 88.5% de los canceres tuvieron verificación morfológica (VM). La proporción de los casos codificada como de sitio mal definido representó el 5% y el certificado de defunción como única evidencia del diagnóstico de cáncer (DCO) varió entre 0-3% dependiendo de la localización. Todas las defunciones fueron certificadas por un médico, el 94.2% de las muertes por cáncer fueron bien certificadas. La proporción de sitio mal definido fue 5.3% y la de cáncer de útero no especificado (C55) fue 0.5%. En todos los casos de supervivencia fue posible el seguimiento y la proporción de censuras fue 13.2% Comentario: La información ha sido publicada en los once volúmenes de "Cancer Incidence in Five Continents". El RPCC participó en el Estudio Concord y está participando en SURVCAN-3.

Cáncer de laringe y sinunasal en Cali, Colombia 1962 ­ 2015 / Sinonasal and laryngeal carcinoma in Cali, Colombia 1962 ­ 2015

Introducción: El cáncer es una enfermedad de alta incidencia, con múltiples factores etiológicos y diferentes características evolutivas. Objetivo: Describir la supervivencia y la tendencia de las tasas de incidencia y mortalidad por cáncer de laringe y senos paranasales en Cali (Colombia) durante el periodo 1962 a 2015. Diseño: Estudio observacional descriptivo. Métodos: La información de incidencia, durante el periodo 1962 a 2012, se obtuvo en el RPCC y la mortalidad entre 1984-2015 de la SSPM. El comportamiento de la tendencia se evaluó con el porcentaje de cambio anual (APC) y la supervivencia relativa se estimó con el método de Ederer II. La estadificación se realizó con la AJCC. Resultados: Durante 1962 a 2012, se diagnosticaron 1623 casos nuevos de cáncer, 85.2% (1383 casos) fueron de laringe y 14.8% (240 casos) sinunasal 76% fueron hombres y el CCE fue el tipo histológico más frecuente 84.1% y 59.6% en laringe y sinunasal respectivamente. Se observó una disminución significativa del riesgo de cáncer de laringe en ambos sexos, siendo mayor la disminución en hombres (APC=-1,1*(ICD95%: -1,6; -0,7)). La disminución en la tasa de incidencia de cáncer de laringe CEC fue mayor en hombres (APC=-1,1*(ICD95%: -1,6; -0,6)) durante 1962-2012. Las tasas de mortalidad disminuyeron significativamente (APC=- 2,5*(ICD95%:-3,6 -1,5)). La supervivencia relativa a 5 años durante el periodo 2008- 2012, 43,5%; 93 pacientes se estadificaron con supervivencia: T3-T4 (41,5%) y T1- T2 (55,0%). Conclusiones: El riesgo del cáncer de laringe y sinunasal escamocelular asociado al tabaquismo disminuyó de manera significativa en hombres y mujeres de Cali durante los últimos 53 años.

Introduction: Cancer is disease with high incidence, multiple etiological factors and different characteristics. Objective: To describe the survival and trend of the incidence and mortality rates for cancer of the larynx and paranasal sinuses in Cali (Colombia) during the period 1962 to 2015. Design: Descriptive observational study. Methods: Incidence information, during the period 1962 to 2012, was obtained in the RPCC and mortality between 1984-2015 of the SSPM. The behavior of the trend was evaluated with the percentage of annual change (APC) and the relative survival was estimated with the method of Ederer II. The arrangement was made with the AJCC. Results: During 1962 to 2012, 1623 new cases of cancer were diagnosed, 85.2% (1383 cases) were laryngeal and 14.8% (240 cases) sinunasal 76% were men and the CCE was the most frequent histological type 84.1% and 59.6% in larynx and sinunasal respectively. A significant decrease in the risk of laryngeal cancer was observed in both sexes, with a greater decrease in men (APC = -1.1 * (ICD95%: -1.6, -0.7)). The decrease in the incidence rate of laryngeal cancer CEC was higher in men (APC = -1.1 * (ICD95%: -1.6, -0.6)) during 1962-2012. Mortality rates decreased significantly (APC = -2.5 * (ICD95%: - 3.6 -1.5)). The 5-year relative survival rate during the period 2008-2012 was 43.5%; 93 patients were stratified with survival: T3-T4 (41.5%) and T1-T2 (55.0%). Conclusions: The risk of laryngeal and squamous cell sinonasal cancer associated to smoking decreased significantly in men and women of Cali during the last 53 years.