Tendencia de la mortalidad por edad y sexo en España (1981-2016). Cambios asociados a la crisis económica / Trends in age-sex-specific mortality in Spain (1981-2016). Changes associated with the economic crisis

OBJETIVO: Analizar la tendencia de las tasas de mortalidad por edad y sexo en España e identificar si se han producido cambios tras el comienzo de la crisis económica. MÉTODO: Estudio de tendencias de las tasas de mortalidad por grupos quinquenales de edad y sexo en el periodo 1981-2016, mediante regresión joint-point. Se detallan los resultados de los dos últimos periodos identificados en las regresiones, que permiten identificar cambios ocurridos después del inicio de la crisis. En caso de ralentización o estancamiento de la tendencia de mortalidad en varios grupos de edad sucesivos, se realizó un análisis de tendencias por causas. RESULTADOS: La mortalidad se redujo de forma significativa entre 1981 y 2016. Tras el inicio de la crisis económica, la tendencia de la mortalidad total estandarizada no cambió en los hombres, y sufrió un estancamiento en las mujeres entre 2013 y 2016. En el análisis por grupos quinquenales de edad, la tendencia descendente de la mortalidad sufrió un estancamiento en los hombres en todos los grupos entre los 15 y 39 años, que se inició entre 2011 y 2014 y duró hasta 2016. En ambos sexos, en los cuatro grupos de edad entre 60 y 79 años, la reducción previa de la mortalidad sufrió una ralentización o estancamiento, que se inició entre 2009 y 2014, y continuó hasta 2016. Las causas que más contribuyeron al cambio de tendencia fueron las causas externas en hombres de 15-39 años, y las enfermedades del sistema circulatorio y respiratorio en las personas de 60-79 años. CONCLUSIÓN: La tendencia descendente de la mortalidad ha sufrido una ralentización o un estancamiento después del inicio de la crisis económica, principalmente en hombres jóvenes, y en hombres y mujeres de 60-79 años

OBJECTIVE: To analyze trends in age-sex-specific mortality in Spain, and to identify if there have been changes following the onset of economic crisis. METHOD: A study of trends in mortality rates by sex and quinquennial groups of age was carried out, from 1981 to 2016. Time trends were established by joint-point regression models. The results of the last two periods identified in the regressions are presented in detail, identifying changes after the onset of the economic crisis. When slowdown or stagnation of the mortality trends were identified in several successive age groups, an analysis of trends by causes was carried out. RESULTS: Mortality was significantly reduced between 1981 and 2016. After the beginning of the economic crisis, the trend in total age-standardized mortality did not change for men, but it stagnated for women from 2013 to 2016. In the analysis by quinquennial age groups, the downward trend in mortality suffered a stagnation in men in all the groups between 15 and 39 years, which started between 2011 and 2014, and lasted until 2016. In both women and men, in the four groups between 60 and 79 years, the previous decline in mortality suffered a slowdown or stagnation, which began between 2009 and 2014, and continued until 2016. Negative changes in mortality trends were mainly influenced by external causes (in 15-39 years men) and diseases of the circulatory and respiratory systems (in 60-79 years men and women). CONCLUSIONS: The downward trend of mortality suffered stagnation or deceleration after the onset of the economic crisis in young men and 60-79 years old men and women

[Trends in age-sex-specific mortality in Spain (1981-2016). Changes associated with the economic crisis]. / Tendencia de la mortalidad por edad y sexo en España (1981-2016). Cambios asociados a la crisis económica.

OBJECTIVE: To analyze trends in age-sex-specific mortality in Spain, and to identify if there have been changes following the onset of economic crisis. METHOD: A study of trends in mortality rates by sex and quinquennial groups of age was carried out, from 1981 to 2016. Time trends were established by joint-point regression models. The results of the last two periods identified in the regressions are presented in detail, identifying changes after the onset of the economic crisis. When slowdown or stagnation of the mortality trends were identified in several successive age groups, an analysis of trends by causes was carried out. RESULTS: Mortality was significantly reduced between 1981 and 2016. After the beginning of the economic crisis, the trend in total age-standardized mortality did not change for men, but it stagnated for women from 2013 to 2016. In the analysis by quinquennial age groups, the downward trend in mortality suffered a stagnation in men in all the groups between 15 and 39 years, which started between 2011 and 2014, and lasted until 2016. In both women and men, in the four groups between 60 and 79 years, the previous decline in mortality suffered a slowdown or stagnation, which began between 2009 and 2014, and continued until 2016. Negative changes in mortality trends were mainly influenced by external causes (in 15-39 years men) and diseases of the circulatory and respiratory systems (in 60-79 years men and women). CONCLUSIONS: The downward trend of mortality suffered stagnation or deceleration after the onset of the economic crisis in young men and 60-79 years old men and women.

How a deliberative approach includes women in the decisions of screening mammography: a citizens' jury feasibility study in Andalusia, Spain.

OBJECTIVES: To verify whether a citizens' jury study is feasible to the Andalusian population and to know if women, when better informed, are able to answer the research question of whether the Andalusian Public Health System must continue offering screening mammography to women aged 50-69. The reasons for the pertinent decision and recommendations to the political authorities will be stated. DESIGN: Qualitative research study with the methodology of citizens' jury. SETTING: Breast cancer screening programme in Andalusia (Spain). PARTICIPANTS: Thirteen women aged 50-69 with secondary school or higher education accepted to participate as a jury. Two epidemiologists were the expert witnesses. The main researcher was the neutral moderator. INTERVENTIONS: Jury met on Monday, 15 February 2016. The moderator indicated to the jury that it had to assess the screening programme's key benefits and main harm. On Tuesday, 16 February, the expert witnesses positioned for and against the programme. On Thursday, 18 February, the jury deliberated, reached final conclusions, submitted its vote and stated its recommendations to politicians. The deliberation session was transcribed and analysed with the support of ATLAS.ti.5.2 software. PRIMARY AND SECONDARY OUTCOME MEASURES: Feasibility in the Andalusian population, women's vote and opinion, reasons for votes and recommendations to political authorities. RESULTS: Eleven participants voted yes and two voted no. There are three reasons to vote 'yes': health, the test nature, and individual freedom. Some women invoke the lack of efficacy and the cost to justify their negative vote, at least in universal terms. On completion, they made suggestions to be submitted to the pertinent authorities for the improvement of information, psychology services and research. CONCLUSIONS: The deliberative strategy is feasible and causes a favourable positioning regarding screening mammography, although information changes the opinion of some women, who desire informed decision making and to keep or increase medicalisation in their lives.

Lecciones desde fuera. Otros países en ésta y otras crisis anteriores. Informe SESPAS 2014 / Lessons from abroad. Current and previous crisis in other countries. SESPAS report 2014

La evidencia acumulada sobre el efecto de crisis anteriores en la salud presenta patrones muy diferenciados atribuibles al diseño de los estudios, a la naturaleza de cada crisis y a otros factores del entorno socioeconómico y político. Existe, no obstante, un consenso cada vez mayor sobre el papel mediador de las respuestas políticas de los gobiernos, que pueden magnificar, o al contrario mitigar, los efectos adversos de las crisis. Estudios recientes revelan un deterioro en algunos indicadores de salud en el contexto de la crisis actual, fundamentalmente en salud mental y enfermedades transmisibles. En algunos países europeos también se ha constatado un descenso en el consumo de tabaco y alcohol. Por otro lado, algunos gobiernos están haciendo uso del contexto de crisis para avanzar reformas tendentes a la privatización de servicios y prestaciones sanitarias, restringiendo con ello el derecho a la salud y a la atención sanitaria. Se está actuando sobre los tres ejes que determinan el campo de la financiación de los sistemas sanitarios: la población protegida, la contribución del usuario y la cobertura de servicios. Estas medidas están siendo adoptadas a menudo de manera arbitraria basándose en decisiones ideológicas más que en la evidencia disponible, de lo que cabría esperar consecuencias adversas en términos de protección financiera, eficiencia y equidad (AU)

The evidence available on the impact of previous crises on health reveals different patterns attributable to study designs, the characteristics of each crisis, and other factors related to the socioeconomic and political context. There is greater consensus on the mediating role of government policy responses to financial crises. These responses may magnify or mitigate the adverse effects of crises on population health. Some studies have shown a significant deterioration in some health indicators in the context of the current crisis, mainly in relation to mental health and communicable diseases. Alcohol and tobacco use have also declined in some European countries. In addition, this crisis is being used by some governments to push reforms aimed at privatizing health services, thereby restricting the right to health and healthcare. Specifically, action is being taken on the three axes that determine health system financing: the population covered, the scope of services, and the share of the costs covered. These measures are often arbitrarily implemented based on ideological decisions rather than on the available evidence and therefore adverse consequences are to be expected in terms of financial protection, efficiency, and equity (AU)

Promoción de la salud y prevención en tiempos de crisis: el rol del sector sanitario. Informe SESPAS 2014 / Health promotion and prevention in the economic crisis: the role of the health sector. SESPAS report 2014

Este artículo revisa la evolución de los estilos de vida e identifica algunas prioridades y líneas de mejora en prevención y promoción de la salud en el momento actual de crisis económica. Se utilizan diversas fuentes, incluida una encuesta a 30 expertos/as en salud pública y atención primaria. Entre 2006 y 2012 no se detectan grandes cambios en estilos de vida, salvo un descenso en el consumo habitual de alcohol. Desciende ligeramente el consumo de drogas ilegales, pero aumenta el de psicofármacos. La mayoría de los/las expertos/as considera que debe mejorarse la toma de decisiones sobre cribados poblacionales y vacunas, incluyendo el análisis del coste de oportunidad, y mayor transparencia e independencia de los/las profesionales implicados/as. La prevención está contribuyendo a la medicalización de la vida, pero hay opiniones divididas sobre la necesidad de algunas actividades preventivas. Las prioridades en prevención están en el ámbito de la salud mental y de la infección por el virus de la inmunodeficiencia humana en grupos vulnerables. La mayoría de los/las expertos/as considera que las intervenciones de promoción de la salud tienen potencial para mitigar los efectos de la crisis, y que son grupos prioritarios la infancia, las personas desempleadas y otros grupos vulnerables. Son intervenciones prioritarias las actividades comunitarias en colaboración con ayuntamientos y otros sectores, la abogacía y la promoción de la salud mental. Se considera deseable un mayor uso de la legislación y de los medios de comunicación como herramientas de promoción. Es importante clarificar el rol del sector sanitario en las actividades intersectoriales, y reconocer las limitaciones, puesto que los determinantes sociales de salud dependen de otros sectores. Se advierte asimismo del riesgo derivado de los recortes y de las políticas que inciden negativamente en las condiciones de vida (AU)

This article reviews trends in lifestyle factors and identifies priorities in the fields of prevention and health promotion in the current economic recession. Several information sources were used, including a survey of 30 public health and primary care experts. Between 2006 and 2012, no significant changes in lifestyle factors were detected except for a decrease in habitual alcohol drinking. There was a slight decrease in the use of illegal drugs and a significant increase in the use of psychoactive drugs. Most experts believe that decision-making about new mass screening programs and changes in vaccination schedules needs to be improved by including opportunity cost analysis and increasing the transparency and independence of the professionals involved. Preventive health services are contributing to medicalization, but experts’ opinions are divided on the need for some preventive activities. Priorities in preventive services are mental health and HIV infection in vulnerable populations. Most experts trust in the potential of health promotion to mitigate the health effects of the economic crisis. Priority groups are children, unemployed people and other vulnerable groups. Priority interventions are community health activities (working in partnership with local governments and other sectors), advocacy, and mental health promotion. Effective tools for health promotion that are currently underused are legislation and mass media. There is a need to clarify the role of the healthcare sector in intersectorial activities, as well as to acknowledge that social determinants of health depend on other sectors. Experts also warn of the consequences of austerity and of policies that negatively impact on living conditions (AU)

[Lessons from abroad. Current and previous crisis in other countries. SESPAS report 2014]. / Lecciones desde fuera. Otros países en ésta y otras crisis anteriores. Informe SESPAS 2014.

The evidence available on the impact of previous crises on health reveals different patterns attributable to study designs, the characteristics of each crisis, and other factors related to the socioeconomic and political context. There is greater consensus on the mediating role of government policy responses to financial crises. These responses may magnify or mitigate the adverse effects of crises on population health. Some studies have shown a significant deterioration in some health indicators in the context of the current crisis, mainly in relation to mental health and communicable diseases. Alcohol and tobacco use have also declined in some European countries. In addition, this crisis is being used by some governments to push reforms aimed at privatizing health services, thereby restricting the right to health and healthcare. Specifically, action is being taken on the three axes that determine health system financing: the population covered, the scope of services, and the share of the costs covered. These measures are often arbitrarily implemented based on ideological decisions rather than on the available evidence and therefore adverse consequences are to be expected in terms of financial protection, efficiency, and equity.

[Health promotion and prevention in the economic crisis: the role of the health sector. SESPAS report 2014]. / Promoción de la salud y prevención en tiempos de crisis: el rol del sector sanitario. Informe SESPAS 2014.

This article reviews trends in lifestyle factors and identifies priorities in the fields of prevention and health promotion in the current economic recession. Several information sources were used, including a survey of 30 public health and primary care experts. Between 2006 and 2012, no significant changes in lifestyle factors were detected except for a decrease in habitual alcohol drinking. There was a slight decrease in the use of illegal drugs and a significant increase in the use of psychoactive drugs. Most experts believe that decision-making about new mass screening programs and changes in vaccination schedules needs to be improved by including opportunity cost analysis and increasing the transparency and independence of the professionals involved. Preventive health services are contributing to medicalization, but experts' opinions are divided on the need for some preventive activities. Priorities in preventive services are mental health and HIV infection in vulnerable populations. Most experts trust in the potential of health promotion to mitigate the health effects of the economic crisis. Priority groups are children, unemployed people and other vulnerable groups. Priority interventions are community health activities (working in partnership with local governments and other sectors), advocacy, and mental health promotion. Effective tools for health promotion that are currently underused are legislation and mass media. There is a need to clarify the role of the healthcare sector in intersectorial activities, as well as to acknowledge that social determinants of health depend on other sectors. Experts also warn of the consequences of austerity and of policies that negatively impact on living conditions.

Promoción de la salud en poblaciones de distinta etnia o cultura a la mayoritaria: revisión de las intervenciones y recomendaciones / Health promotion in minority groups: a review of interventions and recommendations

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[Caesarean delivery in Andalusia, Spain: relationship with social, clinical and health services factors (2007-2009)]. / Frecuencia de la cesárea en Andalucía: relación con factores sociales, clínicos y de los servicios sanitarios (2007-2009).

BACKGROUND: Increasing trend and geographical variations in the use of caesarean section suggest the influence of non-clinical factors. The objective was to describe the use of caesarean section in the Andalusian region in Spain by exploring the role of social, clinical, and health services variables. METHODS: A cross-sectional study was carried out using vital statistics. It involves all births occurred in Andalusia during the period of 2007-2009. The dependent variable was the use of caesarean section and the set of covariates were classified into three groups: those with a clinical meaning, those related to the health services organization, and those with a social significance. Multivariate logistic regressions were used. RESULTS: In the data set of 293,558 births, the prevalence of caesarean delivery was 24.8%. The multivariate analysis highlights the labour complications as the clinical variable with the highest odds ratio (OR=19.36). Regarding the health services variables, the odds of experiencing a caesarean delivery were 55% higher on weekdays than on weekends. Cádiz was the province with the highest OR for caesarean section (comparison between Cádiz and Almería: OR=1,21) where the ratio between births in public and private hospitals was 3.7. The frequency of caesarean section was 34% higher in women with third level education than those with no education. CONCLUSIONS: Labour complication is the most influential variable for caesarean section. Caesarean birth rate is above the accepted standards for all social classes and increases with educational level. Inter-provincial differences reflect different patterns with regard to the use of private medicine.

Frecuencia de la cesárea en Andalucía. Relación con factores sociales, clínicos y de los servicios sanitarios (2007-2009) / Caesarean delivery in andalusia, Spain. Relationship with social, clinical and health services factors (2007-2009)

Fundamento: La tendencia creciente y variabilidad geográfica en el uso de la cesárea sugiere la existencia de factores explicativos no clínicos. El objetivo del estudio es analizar eluso de las cesáreas en Andalucía, explorando el papel de variables sociales, clínicas y de los servicios sanitarios. Métodos: Estudio transversal de todos los nacimientos de Andalucía (2007-2009) utilizando como fuente de información el Movimiento Natural de la Población. La variable dependiente fue la frecuencia de cesáreas y las explicativas se clasificaron en tres grupos: con significado clínico, relacionadas con el funcionamiento de los servicios sanitarios, y con significado social. Se realizó una regresión logística multivariante. Resultados: El 24,8% de los 293.558 nacimientos fue porcesárea. En el análisis multivariante se observó que la variable clínica con la mayor odds ratio (OR) fue la existencia de complicaciones (OR=19,36). En cuanto a las variables relacionadas con los servicios sanitarios hubo un 55% más cesáreas de lunes a viernes que en fines de semana y la provincia con mayor uso de cesárea fue Cádiz (OR de 1,21 frente a Almería) con unarazón de partos en centros públicos frente a privados de 3,7. La frecuencia de cesáreas fue un 34% superior en las mujeres conestudios de tercer grado que en las que no tenían estudios. Conclusiones: La variable con mayor influencia en la práctica de cesárea fue la existencia de complicaciones. La tasa decesárea estuvo por encima de los estándares aceptados en todas las clases sociales, con mayor incidencia a mayor nivel educativo. Las diferencias interprovinciales reflejan distintos patrones de uso de la medicina privada(AU)

Background: Increasing trend and geographical variationsin the use of caesarean section suggest the influence of non-clinical factors. The objective was to describe the use of caesareansection in the Andalusian region in Spain by exploring the role of social, clinical, and health services variables. Methods: A cross-sectional study was carried out usingvital statistics. It involves all births occurred in Andalusia during the period of 2007-2009. The dependent variable was theuse of caesarean section and the set of covariates were classified into three groups: those with a clinical meaning, those related tothe health services organization, and those with a social significance. Multivariate logistic regressions were used. Results: In the data set of 293,558 births, the prevalence ofcaesarean delivery was 24.8%. The multivariate analysis highlights the labour complications as the clinical variable with thehighest odds ratio (OR=19.36). Regarding the health services variables, the odds of experiencing a caesarean delivery were55% higher on weekdays than on weekends. Cádiz was the province with the highest OR for caesarean section (comparisonbetween Cádiz and Almería: OR=1,21) where the ratio betweenbirths in public and private hospitals was 3.7. The frequency of caesarean section was 34% higher in women with third leveleducation than those with no education. Conclusions: Labour complication is the most influentialvariable for caesarean section. Caesarean birth rate is above the accepted standards for all social classes and increases with educational level. Inter-provincial differences reflect different patterns with regard to the use of private medicine(AU)

Investigación sobre las desigualdades en la incidencia, mortalidad, prevención y atención del cáncer en España / The state of research in Spain into inequalities in the incidence, mortality, prevention and healthcare in cancer

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Efectividad de la simpatectomía lumbar en el tratamiento de la arteriopatía periférica oclusiva de miembros inferiores: revisión sistemática / Effectiveness of lumbar sympathectomy in the treatment of occlusive peripheral vascular disease in lower limbs: Systematic review

Fundamento y Objetivos: Este trabajo revisa la efectividad de la simpatectomía lumbar en el tratamiento de la enfermedad arterial periférica de miembros inferiores mediante una revisión sistemática. Material y Método: Revisión sistemática de la bibliografía. Fuentes de datos utilizadas: Medline, Embase, Cochrane Library, INHATA, CRD, BioMed Central y el registro de ensayos clínicos ClinicalTrials.gov. Los términos MeSH usados fueron “sympathectomy”, “peripheral vascular disease”, “lower extremity”, “vascular therapy”, “iliac artery”, “femoral artery” y “popliteal artery”. Se incluyeron pacientes adultos con arteriopatía periférica oclusiva de miembros inferiores tratados con simpatectomía lumbar. La calidad de los estudios se evaluó mediante los criterios del listado de comprobación CASP (Critical Appraisal Skills Programme) y un cuestionario realizado ad hoc. Resultados: Se incluyeron 4 ensayos clínicos y 4 estudios observacionales. La simpatectomía no aportó diferencias significativas en cuanto a mortalidad, amputaciones y gravedad de la claudicación intermitente. Cuando se valoró frente a anestésicos locales o prostaglandina E1 tampoco hubo diferencias. La simpatectomía química registró mejores resultados en relación con la estancia hospitalaria que la simpatectomía quirúrgica.Conclusiones: La evidencia sobre la eficacia de la simpatectomía no ofrece diferencias en relación con los tratamientos farmacológicos convencionales. Ambas técnicas de simpatectomía (quirúrgica y química) no presentan diferencias estadísticamente significativas en términos de mortalidad ni amputaciones (AU)

Background and Objectives: The aim of this work has been to check the scientific evidence on the efficacy of lumbar sympathectomy in the treatment of peripheral arterial disease of lower limbs. Material and Methods: Systematic review of the literature. Data Source: MedLine, Embase, Cochrane Library, INHATA, CRD, BioMed Central, and ClinicalTrials.gov register. Mesh terms: sympathectomy, peripheral vascular disease, lower extremity, vascular therapy, iliac artery, femoral artery, popliteal artery. Inclusion criteria: adult patients with occlusive peripheral arterial disease of lower limbs treated with sympathectomy. The quality was evaluated by means of the criteria of the CASP checklist and “ad hoc” questionnaire. Results: Four clinical trials and four observational studies were included. Sympathectomy did not show significant differences for mortality, amputations and grade of intermittent claudication. When it was assessed regarding local anaesthetics or prostaglandin-E1, differences were not detected. Chemical sympathectomy showed better results than surgical sympathectomy in hospital stance.Conclusions: Evidence on the efficacy of sympathectomy does not show differences related to conventional treatments. Both sympathectomy techniques (surgical and chemical) do not report statistical differences regarding mortality or amputations (AU)

[Effectiveness of lumbar sympathectomy in the treatment of occlusive peripheral vascular disease in lower limbs: systematic review]. / Efectividad de la simpatectomía lumbar en el tratamiento de la arteriopatía periférica oclusiva de miembros inferiores: revisión sistemática.

BACKGROUND AND OBJECTIVES: The aim of this work has been to check the scientific evidence on the efficacy of lumbar sympathectomy in the treatment of peripheral arterial disease of lower limbs. MATERIAL AND METHODS: Systematic review of the literature. DATA SOURCE: MedLine, Embase, Cochrane Library, INHATA, CRD, BioMed Central, and ClinicalTrials.gov register. Mesh terms: sympathectomy, peripheral vascular disease, lower extremity, vascular therapy, iliac artery, femoral artery, popliteal artery. INCLUSION CRITERIA: adult patients with occlusive peripheral arterial disease of lower limbs treated with sympathectomy. The quality was evaluated by means of the criteria of the CASP checklist and "ad hoc" questionnaire. RESULTS: Four clinical trials and four observational studies were included. Sympathectomy did not show significant differences for mortality, amputations and grade of intermittent claudication. When it was assessed regarding local anaesthetics or prostaglandin-E1, differences were not detected. Chemical sympathectomy showed better results than surgical sympathectomy in hospital stance. CONCLUSIONS: Evidence on the efficacy of sympathectomy does not show differences related to conventional treatments. Both sympathectomy techniques (surgical and chemical) do not report statistical differences regarding mortality or amputations.

Influencia de la población inmigrante en la variabilidad de la tasa de abortos entre comunidades autónomas / Influence of the immigrant population in the variability of the rate of abortions among autonomous communities

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Estado actual de la cirugía oncológica de mama en Andalucía y Cataluña / Current state of breast cancer surgery in Andalusia and Catalonia

Introducción La cirugía es un elemento esencial en el tratamiento del cáncer de mama. El objetivo del trabajo es describir la evolución y el estado actual de la cirugía oncológica de mama en Cataluña y Andalucía. Material y método Se llevó a cabo un estudio observacional basado en el análisis del Conjunto Mínimo Básico de Datos de Altas Hospitalarias en el período 1996–2005.ResultadosLa muestra incluyó a 37.537 mujeres de Cataluña y 24.186 de Andalucía. En el periodo estudiado se produjo un notable incremento de las tasas de hospitalización. Igualmente hay un marcado incremento en el porcentaje de casos intervenidos mediante cirugía conservadora. Sin embargo, esta difusión de la cirugía conservadora ha sido desigual por grupos de edad y tipo de centro. Conclusiones En conjunto se pone de relieve el aumento de la proporción de mujeres tratadas con mastectomía subtotal y la necesidad de estrategias que favorezcan la diseminación de intervenciones de probada efectividad (AU)

Background Surgery is an essential element of breast cancer treatment. The aim of this study was to describe the progress and current practice in oncological breast surgery in Catalonia and Andalusia. Material and method An observational study was conducted, collecting data from the Minimum Basic Data Set at Hospital Discharge. Results A total of 37,537 women from Catalonia and 24,186 from Andalusia were studied. The rate of admission due to breast cancer in women increased substantially during the study period, as well as the percentage of women who underwent breast-conserving surgery. However, the increase in breast-conserving surgery has not been consistent among age groups and hospital levels. Conclusions As a whole, the increase in breast-conserving surgery has shown the need for interventions to promote the use of procedures of proven effectiveness (AU)

[Current state of breast cancer surgery in Andalusia and Catalonia]. / Estado actual de la cirugía oncológica de mama en Andalucía y Cataluña.

BACKGROUND: Surgery is an essential element of breast cancer treatment. The aim of this study was to describe the progress and current practice in oncological breast surgery in Catalonia and Andalusia. MATERIAL AND METHOD: An observational study was conducted, collecting data from the Minimum Basic Data Set at Hospital Discharge. RESULTS: A total of 37,537 women from Catalonia and 24,186 from Andalusia were studied. The rate of admission due to breast cancer in women increased substantially during the study period, as well as the percentage of women who underwent breast-conserving surgery. However, the increase in breast-conserving surgery has not been consistent among age groups and hospital levels. CONCLUSIONS: As a whole, the increase in breast-conserving surgery has shown the need for interventions to promote the use of procedures of proven effectiveness.