Cancer mortality in Latin America: implications for prevention.


Journal of Public Health address the problem of detection and screening strategies for cancer prevention. One paper is on the diffusion of Pap smear tests for cervical cancer prevention in a high-risk area of South America (1), and the other is on prostate-specific antigen (PSA) and digital rectal examinations in the diagnosis of prostate cancer (2). A third study in this issue analyzes the incidence of cancer among Hispanic children in the United States of America, including mainly neoplasms of the lymphoid and hematopoietic system, many of which are amenable to treatment (3). These screening and diagnostic tests, as well as modern treatments for leukemias and Hodgkin’s lymphomas, are largely available in developed countries, such as those of North America (Canada and the United States) and Western Europe. As illustrated by the paper by Dzuba et al. (1), there have been some delays in the adoption of organized programs and strategies for cancer prevention and treatment in some countries of Central America and South America. Even in the United States there are racial and ethnic disparities in cancer incidence and mortality (3, 4), which suggests that not all segments of the population in the country benefit equally from progress in the prevention, early detection, and treatment of cancer. A recent paper provided an overview summary of cancer mortality in the Americas over the 1970-2000 period, with relevant implications for further investigation and public health intervention (5). Age-standardized (world population) mortality rates, derived from the World Health Organization (WHO) database (6), were presented for several cancers in 10 countries of Latin America with available and updated mortality and population data—Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Ecuador, Mexico, Puerto Rico (United States), and Venezuela—plus in Canada and the United States, for comparative purposes. This comprehensive analysis showed widely diverging patterns in total cancer mortality in the countries of Latin America, which reflect the variable mortality and trends for site-specific cancers. In 2000 the highest total male cancer mortality was seen in Argentina and Chile, with rates comparable to those of North America, i.e., about 155/100 000. For women, Chile and Cuba had the highest rates in Latin America (both over 100/100 000), again comparable to those of North America. These rates reflect the high mortality from cancer of the stomach (for Chile), lung and prostate (for Cuba) in men, stomach and cervix uteri (for Chile), and intestines and lung (for Cuba) in women. Colombia, Ecuador, and Mexico had the lowest male cancer mortality rates, due to low mortality from stomach, colorectal, and lung cancer. For women, the lowest rates were in Brazil and Puerto Rico, reflecting their low stomach and cervical cancer rates. In Argentina, Chile, Colombia, Costa Rica, and Venezuela, cancer mortality rates tended to decrease between 1970 and 2000, particularly among men. Rates were stable in Ecuador and Puerto Rico, and they increased in Cuba and Mexico. With reference to head and neck cancers, in the year 2000 the highest rates for oral/pharyngeal cancer mortality in men were in Brazil, Cuba, and Puerto Rico, with values around 5-6/100 000, i.e., 1.5-2.0-fold higher than the values from North America. Colombia, Ecuador, and Mexico showed the lowest rates, with values around 1-2/100 000. As in North America and several countries of Europe (7), a leveling out, or even a fall, in mortality from oral/pharyngeal cancer occurred in various countries of Latin America between 1990 and 2000. Mortality rates for cancer of the mouth/pharynx in women were very low (0.51.5/100 000) in most countries, and showed no appreciable change between 1970 Editorial

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@article{Bosetti2005CancerMI, title={Cancer mortality in Latin America: implications for prevention.}, author={Cristina Bosetti and Carlo La Vecchia}, journal={Revista panamericana de salud pública = Pan American journal of public health}, year={2005}, volume={18 1}, pages={1-4} }