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Infection and cancer
O2-1.5 Cervical and breast cancer in Latin America: a neoplastic transition
  1. S Lewis1,
  2. H Gómez Dantés1,
  3. R Lozano2
  1. 1National Institute of Public Health, Cuernavaca, Morelos, Mexico
  2. 2Institute for Health Metrics and Evaluation, Seattle, Washington, USA

Abstract

Introduction Demographic and epidemiologic transitions in Latin American and Caribbean countries have contributed to shifts in the main types of cancers that affect women, characterised by differential burdens of cancer associated with a country's stage of demographic transition.

Methods We compiled statistics from literature indexes, registries and databases on breast and cervical cancer morbidity, mortality, and disability-adjusted life years for 28 LAC countries. Incidence was analysed over time and mortality and DALYs were analysed descriptively and comparatively to arrive at proportional burdens of each cancer. Case-fatality ratios were calculated and plotted against single-year incidence rates.

Results Countries further advanced in their demographic transitions have a greater magnitude of breast cancer, namely in the anglophone Caribbean, Uruguay, and Argentina. Cervical cancer burden is generally greater in Andean and Central American countries and Haiti, which are in earlier stages of demographic transition. Case-fatality ratios for breast cancer range from 0.28 in the Dominican Republic to 0.49 in Cuba, and decrease as incidence rates increase. Cervical cancer ratios vary between 0.34 in Puerto Rico and Argentina to more than 0.50 in nine LAC countries and tend to increase with increased incidence. Bolivia, Honduras, Guatemala and Haiti have ratios above 0.45 for both cancers.

Conclusions Mortality is unacceptably high for both cancers due to lack of early detection and inadequate resources for effective treatment. Since the risk factors that cause breast cancer are largely un-modifiable and tend to increase with economic development, its share of the burden is likely to grow.

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