TY - JOUR
T1 - Cervical cancer mortality in Peru
T2 - regional trend analysis from 2008–2017
AU - Torres-Roman, J. Smith
AU - Ronceros-Cardenas, Luz
AU - Valcarcel, Bryan
AU - Arce-Huamani, Miguel A.
AU - Bazalar-Palacios, Janina
AU - Ybaseta-Medina, Jorge
AU - La Vecchia, Carlo
AU - Alvarez, Christian S.
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Background: Cervical cancer is the third leading cause of cancer-related death among Latin American women. Peru has the sixth highest mortality rate for cervical cancer in the region with regional variations. We aimed to determine overall and regional cervical cancer mortality rates and trends in Peru between 2008 and 2017. Methods: We performed an ecological study on the number of deaths by cervical cancer in Peru. Deaths were extracted from the Peruvian Ministry of Health mortality database. Age-standardized mortality rates (ASMR) were estimated per 100,000 women-years using the world standard Segi population. We computed mortality trends using the Joinpoint regression program, estimating the annual percent change (APC). For spatial analysis, GeoDA software was used. Results: Peru showed downward trends in the last decade (from 11.62 in 2008 to 9.69 in 2017 (APC = − 2.2, 95% CI: − 4.3, − 0.1, p < 0.05). According to regional-specific analysis, the highest ASMR was in the rainforest region, although this declined from 34.16 in 2008 to 17.98 in 2017 (APC = − 4.3, 95% CI: − 7.2, − 1.3, p < 0.01). Concerning spatial analysis and clustering, the mortality rates from 2008 to 2017 showed a positive spatial autocorrelation and significant clustering (Moran’s I: 0.35, p < 0.001) predominantly in the neighboring North-East departments (Loreto, Ucayali, and San Martin). Conclusions: Although mortality trends in the entire population are decreasing, mortality rates remain very high, mainly in the rainforest region. Our results encourage a need for further development and improvement of the current health care delivery system in Peru.
AB - Background: Cervical cancer is the third leading cause of cancer-related death among Latin American women. Peru has the sixth highest mortality rate for cervical cancer in the region with regional variations. We aimed to determine overall and regional cervical cancer mortality rates and trends in Peru between 2008 and 2017. Methods: We performed an ecological study on the number of deaths by cervical cancer in Peru. Deaths were extracted from the Peruvian Ministry of Health mortality database. Age-standardized mortality rates (ASMR) were estimated per 100,000 women-years using the world standard Segi population. We computed mortality trends using the Joinpoint regression program, estimating the annual percent change (APC). For spatial analysis, GeoDA software was used. Results: Peru showed downward trends in the last decade (from 11.62 in 2008 to 9.69 in 2017 (APC = − 2.2, 95% CI: − 4.3, − 0.1, p < 0.05). According to regional-specific analysis, the highest ASMR was in the rainforest region, although this declined from 34.16 in 2008 to 17.98 in 2017 (APC = − 4.3, 95% CI: − 7.2, − 1.3, p < 0.01). Concerning spatial analysis and clustering, the mortality rates from 2008 to 2017 showed a positive spatial autocorrelation and significant clustering (Moran’s I: 0.35, p < 0.001) predominantly in the neighboring North-East departments (Loreto, Ucayali, and San Martin). Conclusions: Although mortality trends in the entire population are decreasing, mortality rates remain very high, mainly in the rainforest region. Our results encourage a need for further development and improvement of the current health care delivery system in Peru.
KW - Cervical cancer
KW - Epidemiology
KW - Indigenous population
KW - Mortality
KW - Peru
KW - Trends
UR - http://www.scopus.com/inward/record.url?scp=85099821806&partnerID=8YFLogxK
U2 - 10.1186/s12889-021-10274-1
DO - 10.1186/s12889-021-10274-1
M3 - Artículo
C2 - 33499858
AN - SCOPUS:85099821806
SN - 1471-2458
VL - 21
JO - BMC Public Health
JF - BMC Public Health
IS - 1
M1 - 219
ER -