Trends and Spatial Patterns of Oral Cancer Mortality in Ecuador, 2001-2016.

Solange Núñez-González,Daniel Simancas-Racines,Christopher Gault,J Andrés Delgado-Ron

doi:10.1155/2018/6086595

Solange Núñez-González, Daniel Simancas-Racines + Show 2 more

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https://doi.org/10.1155/2018/6086595

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Abstract

The aims of this study were to describe the temporal trend of OC from 2001 to 2016 and to analyze the space and space-time clusters of high mortality due to OC in Ecuador from 2011 to 2016. Methods. The present study is a mixed ecological study; the time trends were obtained using a Joinpoint regression model, space-time scan statistics was used to identify high-risk clusters, and Global Moran I index was calculated. Results. In Ecuador, between 2001 and 2016, OC caused a total of 1,025 deaths. Crude mortality rates significantly increased, with an APC (annual percentage change) of 2.7% (p=0.009). The age-standardized mortality rate did not significantly increase (APC: 1.73%; p=0.08). The most likely cluster was detected in 2015, included 20 cantons. The second cluster included 38 cantons, in the years 2014 to 2016. The Global Moran I index for the study period showed a negative spatial autocorrelation (−0.067; p=0.37). Conclusion. Mortality due to OC in Ecuador significantly increased over the 16-year study period, the young groups being the most affected. Ecuadorian provinces present high variability in types of OC and cancer rates.

Highlights

Oral cancer (OC) is a relevant problem of global public health due to its growing tendency and impact on the young population in the last decades [1, 2]
Death registries include “basic cause” of death coded according to the International Classification of Diseases (ICD), which we used for our temporal analysis
According to the area of residence, 81.56% (n 836) of deaths occurred in urban areas and 18.44% (n 189) in rural areas

Summary

Introduction

Oral cancer (OC) is a relevant problem of global public health due to its growing tendency and impact on the young population in the last decades [1, 2]. Deaths from OC increased by 2.6% between 2006 and 2016, while age-standardized death rates from OC showed a slight increase of 0.7% within the same period [3]. In South America, 15,868 new cases of lip and oral cavity cancer occurred in 2012, and 6,046 deaths were registered in the same year [4]. The South American region presented the second lowest mortality rate (1.2 : 100,000) [6] Mortality ranged from 0.72 to 6.04 per 100,000 population from 1999 to 2012; it is significantly decreasing in males from 2.5% to 2.1% in Argentina, Chile, Colombia, and Ecuador, while it is significantly increasing in women in Brazil and Peru [5].

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Discussion

Conclusion