cancer in chile brief introduction
TRANSCRIPT
Latin American Breast Cancer Pilot Project Meeting
CHILE’s Brief Introduction
Bethesda, Md March 2009
CHILECHILE 2008
Departamento de Estadísticas e Información de Salud, 2006 Ministerio de Salud de Chile-FONASA 2006
Total population• 16,763,470Male to Female Index• 98%Urban : 85%Beneficiaries• Public Insurance 70.4%• Private Insurance 15.3%
CHILECHILE 2008
Departamento de Estadísticas e Información de Salud, 2006 Ministerio de Salud de Chile-FONASA 2006
GDP p/c US$ 9,876
Gini coefficient 0.538
Gini Coefficient (0.538)
CHILECHILE 2008
Departamento de Estadísticas e Información de Salud, 2006 Ministerio de Salud de Chile-FONASA 2006
GDP p/c US$ 9,876
Gini coefficient 0.538
Literacy: 95.7%
Human Development Index: 0.874
Human Development Index (0.874 – 40º)
CANCER IN CHILECANCER IN CHILE
EPIDEMIOLOGY
- Estimated incidence: 240 new cases x 100,000 inhabitants.
-36500 new cases each year.
-400 to 480 in children (< 15 years)
EPIDEMIOLOGY
- Second cause of death
- Adjusted Mortality Rate: 104.7 x 100.000 h
- 70% in elder than 60 years old
CANCER IN CHILECANCER IN CHILE
ONCOLOGY: The PUBLIC HEALTH SYSTEM REPLY
• 42 “Breast Pathology” Units• 43 “Cervix Pathology” Units• 13 Pediatric Treatment Centers • 21 Adults Treatment Centers
• Radiotherapy : 5 Regional Centers
• One Pediatric Bone Marrow Transplantation Unit• One Adult Bone Marrow Transplantation Unit (in
process).• 53 Palliative Care Units
DEIS 2005
MORTALITY RATE MALE CANCER
MAIN LOCALIZATIONS CHILE 2006
3,8
3,8
25,4
18,4
6,4
5,3
18,3
5,3
4,9
5,0
2,1
4,2
0 10 20 30
STOMACH
LUNGS
PROTATE
GALLBLADDER
ESOPHAGUS
COLON
PANCREAS
LIVER
RECTUM
KIDNEY
LEUKEMIA
LYMPHOMA
FOD.: INE-MINSAL Unidad de Cáncer
n = 10.392
Rate x 100,000 men
MORTALITY RATE FEMALE CANCER
MAIN LOCALIZATIONS CHILE 2006
3.3
3.5
4.5
3.6
4.0
6.3
7.1
9.4
8.3
13.5
12.6
15.7
0 5 10 15 20
GALLBLADDER
STOMACH
BREAST
UTERUS
LUNGS
COLON
PANCREAS
OVARY
ESOPHAGUS
LIVER
LEUKEMIA
LYMPHOMA
FOD.: INE-MINSAL Unidad de Cáncer
n = 9.661
Rate x 100,000 women
0
2
4
6
8
10
12
14
16
18
20
20062005200420032002200120001999
Gallbladder Stomach Breast Lungs Cervix
Rate x 100,000
FEMALE CANCER MORTALITY, 5 MAIN CAUSES CHILE, 1999 - 2006
Source: Health Ministry, Chile
0
5
10
15
20
25
30
15-2
4
25-3
4
35-4
4
45-5
4
55-6
4
65 y
74
75 y
más
Ignor
ado
%
2004 n= 2.306 2005 n = 2.338 2006 n= 2.667
63,3
34,1
2,3
< 35 years 35 - 64 years> 64 yearsUnknown
Breast Cancer Incidence, grouped by age, Public Health System only, Chile 2004 - 2006
2006
Source: Cancer Unit/ M. Prieto/ Health Ministry
BREAST CANCER: Crude and Adjusted Mortality Rate, CHILE 1990 - 2005
10
12
14
16
AÑOS
Tas
a p
or
100.
000
Mu
jere
s
Total Ajustada
Total 12,4 12,2 11,7 11,7 11,9 13,0 13,2 12,0 13,1 12,8 13,4 13,2 13,3 13,3 13,5 14,2
Ajustada 13,1 12,6 11,9 11,7 11,8 12,7 12,7 11,3 12,2 11,7 12 11,6 11,4 11,3 11,3 11,6
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Unidad de Cáncer-MINSAL/ Matrona – MSP Marta Prieto M.
11,6% Reduction
Source: Health Ministry, Chile
Breast Cancer Incidence: Percentage Distribution, grouped by Stages at Diagnosis (Public Health System), Chile 1999 - 2006
Source: Cancer Unit/ M. Prieto/ Health Ministry
0
5
10
15
20
25
30
35
40
45
50
55
60
65
70
75
1999 n = 1.408
2000 n= 1.693
2001 n= 1.803
2002 n= 2.105
2003 n= 2.160
2004 n= 2.311
2005 n= 2.338
2006 n= 2.634
In situ-Stage I- II Stage III Stage IV No Inform.
Increase in Early Stages Diagnosisfrom 42,9 to 70,1%
CHALLENGES
• Improve in early detection– Cost Effective and Affordable Interventions
• Improve in Treatment– “Personalized” treatment
CHALLENGES:
INVESTIGATION
COLLABORATIVE WORK