Effect of healthcare fragmentation on breast, stomach, and colorectal cancer mortality in Colombia: A measurement estimated through administrative databases.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18808-e18808
Author(s):  
Nicolás Rozo Agudelo ◽  
Laura Estefania Saldaña Espinel ◽  
Andres Felipe Patiño Benavidez ◽  
Oscar Andres Gamboa Garay ◽  
Giancarlo Buitrago
Keyword(s):  
Colorectal Cancer ◽  
Survival Time ◽  
Cancer Mortality ◽  
Age Distribution ◽  
Mortality Rates ◽  
Administrative Databases ◽  
Primary Tumor Site ◽  
All Cause Mortality ◽  
Incident Cases ◽  
Colorectal Cancer Mortality

e18808 Background: Fragmentation in healthcare leads to adverse outcomes in cancer patients. Currently there is no fragmentation measurement that has been acknowledged to reliably assess healthcare fragmentation across different health systems. We aimed to measure cancer healthcare fragmentation through administrative databases in Colombia and to calculate its effect on breast, stomach and colorectal cancer mortality. Methods: We conducted a cohort study based on health administrative databases from 2013 to 2017. We combined data from two Colombian national health databases (Capitation Payment Unit database and Vital Statistics from DANE). We developed an algorithm based on ICD-10 codes and oncological procedures to select incident cases of breast, stomach and colorectal cancer. To measure healthcare fragmentation, we identified the number of providers between the dates of the first and last registered services. For patients who died during observation we adjusted the number of providers for survival time in days, otherwise survival time was set to 31 december, 2017. We categorized fragmentation in quartiles and evaluated its effect on mortality rate by Kaplan Meier estimates. Results: We identified three cohorts of patients based on primary tumor site. Age distribution was similar in stomach and colorectal cancer. Fragmentation measured as a continuous variable has a non-parametric distribution in all cohorts. The median of follow-up time ranged between 2.4 to 4.4 years. All-cause mortality rates were highest in stomach cancer, lowest in breast cancer. When measured as quartiles, fragmentation has a consistent dose-response effect increasing all-cause mortality rates. Conclusions: Healthcare fragmentation can be measured through algorithms applied to administrative databases in Colombia. Fragmentation is a predictor for all-cause mortality across different oncologic populations. This measurement based on real-world national administrative data could be used as an indicator of high-quality oncological healthcare for the Colombian healthcare system.[Table: see text]

scholarly journals Sustainable Development Goal 3.4: Regional disparities in cancer premature mortality in Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M De Camargo Cancela ◽  
L Borges Lopes de Souza ◽  
L F Leite Martins ◽  
A Correa Schilithz ◽  
D L Bezerra de Souza ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lung Cancer ◽  
Cervical Cancer ◽  
Sustainable Development ◽  
Cancer Mortality ◽  
Premature Mortality ◽  
Mortality Rates ◽  
Sustainable Development Goal ◽  
Development Goal ◽  
Colorectal Cancer Mortality

Abstract Background The Sustainable Development Goal 3.4 has a target of 1/3 reduction in premature mortality (30-69 years) from chronic noncommunicable diseases. Although cancer is a chronic disease, it comprises more than 100 different conditions, with different risk factors and prognosis. This study aimed to calculate current and predicted premature mortality by 2030 for Brazil and regions, compare with SDG 3.4 target and identify regional progress and future needs. Methods Mortality data were extracted from the National Mortality Information System of Brazil (SIM) and subsequently corrected for ill-defined causes. Crude and age-standardized mortality rates per 100,000 inhabitants were calculated. NordPred package by software R was used to calculate predictions up to 2030 and compared with the goal of 1/3 reduction of premature deaths. Results Comparison of observed (2011-2015) and predicted (2016-2030) mortality rates show a 12.0% reduction in the likelihood of death among men and 4.6% among women nationally. Although predicted rates for 2026-2030 are lower than those observed in 2011-2015 predicted number of deaths increases by 75,341 for men and 90,513 for women. Lung cancer mortality rates are predicted to decrease more among men than women, while colorectal cancer mortality will increase for both sexes, in all regions (except in the Southeast). Conclusions The profile of premature cancer mortality is diverse in Brazil. Nationally, only male lung cancer will be close to reaching SDG 3.4 target, endorsing government's long-term efforts to reduce tobacco consumption. The increase in colorectal cancer mortality reflects the epidemiological transition. Despite progress in cervical cancer control, it will continue to be a major challenge. Our results provide a baseline for public policies for both prevention and access to treatment to reduce premature mortality in Brazil. Differences in mortality patterns highlight the need to adapt cancer prevention policies regionally. Key messages Cancer premature mortality decrease in Brazil is expected to occur, but far from the SDG 3.4 target – including preventable cancers as cervical cancer. An increase is expected to occur in colorectal premature cancer mortality rates and strategies to face it need to be developed regionally.

Disparities in cancer premature mortality in Brazil: Predictions up to 2030 and sustainable development goals.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13614-e13614
Author(s):  
Marianna De Camargo Cancela ◽  
Leonardo Borges Lopes de Souza ◽  
Luis Felipe Leite Martins ◽  
Arthur Correa Schilithz ◽  
Dyego Souza ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lung Cancer ◽  
Sustainable Development ◽  
Cancer Mortality ◽  
Sustainable Development Goals ◽  
Premature Mortality ◽  
Mortality Rates ◽  
Mortality Data ◽  
Development Goals ◽  
Colorectal Cancer Mortality

e13614 Background: Premature mortality affects the economy directly due to the loss of productivity of individuals who decease, thus ceasing to contribute economically to the country. The 1/3 reduction in premature mortality (30-69 years) from chronic noncommunicable diseases is goal 3.4 of the UN Sustainable Development Goals (SDG). Although cancer is a chronic disease, it comprises more than 100 different conditions, with different risk factors and prognosis. This study aimed to calculate current and predicted premature mortality by 2030 for Brazil and regions, compare with SDG 3.4 target and identify regional progress and future needs. Methods: Mortality data were extracted from the National Mortality Information System of Brazil (SIM) and subsequently corrected for ill-defined causes. Crude and age-standardized mortality rates per 100,000 inhabitants were calculated. NordPred package by software R was used to calculate predictions up to 2030 and compared with the goal of 1/3 reduction of premature deaths. Results: Comparison of observed (2011-2015) and predicted (2016-2030) mortality rates show a 12.0% reduction in the likelihood of death among men and 4.6% among women nationally. Although predicted rates for 2026-2030 are lower than those observed in 2011-2015 predicted number of deaths increases by 75,341 for men and 90,513 for women. Lung cancer mortality rates are predicted to decrease more among men than women, while colorectal cancer mortality will increase for both sexes. Conclusions: The profile of cancer premature mortality is diverse in Brazil. Nationally, only male lung cancer will be close to reaching SDG 3.4 target, endorsing government’s long term efforts to reduce tobacco consumption. Colorectal cancer mortality increases in most regions, reflecting the epidemiological transition. Despite progress in cervical cancer control, it will continue to be a major challenge, especially in the North and Northeast. Our results provide a baseline for public policies for both prevention and access to treatment to reduce premature mortality in Brazil. Differences in cancer patterns show the need to plan and to adapt regionally for each reality.

scholarly journals MORTALITY RISK OF COLORECTAL CANCER IN BRAZIL FROM 1980 TO 2013

2016 ◽  
Vol 53 (2) ◽  
pp. 76-83 ◽  
Author(s):  
Ronaldo Coimbra OLIVEIRA ◽  
Marco Antônio Vasconcelos RÊGO
Keyword(s):  
Colorectal Cancer ◽  
Cancer Mortality ◽  
Statistical Tests ◽  
Age Groups ◽  
Developed Countries ◽  
Mortality Rates ◽  
Significance Level ◽  
Risk Of Death ◽  
The Us ◽  
Colorectal Cancer Mortality

ABSTRACT Background - Colorectal cancer is one of the most common cancer worldwide, and variation in its mortality rates indicates the importance of environmental factors in its occurrence. While trend studies have indicated a reduction in colorectal cancer mortality rates in most developed countries, the same trends have not been observed in developing countries. Moreover, trends may differ when analyzed by age and sex. Objective - The present study aimed to analyze the trends in risk of colorectal cancer death in Brazil based on sex and age group. Methods - Death records were obtained from the Mortality Information System of the Ministry of Health. The risk of death and the average annual percent changes (AAPC) in the mortality rates were estimated using joinpoint analysis of long-term trends from 1980 to 2013. All of the statistical tests were two-sided and had a significance level of 5%. Results - Colorectal cancer mortality rates were found to have increased in the last 15 years for both sexes and for all age ranges. The rate ratio (RR) was statistically higher at ages 70 to 79 for men (RR: 1.37; 95% CI: 1.26; 1.49) compared to women (RR: 1.14; 95% CI: 1.06; 1.24). Increases in AAPC were observed in both sexes. Although men presented higher percent changes (AAPC: 1.8; 95% CI: 1.1; 2.6) compared to women (AAPC: 1.2; 95% CI: 0.4; 2.0), this difference was not statistically significant. Growth trends in mortality rates occurred in all age groups except for in women over 70. Conclusion - Unlike Europe and the US, Brazil has shown increases in death rates due to colorectal cancer in the last three decades; however, more favorable trends were observed in women over 70 years old. The promotion of healthier lifestyles in addition to early diagnosis and improved treatment should guide the public health policies targeting reductions in colorectal cancer.

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