2006, Number 4
Gastrointestinal cancer in four medical centers in Mexico City. A 25-year study.
Villalobos PJJ, Olivera MMA, Loaeza C, Villalobos ML, Torres VGM
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Language: Spanish
References: 0
Page: 460-472
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ABSTRACT
Background: Digestive cancer is an important mortality cause in Mexico. In the past decades a change in the frequency of digestive malignancies has been observed. Aim: To evaluate the frequency of digestive malignancies in four hospitals in México City during a 25 years period. Patients and Methods: All digestive cancers were studied at the following hospitals: Hospital General de México (HGM), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Centro Médico Nacional 20 de Noviembre (CMN20Nov) and Hospital Español (HE). The diagnosis was established by histopathology study. Cases frequency is were compared in three-years intervals. Results: 8,879 digestive cancers were documented. Gastric cancer frequency decreased during the study period at HGM (59% in 1978 to 38% in 2003) and at INCMNSZ (32% in 1978 to 24% in 2003), p = 0.013 and p = 0.012 respectively. Colon cancer frequency increased significantly at HGM (15% in 1978 to 36% in 2003, p ‹ 0.001) and at CMN20Nov (20% in 1981 to 51% in 2003, p ‹ 0.01) and at INCMNSZ with tower significancy. A change in squamous esophageal cancer (SC) and esophageal adenocarcinoma (EA) frequencies was observed in at the INCMNSZ, with a SC:EA ratio of 7:1 between 1977 to 1987 and 1:2 between 1988 to 2005. Alimentary habits questionnaries showed early during the study diferences in caloric intake between the four hospitals (mean HGM: 2,169 kcal, INCMNSZ: 2,195 kcal, CMN20Nov: 3,133 y 2,262 kcal HE) and in animal protein intake, being lower at HGM (9.3 g/day) and INCMNSZ (11.8 g/day) compared with CMN20Nov (45.6 g/day) and HE (63.4 g/day), in the next questionnary these differences dissapeared and there was an increase in both, the same was observed for lipid intake. Conclusions: We observed a reduction in gastric cancer frequency and an increase in colon cancer in 25 years, probably associated to a change in habits dietary. Also a change in the main histological type of esophageal cancer was observed, initially epidermoid cancer was the most frequent and in the last 10 years adenocarcinoma is the most frequent.