Inequidades en salud: análisis sociodemográfico y espacial del cáncer de mama en mujeres de Córdoba,Argentina

Objective

To identify sociodemographic determinants associated with the spatial distribution of the breast cancer incidence in the province of Córdoba, Argentina, in order to reveal underlying social inequities.

Distribución municipal de la incidencia de los tumores más frecuentes en un área de elevada mortalidad por cáncer

Objective

To describe the geographic distribution patterns of the municipal incidence of the most common tumours in the Huelva province (Spain) as compared to the estimated incidence for all of Spain.

Guía de buenas prácticas de seguridad informática en el tratamiento de datos de salud para el personal sanitario en atención primaria

The appearance of electronic health records has led to the need to strengthen the security of personal health data in order to ensure privacy. Despite the large number of technical security measures and recommendations that exist to protect the security of health data, there is an increase in violations of the privacy of patients’ personal data in healthcare organizations, which is in many cases caused by the mistakes or oversights of healthcare professionals. In this paper, we present a guide to good practice for information security in the handling of personal health data by health personnel, drawn from recommendations, regulations and national and international standards. The material presented in this paper can be used in the security audit of health professionals, or as a part of continuing education programs in ambulatory care facilities.     

Representatividad del Registro de Tumores Torácicos de España. Comparación de datos sociodemográficos con otros registros nacionales

ObjectiveIn Spain, due to the lack of data at national level a lung cancer registry, the Thoracic Tumour Registry (TTR), was created. Such registry should demonstrate comparability with population-based data to ensure representativeness at population level. The aim is to compare the socio-demographic characteristics of the TTR with incidence data from the Red de Registros de Cáncer (REDECAN) and mortality data from the Instituto Nacional de Estadística (INE).MethodLung cancer data sources available to date, REDECAN and INE, were used. Lung cancer cases overall and disaggregated by sex and age groups were collected from each source of information and data were compared for the period 2017-2020. Sex and age group proportions of TTR were calculated for both databases (which collect incidence and mortality data), for the entire study period and broken down by year.ResultsA total of 17,109 incident lung cancer cases from the TTR, 58,668 estimated incident cases from REDECAN and 88,083 deaths registered from INE between 2017 and 2020 were included. In terms of sex, the proportions are very similar between the three sources and the differences do not exceed 4%. In terms of age, the differences are not large, being larger for mortality data in the older age group from the INE versus the TTR.ConclusionsThe TTR seems to be representative of lung cancer cases diagnosed in Spain between 2019 and 2020, both by sex and age. This allows us to accurately characterise the status of this disease, which is the leading cause of cancer death in Spain, and that the analysis of results obtained from the RTT can be applied to cases of lung cancer diagnosed in our country.     

Hábitos saludables y prevención de la osteoporosis en mujeres perimenopáusicas de un ámbito rural

ObjectiveThe probability of developing osteoporosis decreases with an adequate supply of vitamin D, a balanced diet, and increased physical activity. In this study, we evaluated whether an educational intervention improves osteoporosis-related behavior in perimenopausal women from rural areas.MethodsA randomized experimental evaluation was performed of an educational intervention. The variables were physical activity, calcium intake and sun exposure in women from rural areas aged 45-54 years (n = 216) at time 0 and 12 months after the educational intervention. In the control group (n = 106), the information was sent by surface mail (month 0). In the intervention group (n = 110), two interactive workshops were given (month 0). The topic of the workshops and the information sent by surface mail was healthy habits for osteoporosis prevention.ResultsAfter 12 months, the intervention group, but not the control group, had increased their physical activity (p = 0.006), sun exposure (p = 0.029), and calcium intake (53% to 64%).ConclusionA simple educational intervention in perimenopausal women from rural areas improved healthy habits for osteoporosis prevention.     

Conocimientos tácito y explícito: análisis comparativo de la priorización de problemas de salud materna en México

Objective

To identify coincidences and differences in the identification and prioritization of maternal healthcare service problems in Mexico based on the perspective of tacit knowledge and explicit knowledge that may offer evidence that can contribute to attaining the Sustainable Development Goals.

Supervivencia por estadio del cáncer de cuello uterino en Mallorca y factores asociados recogidos por el Registro de Cáncer

ObjectiveTo ascertain the survival by stage of cervical cancer in Mallorca (Spain), to explore factors collected by the Mallorcan Cancer Registry associated with survival, and to determine the distribution of cervical cases by stage.MethodRetrospective follow-up study of cases diagnosed with cervical cancer between 2006 and 2012 through the Mallorcan Cancer Registry. Cases identified only by death certificate were excluded. Variables: age; date and method of diagnosis; histology (ICD-O 3 rd ed.); TNM and stage (UICC 7 th ed.); date of follow-up or death and cause of death. Follow-up ended on 31 of December 2015. Multiple imputation was used for missing stage cases. Actuarial and Kaplan-Meier methods were used for survival analysis and Cox regression models to identify factors that explain and predict survival.Results321 cases were identified. The stage was missing in 8.4% of cases. After multiple imputation, 42.63% were stage I, 24.01% stage II, 19.94% stage III and 13.42% stage IV. Survival was 63% at 5 years: 92% for women diagnosed in stage I, 59% in stage II, 37% in stage III and 18% in stage IV. Stage and age were associated to survival.ConclusionsDiagnosis of cervical cancer in stage I is essential. Less than half of the women were diagnosed in stage I. Cervical cancer screening programmes must be improved.     

Antecedentes familiares de primer grado como factor de riesgo en el cáncer colorrectal

ObjectiveTo evaluate the association between first-degree family history and colorectal cancer (CRC).MethodWe analyzed data from 2857 controls and 1360 CRC cases, collected in the MCC-Spain project. The adjusted odds ratio (OR) and 95% confidence interval (95% CI) of association with the family history of CRC was estimated by non-conditional logistic regression.ResultsFirst-degree relatives doubled the risk of CRC (OR: 2.19; 95% CI: 1.80–2.66), increasing in those with two or more (OR: 4.22; 95% CI: 2.29–7.78) and in those whose relatives were diagnosed before 50 years (OR: 3.24; 95% CI: 1.52–6.91). Regarding the association of the family history with the location, no significant differences were observed between colon and rectum, but there were in the relation of these with the age of diagnosis, having more relatives those diagnosed before 50 years (OR: 4.79; 95% CI: 2.65–8.65).ConclusionsFirst-degree relatives of CRC increase the chances of developing this tumor, they also increase when the relative is diagnosed at an early age. Therefore, it must be a target population on which to carry out prevention measures.     

Análisis del uso racional de antihipertensivos en la región de Murcia

ObjectiveThe objective of this study was to determine the pattern of use of antihypertensive drugs in the Murcia Region, comparing the results with the national data, and detecting problems in order to make improvements, or establish hypotheses and to plan new studies.DesignPharmacoepidemiological study (from 2004 to 2008) in accordance with the recommendations from World Heath Organization.Setting: Murcia Region.ParticipansAnnual census of each year.Main measurementsThe use of antihypertensive drugs was measured by the daily doses per 1000 inhabitans-day (DHD).ResultsThe use of antihypertensive drugs has significantly increased from 196.6 DHD to 235.8 DHD. The antihypertensives more used at the end of 2008 were: angiotensin II receptor blockers–ARB- (38.6%) and angiotensin converting enzyme inhibitors–ACEI- (21.8%). There has been a tendency to change the use of rennin-angiotensin system blockers–RASB-, with an increase in ARB of 77.5% and and a decrease in ACEI 9.5%. The comparison with the national data shows qualitative and quantitative differences in the pattern of antihypertensive drugs used during the studied period.ConclusionsThe use of antihypertensive drugs in Murcia is less than in the rest of Spain. Therefore, this may be due to a problem of under treatment of this illness or other cardiovascular illnesses in the region. A greater use of ARB in Murcia and a lower use of ACEI was observed in Murcia. The differences found suggest that further studies are required to clarify their origins and causes, with the objective of achieving a more rational and efficient use of these drugs.     

Facilitando la salud comunitaria. Indicadores básicos de salud por área básica de salud en Cataluña

Health depends mostly on factors that lay outside the health system, such as socioeconomic determinants. Intersectorality and participation are key elements for an integrated care person and community centred. In Catalonia, the National Primary Health and Community Strategy aims to reinforce primary health care, so that it becomes the backbone of the health system and with a strong community orientation. To deploy a community oriented primary health care it is important to count with reliable and robust data by small areas. Thirty-eight basic indicators were selected for each of the 370 primary health care in Catalonia. Indicators were calculated and presented following the social determinants model: demographic (4), socioeconomic (3), morbidity (9), mortality (6), lifestyles (4), preventive practices (1), resources and use of health services (9) and physical environment (2). These indicators will allow health professionals to carry out local health assessments in a fast and systematic manner.     

Variaciones en el proceso de confirmación diagnóstica entre unidades de cribado poblacional de cáncer de mama

ObjectiveTo analyse variations in the diagnostic confirmation process between screening units, variations in the outcome of each episode and the relationship between the use of the different diagnostic confirmation tests and the lesion detection rate.MethodObservational study of variability of the standardised use of diagnostic and lesion detection tests in 34 breast cancer mass screening units participating in early-detection programmes in three Spanish regions from 2002–2011.ResultsThe diagnostic test variation ratio in percentiles 25–75 ranged from 1.68 (further appointments) to 3.39 (fine-needle aspiration). The variation ratio in detection rates of benign lesions, ductal carcinoma in situ and invasive cancer were 2.79, 1.99 and 1.36, respectively. A positive relationship between rates of testing and detection rates was found with fine-needle aspiration-benign lesions (R²: 0.53), fine-needle aspiration-invasive carcinoma (R²: 0 28), core biopsy-benign lesions (R²: 0.64), core biopsy-ductal carcinoma in situ (R²: 0.61) and core biopsy-invasive carcinoma (R²: 0.48).ConclusionsVariation in the use of invasive tests between the breast cancer screening units participating in early-detection programmes was found to be significantly higher than variations in lesion detection. Units which conducted more fine-needle aspiration tests had higher benign lesion detection rates, while units that conducted more core biopsies detected more benign lesions and cancer.