Artigo

Situación de la salud mamaria en el mundo y en latinoamérica en particular

MAIRA CALEFFI, BENJAMIM O. ANDERSON

Revista médica Clínica Las Condes , v. 17, n. 4, p. 137-141, 2006.

Motivo: Produção Corpo Clínico

Setor HMV: Nucleo Mama Moinhos

Área da saúde: Mastologia

Resumo: El cáncer de mama es el cáncer más común entre las mujeres en el mundo y es la causa más frecuente de muerte por cáncer en la mujer. Se reportan tasas de incidencia y mortalidad de este cáncer en el continente americano. La práctica clínica, en países con recursos limitados, con relación al cáncer de mama, puede obligar a los médicos a tomar decisiones contrarias a su conocimiento y a lo que indican las guías clínicas internacionales. El desarrollo de los métodos de diagnóstico y de tratamiento alcanzado en los países ricos, no necesariamente se puede trasladar a los países más pobres. En 2002 se creó la Iniciativa Global para la Salud Mamaria, que es una alianza internacional la cual ha desarrollado guías clínicas basadas en evidencia para países con recursos limitados, con el propósito de colaborar en mejorar la calidad de la atención de las enfermedades de la mama. La última revisión de dichas guías fue publicada en 2005 y en octubre del 2007 se realizará una nueva reunión cuyos pasos estarán dirigidos a la implementación programática de éstas en los países con recursos limitados. KEY WORDS: breast cancer, limited resource countries, diagnosis, early detection, screening, treatment, guideline, health care systems, health planning, international health problems, pathology, public policy, recommendations, resource allocation. Globally, breast cancer is the most common cancer among women and is the most likely reason that a woman will die of cancer. Each year, breast cancer is newly diagnosed in more than 1.1 million women, representing more than 10% of all new cancer cases. With over 410,000 deaths each year, breast cancer accounts for over 1.6% of all female deaths worldwide (1, 2). Countries with established and adequately funded health care systems have higher breast cancer diagnosis rates, but also have improved breast cancer survival (3). Breast cancer is becoming an increasingly urgent problem in low resource regions where incidence rates have been rising by up to 5% per year (4). Despite the common impression that breast cancer is a disease of wealthy countries, the majority of breast cancer deaths occur in developing countries (5). Among the Americas, breast cancer incidence is highest in North America (99 / 100,000) and lowest in Central America (26 / 100,000), as estimated by the International Agency for Research on Cancer (IARC) (2). South America’s breast cancer incidence is intermediate between the two (46 / 100,000) (Figure 1a). Breast cancer incidence varies widely among South American countries. The highest risk South American countries include Argentina (74 / 100,000) and Uruguay (83 / 100,000); the lowest include Bolivia (25 / 100,000) and Ecuador (24 / 100,000) (Table 1). In all regions, the breast cancer age incidence curves are biphasic. The steepest rise in incidence occurs in women under age 45. The likelihood of breast cancer continues to increase in women in their 50s and 60s, but at a slower rate of rise than in the premenopausal years (Figure 2a). The rise in postmenopausal breast cancer is greatest in North America. Breast cancer mortality rates vary similarly to incidence rates among countries in the Americas, but the numbers are more tightly clustered (Figure 1b), ranging from 19 / 100,000 in North America to 11 / 100,000 in Central America. The ratio of mortality to incidence in a country approximates case-fatality rates in that country. The mortality to incidence ratio is the most favorable in North America (19%) and least favorable in Central America (41%), suggesting that early breast cancer detection, which occurs in conjunction with screening programs, increases the known incidence of breast cancer within a country, but effectively saves lives by down-staging disease (Table 1). Breast cancer age mortality curves also show a biphasic pattern (Figure 2b). Mortality curves nearly overlap for women < 45 years in North, Central and South America. The differences in breast cancer mortality among the Americas are greatest among older women. Postmenopausal breast cancer appears to be a bigger problem in North America than it does in Central America, with South America midway between the two. Comparing the Americas, breast cancer appears to be the most different among postmenopausal women and the most similar among premenopausal women.

Envie um e-mail para os autores

© Copyright 2010 Hospital Moinhos de Vento - Todos os Direitos Reservados

Hospital Moinhos de Vento - Rua Ramiro Barcelos 910 - Bairro Moinhos de Vento - Porto Alegre - RS , CEP: 90035-001 - Fone: (51) 3314 - 3434

Hospital Moinhos de Vento Iguatemi - Shopping Iguatemi 3º andar - Porto Alegre - RS, CEP: 91340-001 - Fone: (51) 3327 - 7000

Responsável Técnico - Dr. Luiz Antonio Nasi - CREMERS 11217

Fale Conosco | Ouvidoria | Trabalhe Conosco | Localize e Visite | Mapa do Site