Publications (2)0.27 Total impact
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ABSTRACT: Background: Since the middle of the last century, North America and occidental countries have reported variations in the frequency of gastrointestinal neoplasms. Several environmental factors, mainly nutritional and dietary exposure, as well as habits have contributed to these changes. We have documented these changes in Mexico during the last 35 years. Aims: To define the epidemiologic changes of gastrointestinal neoplasms during the last three decades in our population. Methods: We summarized the evidence of an observational study, registering the frequency of different gastrointestinal malignancies from four institutions of socioeconomically different populations in Mexico City during 35 years. The Mexican National Academy of Medicine supported this effort. During this period, two nutritional surveys took place, letting us define the relationship between dietary changes and cancer occurrence. Results: Replacement of gastric cancer by colorectal cancer as the leading gastrointestinal malignancy. Relationship between cancer and diet changes. Increase of esophageal adenocarcinoma in relation to epidermoid carcinoma secondary to gastroesophageal reflux and Barrett's esophagus rising incidence. Gall bladder cancer had a high frequency in one institution, probably related to genetic and racial factors. Conclusions: This epidemiologic data should lead us to implement sanitary measures for the prevention, early diagnosis, and appropriate treatment of gastrointestinal neoplasms.
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ABSTRACT: Digestive cancer is an important mortality cause in Mexico. In the past decades a change in the frequency of digestive malignancies has been observed. To evaluate the frequency of digestive malignancies in four hospitals in México City during a 25 years period. All digestive cancers were studied at the following hospitals: Hospital General de México (HGM), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirdn (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. 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 andp = 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 1987and 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, CMN2O0Nov: 3,133 y 2,262 kcal HE) and in animal protein intake, being lower at HGM (9.3 g/day) and IN-CMNSZ (11.8 g/day) compared with CMN2ONov (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. We observed a reduction in gastric cancer fre quency 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.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránTlalpam, The Federal District, Mexico