Trends in cancer mortality in the elderly and oldest old in South America.

Abstract

Background: Little is known about trends in cancer among the older segments of the population, even less for South America.

Objective: To describe time trends in mortality of the most frequent causes of cancer death among the population aged 70 and over.

Methods: Using the World Health Organization´s Cancer Mortality Database, we studied trends in mortality from lung, colorectal, stomach, liver, prostate, breast, and cervical cancer from 1985 onwards. Joinpoint analyses allow discerning changes in average annual percent change (i.e., slope AAPC) of these trends over time.

Results: The region has a 2-3-fold variation in absolute age-specific cancer mortality rates, with the lowest rates in Argentina and Paraguay and the highest in Chile, Uruguay, and Venezuela. In most countries except for Brazil and Paraguay (both sexes), Peru (females and males 80 +), and Venezuela (males), overall cancer mortality rates were declining in the studied age range, with some fluctuations during the period. The most common causes by sex vary throughout the continent and by age group, but overall, increasing trends were observed for colorectal and breast cancer. In all countries, time trends show reductions in mortality from stomach cancer (AAPC up to -4.77 %) and in some countries (Argentina, Chile, Colombia, and Ecuador AAPC between -0.04 % and -4.37 %) for cervical cancer. In the other countries, cervical cancer mortality remained stable. Lung cancer declined in all countries in males (AAPC between -0.39 % and -2.24 %) except Brazil, Paraguay and the eldest males in Venezuela but among females, increases were observed in most countries (AAPC between +0.47 % and +4.05 %).

Conclusions: Cancer-specific mortality rates vary considerably between countries in South America and the high cancer mortality rates in the oldest segments of the population. Effective primary prevention strategies, vaccination implementation, early detection, effective treatment programs, and better access to healthcare overall can positively impact the trends.