Gastric cancer mortality rate trend in Peru: Segmented regression model from 1995 to 2013

Abstract

Objective: To analyze the gastric cancer mortality trends in Peru from 1995 to 2013 and their differences by sex, age groups, political and geographic regions. Methods: Ecological time-series study based on 49,690 death records from the Ministry of Health, from 1995 to 2013; Crude, specific and standardized mortality rates (SMR) were calculated by year; according to sex; age group; political and geographic regions, to analyze trends by estimating joinpoints and annual percentage changes (APC); through segmented regression models using the Joinpoint Regression Desktop software version 4.5.0.0. Results: The SMR trend due to gastric cancer in Peru was decreasing, falling from 16.1 x 100 000 inhabitants. in 1995 to 11.4 x 100 000 inhabitants. in 2013 (CPA: -2.3), observing decreasing trends in 17 of 25 political regions. Differences were found: faster decrease in women (CPA -2.5) versus men (-2.0) and at older age (CPA for 75 - 79 years: -2.57 versus CPA for 40 - 44: -1.39); Three geographical areas with high mortality were identified: central Andes, northern area and central coast, there are growing trends in Huancavelica, Ayacucho and Pasco. On the Coast, mortality has decreased since 1998; in the Sierra and Selva it decreases significantly as of 2009. Conclusions: The trend of SMR due to gastric cancer was decreasing for the period 1995 - 2013 with disparities by sex, age groups, political and geographic regions.