Gastric Cancer Epidemiology in Norte De Santander, Colombia. 2007-2011

Abstract

Introduction: In Colombia, gastric cancer is considered for several years as a significant social burden, occupying as the same that the Norte de Santander department, the second place in incidence and the first in cancer mortality in both sexes. For this reason this study pretends to describe the epidemiological and clinical behavior in the population, in the 2007-2011 period. Methods: This study is descriptive - retrospective type, based on the review of clinical records in 15 health institutions. The universe corresponded to all patients seen in this period, confirmed by endoscopy or gastric cancer biopsy. Sociodemographic variables, morbidity, and clinical risk factors were analyzed. The information was analyzed under the Excel program and Epidat 4.0. Results: 742 cases were recorded, with a prevalence of 0.084%. Is more common in men, with an H/M ratio of 1.43. Average age 63.3 years, older than 55 years concentrated a 73.5% of cases. The most affected municipalities are Cúcuta (58.1%), Pamplona (10.9%), Los Patios (5.5%) and Ocaña (4.6%). 88.5% live in urban areas, 39.6% have subsidized regime and the 35.9% tax regime. 77.1% belong to I and II strata. “Unspecified malignant neoplasm” (41.4%) and antropyloric (23.6%) are the most reported locations. Endoscopy showed a 98.6% sensitivity. The more important symptoms are epigastric pain (57.1%), weight loss (41.9%) and vomit (25.6%) it presented in less than 6 months before diagnosis. 1.5% was asymptomatic. Neoplasms were classified as stage III according to Bormann in 67.1%, adenocarcinoma 96.7% and 67.4% of intestinal type. The “poorly differentiated to undifferentiated” tumor differentiation was 46.3%. 76.1% of reported metastasis was positive, affecting one or several organs, mainly the liver (50.7%), lung (14.7%) and pancreas (14%). Intestinal metaplasia recorded a 36.4%. 67.4% of patients got surgery, with 28.2% of unresectable tumor, 12.7% was considered inoperable. Other factors present were: H. pylori 58%, blood group “A” positive 38.8%, alcohol 78.4% and 40.2% cigarette. Gastric cancer mortality recorded 109 events, with 79.8% older than 50 years. No differences between genders (p = 0.9375). Deaths caused by antropyloric malignancy in men are frequently (p = 0.005). The overall survival at year after diagnosis is 0.186. 50% of patients have a survival time of 4.5 months or less, showing no difference with respect to sex and age (p> 0.05). Conclusion: Gastric cancer in Norte de Santander affects population of lower strata, advanced age residing in urban area. It diagnosed in advanced stages where little can be intervene and survival in 50% of patients is ± 4.5 months. Prevail such important risk factors as a H. pylori infection, substance abuse and absence of a screening program.