Browsing by Author "Beasley, Timothy"

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    High Gastric Cancer Mortality and Years of Life Lost in Nicaragua: A Population-Based Study 1997 – 2012
    (American Association for Cancer Research, 2024) Peña-Galo, Edgar M.; Palacios-Navarro, Guillermo; Pastora-Membreño, Javier; Torres-Herman, Tatiana; Norwood, Dalton A.; Montalvan-Sanchez, Eleazar E.; Beasley, Timothy; Bravo, Luis Eduardo; Morgan, Douglas R.; Medicine, School of Medicine
    Background: Gastric adenocarcinoma is the fourth leading cause of cancer-related mortality and leading infection-associated cancer. Gastric adenocarcinoma has striking geographic variability, with high incidence in East Asia and mountainous Latin America. Reliable cancer data and population-based cancer registries are lacking for the majority of low- and middle-income countries, including the Central American Four region (CA-4, Nicaragua, El Salvador, Honduras, and Guatemala). Methods: Mortality data for Nicaragua were obtained from the highly rated Ministry of Health death registry. All the patients were diagnosed with gastric cancer between 1997 and 2012 (ICD-10 codes, C16.0-C16.9) and death due to any cause were included in the study. Data on variables such as sex, age (stratified by 5-year age groups), municipality, urban/rural, altitude, and year of death were analyzed. Results: A total of 3,886 stomach cancer deaths were reported in Nicaragua between 1997 and 2012, of which 2,214 (56.9%) were male. The age-standardized mortality rates were 13.1 and 8.7 per 100,000 habitants for males and females, respectively, and without significant change during the study period (annual percentage change = -0.7, P = 0.2). An average of 17.9 years were lost per death, accounting for 67,964 years of life lost (YLL). Conclusions: The burden of gastric cancer mortality is high in Nicaragua with a significantly elevated age-standardized mortality rate, YYL, and average YLL. Impact: The projected increase in mortality portends the double cancer burden in northern Central America, with persistent infection-associated cancers and growing transition cancers (e.g., breast and colon cancers), which has implications for cancer control in Mesoamerica and US Latino populations. See related commentary by Riquelme and Abnet, p. 1550.
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    High Incidence of Gastric Cancer in El Salvador: A National Multisectorial Study 2000–2014
    (American Association for Cancer Research, 2024) Ruiz de Campos, Lisseth; Valdez de Cuellar, Marisabel; Norwood, Dalton A.; Carrasco, Tiffany Y.; Montalvan-Sanchez, Eleazar E.; Rodriguez Funes, Maria-Virginia; Beasley, Timothy; Dominguez, Ricardo L.; Bravo, Luis Eduardo; Morgan, Douglas R.; Medicine, School of Medicine
    Background: Gastric adenocarcinoma is the fourth leading cause of global cancer mortality and leading infection-associated cancer. Gastric cancer has significant geographic variability, with a high incidence in East Asia and mountainous regions of Latin America. In the United States, gastric cancer represents a marked disparity with incidence rates that are two to three times higher in Hispanics compared to non-Hispanic Whites. Methods: We conducted a national retrospective study of incident gastric cancer in El Salvador from to 2000 to 2014 to estimate the age-standardized incidence rate (ASIR) by using a combination of pathology and endoscopy databases. A unique multisectorial coalition was formed between the Ministry of Health (MINSAL) and ES Gastroenterology Society (AGEDES), representing public hospitals (n = 5), governmental employee hospitals (ISSS, n = 5), and private facilities (n = 6), accounting for >95% of national endoscopy capacity. HER2 and EBV tumor status was ascertained in a representative sample during 2014 to 2016. Results: A total of 10,039 unique cases of gastric cancer were identified, 45.5% female, and mean age of 65. 21% and 9.4% were <55 and <45 years old, respectively. ASIRs (M, F) were 18.9 (95% CI, 14.4-20.7) and 12.2 per 100,000 persons (95% CI, 10.9-13.5), respectively, in the period 2010 to 2014 with all centers operational. Intestinal gastric cancer was 2.8 times more common than diffuse gastric cancer; 23.2% had partial or complete pyloric obstruction. The HER2 2+/3+ status was 16.7% and EBV-encoded RNA positivity was 10.2%. Conclusions: A high incidence of gastric cancer was confirmed in El Salvador and nearly half of the patients were female. Impact: The findings have implications for cancer control in the Central America LMICs and for US Latino populations. See related commentary by Riquelme and Abnet, p. 1550.
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    Population-Based Study of Gastric Cancer Survival and Associations in Rural Western Honduras
    (American Association for Cancer Research, 2024) Dominguez, Ricardo L.; Montalvan-Sanchez, Eleazar E.; Norwood, Dalton A.; Rodriguez-Murillo, Aida; Dominguez, Lucia; Estevez Ordoñez, Dagoberto; Beasley, Timothy; Bravo, Luis Eduardo; Morgan, Douglas R.; Medicine, School of Medicine
    Background: Two-thirds of global cancers occur in low/middle income countries (LMIC). Northern Central America is the largest LMIC region in the Western Hemisphere and lack cancer registries to guide cancer control. We conducted a gastric cancer survival study in rural Western Honduras, characterized as having among the highest gastric cancer incidence rates in Latin America. Methods: The cohort of incident gastric cancer diagnosed between 2002 and 2015 was studied with active follow-up with household visits. The regional gastric cancer registry was primary for case identification, with completeness examination with hospital data and national death certificates. Cox regression models were used for survival calculations. Results: Survival follow-up was achieved in 741/774 patients (95.7%). Household interviews were conducted in 74.1% (n = 549); 65.7% were male, median age at diagnosis was 64 years, 24.5% were <55 years; 43.9% of tumors had pyloric obstruction; 45.2%, 43.2%, and 7.3% of histology was intestinal, diffuse, and mixed, respectively. A total of 24.7% patients received treatment. The 5-year survival rates were 9.9% for both males and females, 7.7% for age <45, and 7.9% for diffuse gastric cancer. Median survival time was 4.8 months [95% confidence interval (CI), 4.2-5.6]. In the final Cox regression model including age, sex, Lauren subtype, and poverty index, only treatment was significantly associated with survival (hazard ratio = 2.43, 95% CI, 1.8-3.2). Conclusions: Markedly low gastric cancer 5-year survival rates are observed in rural Central America. The majority of patients present with advanced disease and a minority have access to therapy. Impact: The findings have implications for cancer control in the Central America LMICs and for US Latino populations. See related commentary by Riquelme and Abnet, p. 1550.