The silent advance of cancer in Chile

In the 1960s, linfectious diseases were the leading cause of death in the country. Less access to medicines, health and poor diet, Chileans then died of digestive diseases (Diarrhea), Respiratory (tuberculosis or pneumonia). In the 70s, 10% of all deaths were rated as "early childhood".

For the 80s, cardiovascular ills went on to lead this record, But since then, and as the country improved its economic income, cancer was advancing and today is the second cause of death. Specialists estimate that next year will already be the leading cause of death. In fact, it is already in several regions of the country: Arica, Antofagasta, Biobío, Aysén, La Araucanía and Los Lagos.

However, a study published by the journal The Lancet, indicates that today cancer already kills more people in Chile than cardiovascular disease.

Research, Entitled "Variations in common diseases, hospital admissions and deaths in middle-aged adults in 21 countries on five continents (PURE): a prospective cohort study", is a long study of urban and rural epidemiology that began in 2005 and is considered the largest of its kind..

The research considered the follow-up for almost 10 years of 162,534 people between 35 and 70 years old (Middle Ages), from 21 countries of the five continents.

The PURE study is the only large prospective international cohort study involving substantial data from a large number of middle-income countries. (like Chile) and high-income, using standardized and concurrent sampling methods, measurement and monitoring.

Among the 21 countries measured was Chile, whose chapter was led by doctor of the U. De La Frontera, Fernando wool, who together with his team followed 3,500 people for 12 years.

Analysis, found that cardiovascular disease was more common in low- and middle-income countries, that in high-income countries. While cancer, is more common in high-income countries and some high middle-income countries, like Chile.

Deaths related to cardiovasuclar disease were 2,5 times more common in middle-aged adults in low-income countries compared to high-income countries. The reason? The authors suggested that this higher mortality from cardiovascular disease in lower-income countries may be mainly due to lower quality of medical care..

On the other hand, in richer or higher-income countries, it is cancer that doubles mortality compared to cardiovascular disease. In low-income countries, death from cardiovascular disease was three times greater than from cancer.

Chile, despite being within middle-income countries, behaves like a rich one and together with Argentina, Turkey and Poland, has cancer as the leading cause of death in middle-aged people (35-70 years).

"Our data are now confirmed that new cases of cancer deaths double cases of cardiovascular disease in high-income countries, including Chile. Cardiovascular diseases are highly preventable through the control of their risk factors and have very effective treatments, cancer does not“, says Lanas a What's wrong from Paris.

"This is an initiative of research cardiologists from many countries.. We start in Temuco, at the Universidad de la Frontera, 12 years ago, following 3,500 people. Two years ago we communicated to the Congress of Cardiology in Chile and the rest of the researchers, that we had twice the incidence of cancer than cardiovascular disease", Adds.

The research divided countries into three categories: Low-income countries: Tanzania, Zimbabwe, Bangladesh, Pakistan and India. Average income: Philippines, Iran, South Africa, Colombia, China, Brazil, Malaysia, Turkey, Poland, Argentina and Chile. And nations with a high-income average: Saudi Arabia, United Arab Emirates, Canada and Sweden.

Within the reasons for this difference in the causes of death according to the type of income, researchers say it could be due to better prevention and treatment of cardiovascular disease in high-income countries, while preventing and treating cancer, is still in process.

The study assessed differences in common disease incidence and related mortality. "We've been watching the decrease in cardiovascular disease for a while in many countries. It was only a matter of time before the progress we make in reducing mortality from these types of diseases would lead to a drop in mortality rates below cancer.", Yusuf said.

The Lancet notes in its publication, that while the study did not include the United States, research published in 2018 by the Annals of Internal Medicine also concludes that heart disease is the leading cause of death in some regions of the low-income country, while cancer-associated deaths, are the leading cause in high-income counties.

"We are seeing a new epidemiological transition., from heart disease to cancer as the leading cause of death, that happens first in high-income communities", said dr.. Latha Palaniappan, lead author of such research.

Cardiovascular disease versus cancer

For Alejandro Corvalan, Senior researcher at the Center for advanced chronic diseases (Accdis) and the Catholic University, this study allows to contextualize the situation of Chile. “Chile is a middle-income country but has mortality from a rich country" so more work needs to be done on cancer, both in prevention and in access to treatments. "Having a cancer law is important in the current situation., it was a historic advance to have approved it last year., but now you need to make changes to the system and that requires more resources.", says.

In addition, highlights Corvalán, it should be considered that the cancer is heterogeneous, has many causes and unlike cardiovascular diseases, has multiple causes.

"The cardiovascular diseases share prevention measures, exercise, take care of weight, healthy diet. But in cancer, the approach is more difficult. For example, quitting smoking may prevent for some cancers but not for all, there are many factors that are related to the development of the disease", Accdis researcher warns.

Jorge Jiménez de la Jara, professor in the Department of Public Health at the U.U. School of Medicine. Catholic and President National Cancer Forum Foundation, highlights that this study confirms the forecast that had already been given for Chile, in 2020-2025 cancer will be the disease that causes the most deaths in Chile.

"What the study shows will be our reality in the coming years. If it already happens in that study cohort, it means that what is coming at the country level is this. The trend is confirmed", insists the expert.

According to Jiménez de la Jara, epidemiological transition affects more developed countries faster. In poorer countries, there are still more deaths from accidents, by infectious diseases, something that does not happen or happens less is those of medium and high development. "In Chile, cifas are coincident with levels of development, type of feeding, sedentary lifestyle, Obesity, tobacco and alcohol which are the other risk factors for cancer", says.

See note complete: What Happens – The Third