Latin American Breast Cancer Pilot Project Meeting

CHILE’s Brief Introduction

Bethesda, Md March 2009

CHILECHILE 2008

Departamento de Estadísticas e Información de Salud, 2006 Ministerio de Salud de Chile-FONASA 2006

Total population• 16,763,470Male to Female Index• 98%Urban : 85%Beneficiaries• Public Insurance 70.4%• Private Insurance 15.3%

CHILECHILE 2008

Departamento de Estadísticas e Información de Salud, 2006 Ministerio de Salud de Chile-FONASA 2006

GDP p/c US$ 9,876

Gini coefficient 0.538

Gini Coefficient (0.538)

CHILECHILE 2008

Departamento de Estadísticas e Información de Salud, 2006 Ministerio de Salud de Chile-FONASA 2006

GDP p/c US$ 9,876

Gini coefficient 0.538

Literacy: 95.7%

Human Development Index: 0.874

Human Development Index (0.874 – 40º)

CANCER IN CHILECANCER IN CHILE

EPIDEMIOLOGY

- Estimated incidence: 240 new cases x 100,000 inhabitants.

-36500 new cases each year.

-400 to 480 in children (< 15 years)

EPIDEMIOLOGY

- Second cause of death

- Adjusted Mortality Rate: 104.7 x 100.000 h

- 70% in elder than 60 years old

CANCER IN CHILECANCER IN CHILE

ONCOLOGY: The PUBLIC HEALTH SYSTEM REPLY

• 42 “Breast Pathology” Units• 43 “Cervix Pathology” Units• 13 Pediatric Treatment Centers • 21 Adults Treatment Centers

• Radiotherapy : 5 Regional Centers

• One Pediatric Bone Marrow Transplantation Unit• One Adult Bone Marrow Transplantation Unit (in

process).• 53 Palliative Care Units

DEIS 2005

MORTALITY RATE MALE CANCER

MAIN LOCALIZATIONS CHILE 2006

3,8

3,8

25,4

18,4

6,4

5,3

18,3

5,3

4,9

5,0

2,1

4,2

0 10 20 30

STOMACH

LUNGS

PROTATE

GALLBLADDER

ESOPHAGUS

COLON

PANCREAS

LIVER

RECTUM

KIDNEY

LEUKEMIA

LYMPHOMA

FOD.: INE-MINSAL Unidad de Cáncer

n = 10.392

Rate x 100,000 men

MORTALITY RATE FEMALE CANCER

MAIN LOCALIZATIONS CHILE 2006

3.3

3.5

4.5

3.6

4.0

6.3

7.1

9.4

8.3

13.5

12.6

15.7

0 5 10 15 20

GALLBLADDER

STOMACH

BREAST

UTERUS

LUNGS

COLON

PANCREAS

OVARY

ESOPHAGUS

LIVER

LEUKEMIA

LYMPHOMA

FOD.: INE-MINSAL Unidad de Cáncer

n = 9.661

Rate x 100,000 women

0

2

4

6

8

10

12

14

16

18

20

20062005200420032002200120001999

Gallbladder Stomach Breast Lungs Cervix

Rate x 100,000

FEMALE CANCER MORTALITY, 5 MAIN CAUSES CHILE, 1999 - 2006

Source: Health Ministry, Chile

0

5

10

15

20

25

30

15-2

4

25-3

4

35-4

4

45-5

4

55-6

4

65 y

74

75 y

más

Ignor

ado

%

2004 n= 2.306 2005 n = 2.338 2006 n= 2.667

63,3

34,1

2,3

< 35 years 35 - 64 years> 64 yearsUnknown

Breast Cancer Incidence, grouped by age, Public Health System only, Chile 2004 - 2006

2006

Source: Cancer Unit/ M. Prieto/ Health Ministry

BREAST CANCER: Crude and Adjusted Mortality Rate, CHILE 1990 - 2005

10

12

14

16

AÑOS

Tas

a p

or

100.

000

Mu

jere

s

Total Ajustada

Total 12,4 12,2 11,7 11,7 11,9 13,0 13,2 12,0 13,1 12,8 13,4 13,2 13,3 13,3 13,5 14,2

Ajustada 13,1 12,6 11,9 11,7 11,8 12,7 12,7 11,3 12,2 11,7 12 11,6 11,4 11,3 11,3 11,6

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Unidad de Cáncer-MINSAL/ Matrona – MSP Marta Prieto M.

11,6% Reduction

Source: Health Ministry, Chile

Breast Cancer Incidence: Percentage Distribution, grouped by Stages at Diagnosis (Public Health System), Chile 1999 - 2006

Source: Cancer Unit/ M. Prieto/ Health Ministry

0

5

10

15

20

25

30

35

40

45

50

55

60

65

70

75

1999 n = 1.408

2000 n= 1.693

2001 n= 1.803

2002 n= 2.105

2003 n= 2.160

2004 n= 2.311

2005 n= 2.338

2006 n= 2.634

In situ-Stage I- II Stage III Stage IV No Inform.

Increase in Early Stages Diagnosisfrom 42,9 to 70,1%

CHALLENGES

• Improve in early detection– Cost Effective and Affordable Interventions

• Improve in Treatment– “Personalized” treatment

CHALLENGES:

INVESTIGATION

COLLABORATIVE WORK