REGIONAL WORKSHOP ON NON COMMUNICABLE DISEASES

RIO DE JANEIRO 3-5 MAY 2012

EPIDEMIOLOGICAL PROFILE AND CANCER CONTROL PROGRAM OF LUIS G. CAPOTE NEGRIN ONCOLOGIST SURGEON, EPIDEMIOLOGY. DIRECTOR OF CANCER REGISTER ONCOLOGY PROGRAM. HEALTH MINISTRY VENEZUELA

• 950.000 KM2

28.000.000 HAB. 23. ESTADOS DISTRITO CAPITAL

VENEZUELAN CANCER CONTROL PROGRAM HISTORICAL BACKGROUND

• THE PROGRAM WAS ESTABLISHED AT BIGINNING OF THE DECADE OF SIXTIES AS A COMPONENT OF THE CHRONIC DESEASES PROGRAM OF HEALTH MINISTERY. VENEZUELAN CANCER CONTROL PROGRAM HISTORICAL BACKGROUND

At the beginning the program was dedicated to promote the practice of the pap smear and supplies the resources necessary for this test, at first level of medical care of

CANCER CONTROL PROGRAM OF VENEZUELA HISTORICAL BACKGROUND

• In 1976 the Program achieve an extraordinary impulse with the Presidential Decree of establishment the Oncology Direction of the Ministry of Health

REPUBLICA BOLIVARIANA DE VENEZUELA MINISTERIO DEL PODER POPULAR PARA LA SALUD PROGRAMA NACIONAL DE ONCOLOGIA

NORMA OFICIAL VENEZOLANA DEL PROGRAMA DE ONCOLOGIA

OFFICIAL GUIDELINES OF THE

CANCER PROGRAM CANCER CONTROL PROGRAM Was defined as process directed to organize resources, appointing to reach viables objectives and using valid strategies with the aim of reducing morbidity and mortality for the most frequents and especially the more vulnerable localizations of cancer; appointing to the mayor risk groups. The Cancer Control Program was established on the base of the principles of promotion a healthy stile of life, prevention of the illness or improving the care of the cases of cancer

The main objective of the Cancer Control Program, aimed to activities as:

• PROMOTION OF THE HEALTH (Encouraging people to live a healthy lifestyle. • EARLY DIAGNOSTIC (Promoting cancer screening tests.) • EFFECTIVE AND OPPORTUNE MEDICAL ATENTION (Increasing access to good cancer care.) • CONTROL AND EVALUATION OF END RESULTS (Improving the quality of the information sistem) Cancer Control Program is supported, with the appropriate knowledge of the epidemiological profile and natural history of the main cancer’s types, as well as an efficient System of Information and Evaluation of End Results

CRITERIA FOR CANCER SCREENING (Fitting to Venezuela) CRETERIA CERVIX BREAST COLON PROSTATE LUNG OVARY STOMACH ORAL

Common Cancer xxx xxx xxx xxx xxx x xxx xx

Natural history known xxx x xx x xxx x xxx xxx

Effective test xxx xx xx x x x x xxx

Acceptable test xxx xx x xxx xx x x xxx

Effective intervention xxx xxx xxx - x - xxx xxx

Health System can facilitate xxx xx x x - x x xxx Services and resources Demonstrable Change in xxx xx x - - - - xx Survival Rate

Favourable Cost/Benefit Ratio xxx xx - - - - - x xxx, Good positive evidence; xx, reasonable positive evidence; x, some positive evidence; -, no evidence EPIDEMIOLOGICAL PROFILE OF CANCER IN VENEZUELA PERCENT DISTRIBUTION OF THE FIVE LEADING CAUSES OF DEATH VENEZUELA. 2009

20,61% 34,74%

14,81%

7,49% 8,14% 14,21%

DESEASES OF HEART. 27.542 MALIGNANT NEOPLASM (CANCER). 19.796 SUICIDES , HOMICIDES AND OTHER INTENTIONAL INJURIES. 18.994 ACCIDENTS ALL KIND. 10.885 CEREBROVASCULAR DESEASES. 10.007 ALL OTHER CAUSES. 46.427 TEN MAIN CAUSES OF DEATH. MALES. VENEZUELA 2009

13,12%

10,89% 46,21%

7,11%

6,12%

5,18%

2,10% 2,11% 2,49% 2,36% 2,30%

ACUTE MYOCARDIAL INFARCTION (I21) 10.934 HOMICIDES. (X85-Y09). (2) 9.072 TRANSPORT ACCIDENTS (V01-V99) 5.924 CEREBROVASCULAR DESEASES. (I60-I69) 5.101 DIABETES MELLITUS. (E10-E14) 4.315 MALIGNANT NEOPLASM OF PROSTATE (C61) 2.077 RESPIRAT. AND CARDIOV. DESEASES OF THE PERINATAL PERIOD(P22-P29) 1.969 TOTAL 83.325 MALIGNANT NEOPLASM OF TRACHEA BRONCHUS AND LUNG (C34) 1.917 CHRONIC LIVER DESEASE AND CIRRHOSIS (K70.2, K70.3, K74) 1.761 PNEUMONIA (J12-J18) 1.748 ALL OTHER CAUSES OF DEATH 38.507 TWELVE MAIN SPECIFIC CAUSES OF DEATHS FEMALES. VENEZUELA 2009

12,99%

9,60% 43,51%

8,77%

3,20% 3,07% 3,02% 2,94% 2,40% 2,62% 2,77% 2,30% 2,82%

ACUTE MYOCARDIAL INFARCTION (I21) 6.677 CEREBROVASCULAR DESEASES. (I60-I69) 4.933 DIABETES MELLITUS. (E10-E14) 4.507 MALIGNANAT NEOPLASM OF BREAST (C50) 1.643 MALIGNANT NEOPLASM OF CERVIX UTERI (C53) AND UT. NON SPEC.(C55) 1.576 PNEUMONIA (J12-J18) 1.551 HYPERTENSIVE HEART DESEASE (I11) 1.513 TOTAL 51.406 RESPIRAT. AND CARDIOV. DESEASES OF THE PERINATAL PERIOD(P22-P29) 1.450 TRANSPORT ACCIDENTS (V01-V99) 1.426 CHRONIC OBSTRUCTIVE RESPIRATORY DESEASE (J44) 1.348 CHRONIC ISCHEMIC HEART DESEASE (I25) 1.233 MALIGNANT NEOPLASM OF TRACHEA BRONCHUS AND LUNG (C34) 1.184 ALL OTHER CAUSES OF DEATH 22.365 INCIDENCE ESTIMATED OF MAIN CAUSES OF CANCER IN MALES. VENEZUELA 2009 406 481 435 523 593 4.881 610

719

841

1.273

2.397 1.578

TOTAL : 17.609

PROSTATE (4.881) BRONCHUS AND LUNG (2.397) STOMACH (1.578)

COLON, RECTUM AND ANUS (1.273) LEUKEMIA (841) LARINX (719)

ORAL CAVITY AND PHARINX (610) NON HODGKIN LINPHOMAS (593) LIVER (523)

BLADDER (481) PANCREAS (435) KIDNEY AND RENAL PELVIS (406) INCIDENCE ESTIMATED OF THE MAIN CAUSES OF CANCER IN FEMALES. VENEZUELA 2009

475 443 336 508

665 3.943 671 799

1.036

1.484 3.860

1.499 TOTAL: 18.778

BREAST (3.943) CERVIX UTERI (3.860) COLON, RECTUM AND ANUS (1.499)

BRONCHUS AND LUNG (1.484) STOMACH (1.036) OVARY (799)

CORPUS UTERI (671) LEUKEMIA (665) LIVER (508)

PANCREAS (475) NON HODGKIN LINPHOMAS (443) BRAIN, MENINGES AND OTHERS CNS. (336) 12 MAIN CAUSES OF DEATH BY CANCER MALES. VENEZUELA 2.009

270 260 219 282 300 2.077 377 443

478

665 1.917

1.168 TOTAL: 10.334

PROSTATE (2.077) TRACHEA, BRONCHUOS AND LUNG (1917) STOMACH (1.168) COLON, RECTUN AND ANOUS (665) LEUKEMIA (478) LIVER (443) PANCREAS (377) LARINX (300) NON HODGKIN LINPHOMAS (282) ORAL CAVITY AND PHARINX (270) BRAIN, MENINGES AND OTHERS CNS. (260) KIDNEY AND RENAL PELVIS (219) 12 MAIN CAUSES OF DEATH BY CANCER FEMALES. VENEZUELA 2.009

210 162

369 232 415 1.643 423

432

1.576 722

750 1.184 TOTAL: 9.954

BREAST (1.643) CERVIX UTERI AND UTERUS PART UNSPECIFIED. (1.576)

TRACHEA, BRONCHUS AND LUNG (1.184) STOMACH (750)

COLON, RECTUM AND ANUS (722) OVARY (432)

LIVER (423) PANCREAS (415)

LEUKEMIA (369) BRAIN, MENINGES AND OTHERS CNS. (232)

NON HODGKIN LINPHOMAS (210) CORPUS UTERI (162) COMPARISON OF STANDARDIZED RATE OF MORTALITY BY CANCER. (ALL TYPES) FEDERAL . BOTH SEX. MEAN RATE OF THE QUINQUENIAL 2005-2009 DISTRITO CAPITAL MERIDA GUARICO TACHIRA VENEZUELA BOLIVAR FEDERAL FEDERAL STATES YARACUY ANZOATEGUI FALCON AMAZONAS 0,00 10,00 20,00 30,00 40,00 50,00 60,00 70,00 80,00 90,00 100,00

STANDARDIZED RATE PER 100.000 INHAB. COMPARISON OF STANDARDIZED RATE OF INCIDENCE BY CANCER. (ALL TYPES) FEDERAL STATES OF VENEZUELA. BOTH SEX. MEAN RATE OF THE QUINQUENIAL 2005-2009 VARGAS DISTRITO CAPITAL MERIDA ZULIA NUEVA ESPARTA GUARICO TRUJILLO COJEDES CARABOBO LARA VENEZUELA ARAGUA MIRANDA FEDERAL FEDERAL STATES TACHIRA SUCRE BOLIVAR MONAGAS YARACUY APURE PORTUGUESA DELTA AMACURO FALCON BARINAS ANZOATEGUI AMAZONAS 0,00 20,00 40,00 60,00 80,00 100,00 120,00 140,00 160,00 180,00 200,00

STANDARDIZED RATE PER 100.000 INHAB. COMPARISON OF STANDARDIZED RATE OF MORTALITY BY CERVIX UTERI CANCER. FEDERAL STATES OF VENEZUELA. MEAN RATE OF THE QUINQUENIAL 2005-2009 COJEDES APURE DELTA AMACURO MONAGAS GUARICO PORTUGUESA BOLIVAR BARINAS AMAZONAS SUCRE ZULIA VARGAS ANZOATEGUI FEDERAL FEDERAL STATES VENEZUELA LARA YARACUY TACHIRA CARABOBO ARAGUA TRUJILLO FALCON MERIDA NUEVA ESPARTA DISTRITO. CAPITAL MIRANDA 0,00 5,00 10,00 15,00 20,00 25,00

STANDARDIZED RATE PER 100.000 FEMALES COMPARISON OF STANDARDIZED RATE OF INCIDENCE BY CERVIX UTERI CANCER. FEDERAL STATES OF VENEZUELA. MEAN RATE OF THE QUINQUENIAL 2005-2009 APURE COJEDES DELTA AMACURO AMAZONAS MONAGAS GUARICO BOLIVAR BARINAS PORTUGUESA SUCRE VARGAS ZULIA YARACUY FEDERAL FEDERAL STATES VENEZUELA LARA TACHIRA TRUJILLO ANZOATEGUI CARABOBO MERIDA ARAGUA FALCON DISTRITO. CAPITAL NUEVA ESPARTA MIRANDA 0,00 10,00 20,00 30,00 40,00 50,00 60,00

ESTANDARDIZED RATE PER 100.000 FEMALES COMPARISON OF STANDARDIZED RATE OF MORTALITY BY BREAST CANCER. FEDERAL STATES OF VENEZUELA. MEAN RATE OF THE QUINQUENIAL 2005-2009 ARAGUA DISTRITO CAPITAL NUEVA ESPARTA VARGAS CARABOBO ZULIA MIRANDA VENEZUELA TRUJILLO LARA DELTA AMACURO YARACUY SUCRE FEDERAL FEDERAL STATES FALCON GUARICO BOLIVAR MERIDA MONAGAS TACHIRA COJEDES ANZOATEGUI BARINAS PORTUGUESA APURE AMAZONAS 0,00 2,00 4,00 6,00 8,00 10,00 12,00 14,00 16,00

STANDARDIZED RATE PER 100.000 FEMALES COMPARISON OF STANDARDIZED RATE OF INCIDENCE BY BREAST CANCER. FEDERAL STATES OF VENEZUELA. MEAN RATE OF THE QUINQUENIAL 2005-2009 VARGAS DISTRITO CAPITAL ARAGUA NUEVA ESPARTA CARABOBO ZULIA MIRANDA TRUJILLO LARA VENEZUELA DELTA AMACURO FALCON GUARICO FEDERAL FEDERAL STATES SUCRE BOLIVAR MERIDA YARACUY TACHIRA MONAGAS COJEDES ANZOATEGUI BARINAS APURE PORTUGUESA AMAZONAS 0,00 5,00 10,00 15,00 20,00 25,00 30,00 35,00 40,00

STANDARDIZED RATE PER 100.000 FEMALES COMPARISON OF STANDARDIZED RATE OF MORTALITY BY PROSTATE CANCER. FEDERAL STATES OF VENEZUELA. MEAN RATE OF THE QUINQUENIAL 2005-2009 GUARICO SUCRE BOLIVAR COJEDES MONAGAS ZULIA VARGAS NVA. ESPARTA D.AMACURO APURE MERIDA TRUJILLO CARABOBO FEDERAL FEDERAL STATES ARAGUA VENEZUELA YARACUY DISTRITO CAPITAL MIRANDA ANZOATEGUI BARINAS LARA TACHIRA FALCON PORTUGUESA AMAZONAS 0,00 5,00 10,00 15,00 20,00 25,00 STANDARDIZED RATE PER 100.000 MALES COMPARISON OF STANDARDIZED RATE OF INCIDENCE BY PROSTATE CANCER. FEDERAL STATES OF VENEZUELA. MEAN RATE OF THE QUINQUENIAL 2005-2009 SUCRE GUARICO TRUJILLO COJEDES MONAGAS BOLIVAR VARGAS ZULIA NVA. ESPARTA MERIDA APURE VENEZUELA CARABOBO FEDERAL FEDERAL STATES ARAGUA DISTRITO CAPITAL D.AMACURO YARACUY MIRANDA ANZOATEGUI BARINAS LARA TACHIRA FALCON PORTUGUESA AMAZONAS 0,00 10,00 20,00 30,00 40,00 50,00 60,00 STANDARDIZED RATE PER 100.000 MALES COMPARISON OF STANDARDIZED RATE OF MORTALITY BY LUNG CANCER. FEDERAL STATES OF VENEZUELA. BOTH SEX. MEAN RATE OF THE QUINQUENIAL 2005-2009 VARGAS ZULIA BOLIVAR DTO. CAPITAL GUARICO MIRANDA ANZOATEGUI D.AMACURO ARAGUA VENEZUELA CARABOBO NVA. ESPARTA SUCRE FEDERAL FEDERAL STATES MONAGAS APURE COJEDES LARA YARACUY MERIDA FALCON AMAZONAS TRUJILLO BARINAS TACHIRA PORTUGUESA 0,00 2,00 4,00 6,00 8,00 10,00 12,00 14,00 16,00 18,00 20,00 STANDARDIZED RATE PER 100.000 INHAB. COMPARISON OF STANDARDIZED RATE OF INCIDECE BY LUNG CANCER. FEDERAL STATES OF VENEZUELA. BOTH SEX. MEAN RATE OF THE QUINQUENIAL 2005-2009 VARGAS ZULIA GUARICO DTO. CAPITAL BOLIVAR MIRANDA NVA. ESPARTA ARAGUA VENEZUELA ANZOATEGUI D.AMACURO CARABOBO SUCRE FEDERAL FEDERAL STATES COJEDES MONAGAS APURE LARA FALCON YARACUY MERIDA TRUJILLO TACHIRA PORTUGUESA AMAZONAS BARINAS 0,00 5,00 10,00 15,00 20,00 25,00 STANDARDIZED RATE PER 100.000 INHAB COMPARISON OF STANDARDIZED RATE OF INCIDECE BY STOMACH CANCER. FEDERAL STATES OF VENEZUELA. BOTH SEX. MEAN RATE OF THE QUINQUENIAL 2005-2009 TACHIRA MERIDA TRUJILLO COJEDES YARACUY LARA PORTUGUESA BARINAS VENEZUELA SUCRE DTO. CAPITAL VARGAS CARABOBO FEDERAL FEDERAL STATES APURE NUEVA ESPARTA MONAGAS DELTA AMACURO ARAGUA GUARICO MIRANDA ANZOATEGUI FALCON AMAZONAS ZULIA BOLIVAR 0,00 5,00 10,00 15,00 20,00 25,00 30,00 STANDARDIZED RATE PER 100.000 INHAB. COMPARISON OF STANDARDIZED RATE OF MORTALITY BY STOMACH CANCER. FEDERAL STATES OF VENEZUELA. BOTH SEX. MEAN RATE OF THE QUINQUENIAL 2005-2009 TACHIRA MERIDA COJEDES TRUJILLO BARINAS PORTUGUESA YARACUY LARA SUCRE APURE VENEZUELA DTO. CAPITAL NUEVA ESPARTA FEDERAL FEDERAL STATES CARABOBO DELTA AMACURO VARGAS MONAGAS GUARICO ARAGUA ANZOATEGUI MIRANDA FALCON BOLIVAR ZULIA AMAZONAS 0,00 2,00 4,00 6,00 8,00 10,00 12,00 14,00 16,00 18,00 20,00 STANDARDIZED RATE PER 100.000 INHAB. COMPARISON OF STANDARDIZED RATE OF MORTALITY BY COLON & RECTUN CANCER. FEDERAL STATES OF VENEZUELA. BOTH SEX. MEAN RATE OF THE QUINQUENIAL 2005-2009 VARGAS DTO. CAPITAL LARA ARAGUA CARABOBO

NUEVA ESPARTA MIRANDA TACHIRA VENEZUELA ZULIA PORTUGUESA COJEDES FEDERAL FEDERAL STATES YARACUY SUCRE BOLIVAR MERIDA GUARICO ANZOATEGUI FALCON MONAGAS BARINAS DELTA AMACURO TRUJILLO APURE AMAZONAS 0,00 1,00 2,00 3,00 4,00 5,00 6,00 7,00 8,00 STANDARDIZED RATE PER 100.000 INHAB. COMPARISON OF STANDARDIZED RATE OF INCIDENCE BY COLON & RECTUN CANCER. FEDERAL STATES OF VENEZUELA. BOTH SEX. MEAN RATE OF THE QUINQUENIAL 2005-2009 DTO. CAPITAL VARGAS LARA ARAGUA CARABOBO

NUEVA ESPARTA MIRANDA ZULIA VENEZUELA MERIDA TACHIRA PORTUGUESA FEDERAL FEDERAL STATES SUCRE BOLIVAR GUARICO FALCON YARACUY COJEDES ANZOATEGUI MONAGAS DELTA AMACURO TRUJILLO APURE BARINAS AMAZONAS 0,00 2,00 4,00 6,00 8,00 10,00 12,00 14,00 16,00 STANDARDIZED RATE PER 100.000 INHAB. The Components of a Cancer Control Program are • Lung. chooses on the basis of the • Cervix Uteri. knowledge of which are the main types • Breast. of cancer who affect • Prostate the population and the accessibility of • Gastrointestinal. early detection or preventive actions:

LUNG CANCER CONTROL PROGRAM

These Program started in the decade of seventies It is center on avoid the cigarrets smoking Through: Public education campaign, Restriction of advertising and Forbidding smoking on public place CERVICAL CANCER CONTROL PROGRAM

It has been based on screening, with Pap test, to women from 25 to 64 years,

The main objective was reached 80% of the target population every three year period PROGRAMA CONTROL DE CÁNCER DE CUELLO UTERINO FLUJOGRAMA DE ATENCIÓN

I NIVEL DE ATENCION

PESQUISA TAMIZAJE

POBLACION ♀ DE RIESGO Control Periódico Citología Negativa (25 A 64 AÑOS)

•ASCUS - AGUS CENTRO DE PESQUISA •LIE Bg. TOMA DE CITOLOGIA •LIE Ag. •Ambulatorios Urbanos y Rurales •Cá. Epidermoide •Instituciones públicas y privadas •Adenocarcinoma

Una a Dos Dos a Cuatro Semanas Semanas

LABORATORIO DE CITOHISTO- PATOLOGIA PROGRAMA CONTROL DE CÁNCER DE CUELLO UTERINO FLUJOGRAMA de ATENCIÓN

II y III NIVEL DE ATENCION

DIAGNÓSTICO CITOLOGICO

15 Días – 1 mes Tratamiento Ambulatorio

CONSULTA DE PATOLOGIA CERVICAL (C P C) ASA - LEEP NIVEL II DE ATENCIÓN

15 Días – 1 mes

COLPOSCOPIA NIC I CARCINOMA BIOPSIA DIRIGIDA NIC II C P C INVASOR NIC III PREINVASOR 7 Días 1 mes

LABORATORIO DE CITO- 7 Días HISTOPATOLOGIA

III NIVEL DE ATENCION

Tto Hospitalario: •Cirugía •Radiaciones •Quimioterapia

BREAST CANCER CONTROL CANCER

SELF-EXAMINATION CLINIC EXAMENINATION MAMOGRAPHY (50 to 65 YEAR EVERY 2 YEAR) PROGRAMA DE CONTROL DE CANCER DE PULMON

Este Programa se inició en la década de los años sesenta. Esta centrado en evitar el habito de fumar cigarrillo a través de: Campañas de Educación Pública. Restricción de la Propaganda de cigarrillos Prohibición de fumar en sitios Públicos. Establecimiento de Clínicas de Cesación PROGRAMA DE CONTROL DE CANCER DE GLANDULA MAMARIA

AUTOEXAMEN EXAMEN CLINICO

MAMOGRAFIA (APLICADA COMO PESQUISA OPORTUNISTA) SCREENING WITH MAMOGRAPHY IS NOT BASE ON POPULATION PROGRAM, BECAUSE LIMITATION ON RESOURCES REGISTRY OF CANCER

IT IS A BRANCH OF THE CANCER CONTROL PROGRAM WITH THE AIM OF RECOLLETING INFORMATION OF CASES OF CANCER OF HOSPITAL THAT TREAT MORE OF 100 CASES PER YEAR GASTROINTESTINAL CANCER CONTROL PROGRAM

THE MAIN GOAL IS REDUCE LATE DIAGNOSIS: THROUGHT CLINIC AND ENDOSCOPIC EVALUATION OF PEOPLE AT RISK AGE WITH GASTROINTESTINAL SYMPTOMATOLOGY REGISTRY OF CANCER

IT IS A BRANCH OF THE CANCER CONTROL PROGRAM WITH THE AIM OF RECOLLETING INFORMATION OF CASES OF CANCER OF HOSPITAL THAT TREAT MORE OF 100 CASES PER YEAR ESTABLECIMIENTOS HOSPITALARIOS QUE REPORTAN INFORMACION AL REGISTRO CENTRAL DE CANCER

CENTRO HOSPITALARIO ESTADO HOSP. DR. LUIS RAZETTI ANZOATEGUI HOSP. DR. PABLO ACOSTA ORTIZ APURE HOSP. DR. LUIS RAZETTI BARINAS HOSP. DR. RUIZ Y PAEZ BOLIVAR ONC .DR. MIGUEL PEREZ CARREÑO CARABOBO HOSP. DR. EGOR NUCETTE COJEDES HOSP. ONCOLOGICO DR. LUIS RAZETTI CARACAS DTTO CAPITAL SERV. HOSP. ONC. DE LOS SEGUROS SOCIALES (PADRE CARACAS DTTO CAPITAL MACHADO) HOSP. UNIVERSITARIO DE CARACAS CARACAS DTTO CAPITAL HOSP. DR. LUIS GOMEZ LOPEZ LARA HOSP. UNIVERSITARIO DE LOS MERIDA HOSP. DR. MANUEL NUÑEZ TOVAR MONAGAS HOSP. DR. LUIS ORTEGA NUEVA ESPARTA HOSP. CENTRAL DE SAN CRISTOBAL TACHIRA HOSP. DR. PEDRO EMILIO CARRILLO TRUJILLO HOSP. DR. ANTONIO P. ALCALA SUCRE HOSP. DR. PLACIDO D. RODRIGUEZ YARACUY HOSP. UNIVERSITARIO DE ZULIA

TENDENCIA DE LA MORTALIDAD PARA LAS CUATRO MAYORES LOCALIZACIONES DE CANCER PROMEDIO QUINQUENAL DE TASAS ESTANDARIZADAS. VARONES. VENEZUELA 1965 - 2010

30

PROSTATA

ESTOMAGO

25 PULMON

COLON RECTO

20

15

10 TASAS ESTANDARIZADAS 100.000POR VARONES ESTANDARIZADAS TASAS

5

0 1961-65 1966-70 1971-75 1976-80 1981-85 1986-90 1991-95 1996-00 2001-05 2006-10*

PROMEDIOS QUINQUENALES TENDENCIA DE LA MORTALIDAD PARA LAS CINCO MAYORES LOCALIZACIONES DE CANCER SEGUN PROMEDIO QUINQUENAL DE TASAS ESTANDARIZADAS. MUJERES. VENEZUELA 1965-2010

25

CUELLO UTERINO

GL. MAMARIA

ESTOMGO 20 PULMON

COLON y RECTO

15

10

5 TASAS TASAS ESTAND. POR 100.000 MUJERES

0 1961-65 1966-70 1971-75 1976-80 1981-85 1986-90 1991-95 1996-00 2000-05 2006-10* PERIODOS QUINQUENALES T H A N K

Y O U