Abelardo Meneses
Director General
View from the Top

Risk Factor Detection a Shared Responsibility

Fri, 07/05/2019 - 18:21

Q: How has the National Cancer Registry project advanced and what are its next steps?
A: The National Cancer Registry was approved by all the necessary parties and became part of the general Health Law in 2017. So far, we have implemented this registry in seven cities, including Merida, Campeche, La Paz, Tijuana, Acapulco and Sonora. There are many factors that impact our decision on whether a city can be part of the registry. One is collaboration with the local government. We make it a priority to generate a link between the federal, state and municipal governments and the local Ministry of Health. Since the health system is fragmented, we have to look for ways to foster collaboration between all the involved institutions so there can be information exchange. The role of local health ministers is key as they are the ones who put us in touch with the directors of local IMSS, ISSSTE, army and private hospitals.
When a city is chosen to participate in the registry, it has to provide all the information related to every cancer case it has registered and there has to be a follow-up to every diagnosed case. Afterward, the information is compared with the information registered by INEGI regarding cancer mortality, so we can provide estimates regarding how many new cases are appearing and the mortality in each city.
We always choose cities, rather than states, and those cities must have the needed infrastructure for cancer treatment. When cities do not have this, patients are diagnosed locally but then leave to be treated in other places, so we lose their follow-up. That is why we include cities that have all the resources for patient management. Through constant follow-up, we can register the type of tumor, its localization and we try to establish risk factors related to is appearance. This helps us to understand whether cancer develops in the same way throughout country and its response to certain factors, customs, eating habits and lifestyles.
Q: What is the general cancer map in Mexico?
A: Cancer distribution remains more or less the same, with a prevalence of breast, prostate and colon cancer. In certain states there are some cancer types that are above average, such as breast cancer in the north and cervix cancer in the south. Colon cancer, meanwhile, is surging across the country.
When analyzing the factors that could be behind this distribution, we see that the eating habits and lifestyle of people in the north are very similar to those in the US, while in the south we see there is less access to health services. Given these conditions, we have arrived at the conclusion that cervix cancer is more associated with poverty and limited access to healthcare. Colon cancer, on the other hand, is heavily linked to obesity and overweight. Around 71 percent of the population in Mexico is obese or overweight, which is why we see colon cancer spiking in all states. Thyroid cancer has surged to fourth place and is also associated with obesity. Lung cancer is the fifth-most common cancer because of tabaco and exposure to wood smoke. Ovary cancer is also among the most common cancers.
Q: How does INCan and MD Anderson collaborate in cancer-related programs and what are the priorities of this collaboration?
A: We are a sister institution of MD Anderson. We share programs related to prevention, early diagnosis and public policies. We also have resident exchanges, which allow for training that can later be applied at INCan. However, we mostly collaborate in research. We established agreements with MD Anderson to replicate their studies so we can compare US and Mexico pathologies and share this experience. Our goal is to explore the causes of certain diseases in both countries and determine risk factors. For instance, in Anglo-Saxon countries, the percentage of women under 40 years old with breast cancer is around 7 percent, while in Mexico it is 15 percent. We want to know the reasons behind this variation.