Unbounded Medicine

Several times, some people have asked me what causes death to mexicans.

On the last mortality statistics (2004) of general population, the main causes of death were [independently of sex]:

1. Heart disease - 16.4%
2. Complications of Diabetes Mellitus - 13.1%
3. Cancer - 12.9%
4. Traumatic injuries - 7.4%
5. Liver disease (alcoholic and non-alcoholic) - 6.2%
6. Stroke - 5.7%
7. Perinatal complications - 3.5%
8. COPD - 3.0%
9. Pneumonia & influenza - 2.6%
10. Kidney failure - 2.0%

References:

INEGI

Elisa Camahort wrote at Healthy Concerns a Frequently Asked Question: What are the best preventative screeinngs -of cancer- we all should do?
By now, there is evidence for three types of cancer, the recommendations of the US Preventive Services Task Force are the following:

Breast Cancer

• Screening mammography, with or without clinical breast examination, every 1-2 years for women aged 50 and older.
• Discusse with women in their 40s.
• Women should be screened until their predicted life expectancy is less than 10 years.
• Women with a strong family history should receive counseling for several options, which may include genetic testing for BRCA-1 and BRCA-2 and more intensive screening for breast cancer.
• Regular clinical breast examinations.

Cervical Cancer

• Target sexually active women with an intact cervix, starting three years from age of onset of sexual activity or at age 21.
• Screening is routinely done by cytological examination.
• Among women with repeatedly negative findings, screening more often than every three years rarely detects important conditions.
• Screening women with previous negative findings every three years is a reasonable approach.

Colorectal Cancer

• Target patients over age 50 years: Annual FOBT (Fecal Occult Blood Test) plus flexible sigmoidoscopy every five years OR colonoscopy every 10 years.
• Patients should be asked about first and second degree relatives who have had colorectal cancer (number of relatives and age of diagnosis).
• In order to screen high risk patients, ask the following questions starting at age 30 and update every 5 years: Have you ever had colorectal cancer or an adenomatous polyp? Have you had inflammatory bowel disease (ulcerative colitis or Crohn’s disease)? Has a family member had colorectal cancer or an adenomatous polyp? If so, how many, was it a first-degree relative (parent, sibling, or child), and at what age was the cancer or polyp first diagnosed?.
• Patients at high risk should have screening colonoscopy starting at age 40 years, or 10 years younger than the earliest diagnosis in their family, whichever comes first, and repeated every five years.

Other Types of Cancer

• There are not evidence to recommend screening.

Regards,

Dr. Jon Mikel Iñarritu

Related Link: Kids Wish Network Children’s Charity grants wishes for children with life threatening diseases

FDA approves the fist vaccine for cervical cancer, a week ago, the vaccine was aprooved in Mexico. With the name of Gardasil, and a cost of US$120.00/dose (2 doses to complete the treatment), I celebrate this effort against cancer.

Here in Mexico, cervical cancer is by far, the most common type of cancer (24.4%) in general population (including males). In females, again is the most common type of cancer (36%). The most common risk factor is infection from human papillomavirus (HPV).

This virus causes cervical cancer, precancerous genital lesions and genital warts; the vaccine prevents against HPV types 16, 18 (causes 70% of cervical cancer cases); 6 and 11 (causes genital warts).

Let’s celebrate this fight against cancer.

Regards,
Jon Mikel Iñarritu, M.D.