Comparative Longterm Mortality Trends in Cancer Vs. Ischemic Heart Disease in Puerto Rico

Tuesday, June 21, 2016: 11:24 AM
Tubughnenq' 4, Dena'ina Convention Center
Juan Carlos Zevallos , Florida International University, Miami, FL
David Abner Torres , University of Puerto Rico, San Juan., PR
Luis Raśl Pericchi , University of Puerto Rico, San Juan, PR
Hernando Mattei , University of Puerto Rico, San Juan, PR
BACKGROUND:  Although contemporary mortality data are important for health assessment and planning purposes, their availability lag several years. Statistical projection techniques can be employed to obtain current estimates. Objective:  To assess the annual trend of mortality in Puerto Rico due to cancer and Ischemic Heart Disease (IHD), and to predict shorterm and longterm cancer and IHD mortality figures.

METHODS:   Age-adjusted mortality per 100,000 population projections with a 50% interval probability were calculated utilizing a Bayesian statistical approach of Age-Period-Cohort dynamic model. Multiple cause-of-death annual files for years 1994-2010 for Puerto Rico were used to calculate shortterm (2011-2012) predictions. Longterm (2013-2022) predictions were based on quinquennial data. In addition, we calculated gender differences in rates (men–women) for each study period. 

RESULTS:   Mortality rates for women were similar for cancer and IHD in the 1994-1998 period, but changed substantially in the projected 2018-2022 period. Cancer mortality rates declined gradually overtime, and the gender difference remained constant throughout the historical and projected trends. A consistent declining trend for IHD historical annual mortality rate was observed for both genders, with a substantial changepoint around 2004-2005 for men. The initial gender difference of 33% (80/100,00 vs. 60/100,000) in mortality rates observed between cancer and IHD in the 1994-1998 period increased to 300% (60/100,000 vs. 20/100,000) for the 2018-2022 period. 

CONCLUSIONS:   The flexibility of the APC projection model accurately projects shortterm and longterm mortality trends for cancer and IHD in this population: The steady historical and projected cancer mortality rates contrasts with the substantial decline in IHD mortality rates, especially in men.