Prostate cancer survival according to socioeconomic and tumor characteristics in Manizales, Colombia
DOI:
https://doi.org/10.17843/rpmesp.2025.424.14721Keywords:
cancer, prostate neoplasms, health inequities, epidemiology, survivorshipAbstract
Objective. To estimate prostate cancer survival according to socioeconomic and tumor characteristics in the municipality of Manizales, Colombia, during the 2008–2018 period, based on population-based data. Materials and methods. A population-based retrospective cohort study was conducted, including all in-cident cases of primary prostate cancer diagnosed in Manizales between 2008 and 2018, recorded in the Manizales Population-Based Cancer Registry. Overall survival was estimated using the Kaplan-Meier me-thod, both for the total cohort and according to health insurance regimen, area of residence, socioeconomic position, age groups, histological type, essential Tumor–Node–Metastasis (TNM) classification, and risk according to Gleason score. The association between the variables of interest and survival was evaluated using Cox regression models. Results. The overall five-year survival was 76.5%. Significant differences in survival were identified according to the health insurance regimen, with the risk of death before five years being approximately twice as high in patients from the subsidized and non-affiliated regimen compared to those from the contributory, special, and exception regimen. Conclusions. Prostate cancer survival in Manizales is lower than that reported in populations with higher levels of development. Significant gaps in survival persist according to the health insurance regimen, disadvantaging the most socioeconomically vulnerable population, possibly mediated by late diagnoses due to barriers in timely access to treatment.
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References
Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229–63. doi: 10.3322/caac.21834.
Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17–48. doi: 10.3322/caac.21763.
Ferlay J, Ervik M, Lam F, Laversanne M, Colombet M, Mery L, et al. Colombia fact sheet [Internet]. Global Cancer Observatory: Cancer
Today. 2022 [citado el 25 de enero de 2025]. Disponible en: https://gco.iarc.who.int/media/globocan/factsheets/populations/170-colombia-fact-sheet.pdf.
Bernard B, Burnett C, Sweeney CJ, Rider JR, Sridhar SS. Impact of age at diagnosis of de novo metastatic prostate cancer on survival. Cancer. 2020;126(5):986–93. doi: 10.1002/cncr.32630.
Allemani C, Matsuda T, Di Carlo V, Harewood R, Matz M, Nikšić M, et al. Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391(10125):1023–75. doi: 10.1016/S0140-6736(17)33326-3
Mariano López L. Indicadores de gestión del riesgo en cáncer de próstata según pobreza multidimensional en Colombia, 2019. Universidad del Norte; 2021.
Campos-Guzmán NR. Supervivencia de pacientes con cáncer de próstata en un hospital de Bogotá, Colombia 2008-2014. Duazary.
;18(3):259–68. doi: 10.21676/2389783x.4238.
Villegas CR, Chacón JA, Sánchez T. Sobrevida en cáncer de próstata de una población del centro de Colombia. Acta Méd Colomb. 2015;40(2):101–8.
Arias-Ortiz NE, de Vries E. Health inequities and cancer survival in Manizales, Colombia: A population-based study. Colomb Med.
;49(1):63–72. doi: 10.25100/cm.v49i1.3629.
Restrepo JA, Bravo LE, García-Perdomo HA, García LS, Collazos P, Carbonell J. Incidencia, mortalidad y supervivencia al cáncer de próstata en Cali, Colombia, 1962-2011. Salud Publica Mex [Internet]. 2014 [citado el 24 de septiembre de 2024];56:440–7. Disponible en: https://www.scielo.org.mx/pdf/spm/v56n5/v56n5a11.pdf.
Gutiérrez-Juárez RR, Álvarez-Bañuelos MT, Morales-Romero J, Ortiz-Chacha CS, Sampieri-Ramírez CL. Lugar de residencia y grado de
marginación como factores pronósticos de supervivencia al cáncer de próstata en Veracruz, México. Rev Peru Med Exp Salud Pública.
;37(3):423–30. doi: 10.17843/rpmesp.2020.373.4929.
Myint ZW, O’Neal R, Chen Q, Huang B, Vanderpool R, Wang P. Disparities in prostate cancer survival in Appalachian Kentucky: a populationbased study. Rural Remote Health. 2019;19(2). doi: 10.22605/RRH4989
Koo K, Papa N, Evans M, Jefford M, IJzerman M, White V, et al. Mapping disadvantage: identifying inequities in functional outcomes for prostate cancer survivors based on geography. BMC Cancer. 2022;22:283. doi: 10.1186/s12885-022-09389-4.
Navarro E, Caballero H, Cortés Á, Arias N, Casas H, de Vries E, et al. Sistema de información de cáncer en Colombia -SICC (Versión 1.0)
[Internet]. [citado el 14 de septiembre de 2025]. Disponible en: https://www.infocancer.co/portal/#!/home.
Bray F, Parkin DM. Evaluation of data quality in the cancer registry: principles and methods. Part I: comparability, validity and timeliness. Eur J Cancer. 2009;45(5):747–55. doi: 10.1016/j.ejca.2008.11.032.
Parkin DM, Bray F. Evaluation of data quality in the cancer registry: principles and methods Part II. Completeness. Eur J Cancer.
;45(5):756–64. doi: 10.1016/j.ejca.2008.11.033.
Centers for disease control and prevention. Link Plus | NPCR | CDC [Internet]. National Program of Cancer Registries. 2024 [citado el 18 de septiembre de 2025]. p. 1. Disponible en: https://www.cdc.gov/national-program-cancer-registries/registry-plus/link-plus.html?CDC_AAref_Val=https://www.cdc.gov/cancer/npcr/tools/registryplus/lp.htm.
Departamento Administrativo Nacional de Estadística -DANE. Mesa de expertos de estratificación socioeconómica [Internet]. 2021 [citado el 23 de enero de 2025]. 59 p. Disponible en: https://colaboracion.dnp.gov.co/cdt/vivienda%20agua%20y%20desarrollo%20urbano/mesa-expertos-estratificacion/informe%20final.pdf.
Piñeros M, Parkin DM, Ward K, Chokunonga E, Ervik M, Farrugia H, et al. Essential TNM: a registry tool to reduce gaps in cancer staging information. Lancet Oncol. 2019;20(2):e103–11. doi: 10.1016/S1470-2045(18)30897-0.
Guzmán-García F. Cáncer de próstata de bajo riesgo alternativas de manejo: vigilancia activa. Indexia revista médico-científica [Internet]. 2021 [citado el 16 de septiembre de 2025]; Disponible en: https://revistaindexia.com/wp-content/uploads/2021/08/CANCER-DE-PROSTATA-DE-BAJO-RIESGO-ALTERNATIVAS-DE-MANEJO-INDEXIA.pdf
Damico A V, Whittington R, Bruce Malkowicz S, Schultz D, Schnall M, Tomaszewski JE, et al. A multivariate analysis of clinical and pathological factors that predict for prostate specific antigen failure after radical prostatectomy for prostate cancer. J Urol. 1995;154(1):131–8. doi: 10.1016/S0022-5347(01)67248-3.
2Andersson TML, Myklebust TÅ, Rutherford MJ, Møller B, Soerjomataram I, Arnold M, et al. The impact of excluding or including
Death Certificate Initiated (DCI) cases on estimated cancer survival: A simulation study. Cancer Epidemiol. 2021;71(Pt A):101881. doi:
1016/j.canep.2020.101881.
Ministerio de Salud. Resolución número 8430 de 1993 [Internet]. Santafé de Bogotá D.C: Ministerio de Salud; 1993 [citado el 25 de noviembre de 2024]. 19 p. Disponible en: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/RESOLUCION-8430-DE-1993.PDF
Siegel DA, O’Neil ME, Richards TB, Dowling NF, Weir HK. Prostate Cancer Incidence and Survival, by Stage and Race/Ethnicity - United States, 2001-2017. MMWR Morb Mortal Wkly Rep. 2020;69(41):1473–80. doi: 10.15585/MMWR.MM6941A1.
Matti B, Zargar-Shoshtari K. Prostate cancer outcomes disparities: population survival analysis in an ethnically diverse nation. Urol Oncol. 2021;39(367):e19–26. doi: 10.1016/J.UROLONC.2021.02.023.
Barcelo Obrador A. Estudio de alta resolución de los factores asociados a la supervivencia en el cáncer de próstata. Universitat de las Illes Balears; 2020.
Torres-Sánchez L, Hernández-Pérez JG, Escamilla-Nuñez C, Rodríguez-Covarrubias F, Manzanilla-García H, Mohar A, et al. Disparities
on prostate cancer survival in Mexico: a retrospective cohort study. Salud Publica Mex. 2023;65(3):236–44. doi: 10.21149/14266.
Bravo LE, García LS, Collazos P, Holguín J, Soerjomataram I, Miranda-Filho A. Trends in long-term cancer survival in Cali, Colombia: 1998-2017. Colomb Med. 2022;53(1):1–19. doi: 10.25100/cm.v53i1.5082.
Teoh JYC, Hirai HW, Ho JMW, Chan FCH, Tsoi KKF, Ng CF. Global incidence of prostate cancer in developing and developed countries
with changing age structures. PLoS One. 2019;14(10):e0221775. doi: 10.1371/journal.pone.0221775.
DeRouen MC, Schupp CW, Koo J, Yang J, Hertz A, Shariff-Marco S, et al. Impact of individual and neighborhood factors on disparities
in prostate cancer survival. Cancer Epidemiol. 2018;53:1–11. doi: 10.1016/j.canep.2018.01.003
Tomic K, Ventimiglia E, Robinson D, Häggström C, Lambe M, Stattin P. Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. Nationwide population-based study. Int J Cancer. 2018;142(12):2478–84. doi: 10.1002/ijc.31272.
Fantin R, Santamaría-Ulloa C, Barboza-Solís C. Socioeconomic inequalities in cancer mortality: Is Costa Rica an exception to the rule? Int J Cancer. 2020;147(5):1286–93. doi: 10.1002/ijc.32883.
Krimphove MJ, Cole AP, Fletcher SA, Harmouch SS, Berg S, Lipsitz SR, et al. Evaluation of the contribution of demographics, access to health care, treatment, and tumor characteristics to racial differences in survival of advanced prostate cancer. Prostate Cancer Prostatic Dis. 2019;22(1):125–36. doi: 10.1038/S41391-018-0083-4.
Myint ZW, O’Neal R, Chen Q, Huang B, Vanderpool R, Wang P. Disparities in prostate cancer survival in Appalachian Kentucky: a population-based study. Rural Remote Health. 2019;19:4989. doi: 10.22605/RRH4989.
Kim IE, Kim DD, Kim S, Ma S, Jang TL, Singer EA, et al. Changes in prostate cancer survival among insured patients in relation to
USPSTF screening recommendations. BMC Urol. 2022;22(1):91. doi: 10.1186/S12894-022-01045-0.
Congreso de Colombia. Ley 1384 de 2010 [Internet]. Bogota D.C, Colombia; 2010. 6 p. Disponible en: https://www.funcionpublica.gov.co/eva/gestornormativo/norma_pdf.php?i=39368.
Departamento Administrativo Nacional de Estadística - DANE. Resultados Censo Nacional de Población y Vivienda 2018 Manizales, Caldas [Internet]. Manizales; 2019 oct [citado el 24 de enero de 2025]. Disponible en:
Solano-Dazzarola PA, Grilló GA, López JA, Montoya-Cobo E. Panorama colombiano del cáncer de mama, cérvix y próstata. Salutem Scientia Spiritus. 2023;9(1):28–35. Disponible en: http://revistas.javerianacali.edu.co/index.php/salutemscientiaspiritus/article/view/1304.
Campá J, Mar-Barrutia G, Extramiana J, Arróspide A, Mar J. Supervivencia del cáncer de próstata avanzado en España según escala de
Gleason, edad y estadio. Actas Urol Esp. 2016;40(8):499–506. doi: 10.1016/J.ACURO.2016.03.008.
Arias V SA. Inequidad y cáncer: una revisión conceptual. Rev Fac Nac Salud Pública. 2009;27(3):341–8. doi: 10.17533/UDEA.RFNSP.2060.
Giraldo-Osorio A, Manrique-Mendoza YD, Loaiza-Ruiz D, Arias-Ortiz NE. Inequidades en la supervivencia al cáncer de pulmón, Manizales, Colombia 2008-2018: estudio de base poblacional. Salud UIS. 2025;57:e25v57e20. doi: 10.18273/saluduis.57.e:25v57e20.
Cárdenas-Garzón K, Jurado D, Coronell K, Florez-Lozano K, Arias-Ortiz N, Bravo LM, et al. Determinants of survival in women diagnosed with breast cancer between 2008 and 2017: An analysis of a cohort using data from four Population-Based Cancer Registries of Colombia. Cancer Epidemiol. 2025;95:102765. doi: 10.1016/j.canep.2025.102765.
Arias-Ortiz N, Rodríguez-Betancourt JD, Toro-Toro JE, Navarro-Lechuga É, Jurado-Fajardo DM, Cárdenas-Garzón K, et al. The
Impact of Health Inequities on Population-Based Breast Cancer Survival in a Colombian Population, 2008-2015. Cancer Control.
;31:10732748241244928. doi: 10.1177/10732748241244928.
Guzmán-Gallego EA, Arias-Ortiz NE, Rodríguez-Betancourt JD. Supervivencia al cáncer colorrectal en Manizales, Colombia, 2008-2017: un estudio de base poblacional. Rev Bras Epidemiol. 2023;26:e230040. doi: 10.1590/1980-549720230040.2.
Perme MP, Stare J, Estève J. On Estimation in Relative Survival. Biometrics. 2012;68(1):113–20. doi: 10.1111/j.1541-0420.2011.01640.x.
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Copyright (c) 2025 Juan David Ladino, Miguel Ángel Giraldo Restrepo, Luisa Fernanda Vargas-Dussan, Nelson Arias-Ortiz, Alexandra Giraldo-Osorio

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