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Mexico: cancer statistics from IARC GlobalCan (2012)

Population in 2012: 116.1m
People newly diagnosed with cancer (excluding NMSC) / yr: 148,000
Age-standardised rate, incidence per 100,000 people/yr: 131.5
Risk of getting cancer before age 75:13.4%
People dying from cancer /yr: 78,700

Menu: Mexican Cancer Resources

Mexico: Cancer Organisations and Resources
Latest Research Publications from Mexico

Mexico: Cancer Organisations and Resources (6 links)

Latest Research Publications from Mexico

Ortiz-Mendoza CM, de-la-Fuente-Vera TA, Pérez-Chávez E
Metabolic syndrome in Mexican women survivors of breast cancer: a pilot study at a general hospital.
Med Arch. 2014; 68(1):19-21 [PubMed] Related Publications
INTRODUCTION: According to developed countries' studies, in breast cancer survivors there is a high prevalence of metabolic syndrome; however, in Mexico data is lacking about this issue.
GOAL: To explore if metabolic syndrome occurs in Mexican women survivors of breast cancer.
MATERIAL AND METHODS: At a second-level general hospital, women with breast cancer with a surviving > 2 years were studied. The analysis involved their demographic and anthropometric features, blood pressure measurement, time of surviving, besides fasting blood levels of lipids and glucose.
RESULTS: The sample consisted of 100 women; 42% were obese (body mass index > or = 30 kg/m2). The sample's mean age was 60 years with a mean surviving time of 6.5 years. Their mean glucose level was 122 mg/dL and triglycerides 202 mg/dL. There were 33% with blood pressure > or = 130/85mm Hg or diagnosis of hypertension. Fifty-seven percent had glucose > 99 mg/dL or diagnosis of diabetes mellitus, and 58% had triglycerides > 149 mg/dL. Metabolic syndrome occurred in 57% of obese women.
CONCLUSION: Our results suggest that metabolic syndrome occurs in more than 50% of obese Mexican women survivors of breast cancer.

Related: Breast Cancer

Dorantes-Acosta E, Medina-Sanson A, Jaimes-García Y, López-Martínez B
Clinical features and treatment outcomes of pediatric acute promyelocytic leukemia in a Mexican pediatric hospital.
Rev Invest Clin. 2013 Sep-Oct; 65(5):392-8 [PubMed] Related Publications
INTRODUCTION: Acute promyelocytic leukemia (APL) is a distinct type of acute myeloid leukemia (AML) characterized by chromosomal translocations involving the retinoid acid receptor α (RARA) gene on chromosome 17. APL is a relatively rare blood disease that is highly curable with current treatment strategies; however, patient outcomes are heterogeneous in countries with limited resources. Promyelocytic leukemia accounts for 20-25% of all AML cases in Latin American countries.
MATERIAL AND METHODS: We conducted a study from July 2007 to July 2012 and applied the IC-APL2006 protocol. This case study reports the results from eleven patients with AML M3 (five males and six females). In all cases, the diagnoses were made by aspirating bone marrow and evaluating the t(15:17) or t(11:17) transcript. In eight cases, the molecular biology-based diagnostics for the PLM-RARa transcript were positive, and they were negative in two cases. One patient was positive for the PLZF-RARa transcript.
RESULTS: The mean WBC at the time of diagnosis was 10.1 x 10(9)/L, and the mean platelet count was 17.1 x 10(9)/L. The mean percentage of abnormal promyelocytes in the bone marrow aspirates was 68%. Of the eleven patients, four presented with disseminated intravascular coagulation. All of the patients began treatment with transretinoic acid (ATRA) (45 mg/m(2)/day), which led to 4 cases of ATRA syndrome. There were 2 relapses, and the patient died in one case. The remaining ten patients were alive after the median follow-up period of 33.6 months (range from 11 to 60 months).
CONCLUSION: The authors report on a series of cases involving pediatric patients with AML M3 seen at a single institution; the patients were stratified and treated with a standard protocol to obtain satisfactory results. Although the number of patients is limited, the health outcomes are relevant. To our knowledge, this is the first series of pediatric APL patients in Mexico who were treated with the IC-APL2006 protocol.

Related: Mercaptopurine Cytarabine Daunorubicin Methotrexate Mitoxantrone
Departamento de Hemato-Oncología, Hospital Infantil de México Federico Gómez.

Lazcano-Ponce E, Lőrincz AT, Torres L, et al.
Specimen self-collection and HPV DNA screening in a pilot study of 100,242 women.
Int J Cancer. 2014; 135(1):109-16 [PubMed] Related Publications
Since cervical cancer remains common in Mexico despite an established cytology screening program, the Ministry of Health recently introduced pilot front-line HPV testing into the Mexican cervical cancer screening program (CCSP). Here, we present the key field performance metrics of this population-based study. High-risk HPV DNA (hrHPV) testing was conducted on self-collected vaginal specimens from 100,242 women aged 25-75 years residing in Morelos State. All hrHPV positive women and a random sample of 3.2% (n = 2,864) of hrHPV negative participants were referred for colposcopic examination. The main disease endpoint of interest was cervical intraepithelial neoplasia grade 2 or higher (CIN2+). We calculated relative risk, positive predictive value and negative predictive value adjusted for screening test verification bias. The overall prevalence of hrHPV was 10.8% (95% CI 10.6-11.0). Women positive for hrHPV had a relative risk of 15.7 for histologically detectable CIN2+. The adjusted positive predictive value of the hrHPV test was 2.4% (95% CI 2.1-2.7); whereas the adjusted negative predictive value was 99.8% (95% CI 99.8-99.9). These findings suggest that large-scale vaginal hrHPV testing in a middle-income country can identify women at greater risk of advanced cervical abnormalities in a programmatically meaningful way but care is warranted to ensure that disease not detectable at colposcopy is kept to a minimum. PASS shows areas that need improvement and sets the stage for wider use of hrHPV screening of self-collected vaginal specimens in Mexico.

Related: Cancer Screening and Early Detection Cervical Cancer
Centro de Investigacion en Salud Poblacional, Instituto Nacional de Salud Pública de México. Cuernavaca Morelos, México.
Research funded by:

Peñarrieta-de Córdova I, Barrios FF, Gutierrez-Gomes T, et al.
Self-management in chronic conditions: partners in health scale instrument validation.
Nurs Manag (Harrow). 2014; 20(10):32-7 [PubMed] Related Publications
AIMS: This article describes a study that aimed to validate the Self-care in Chronic Conditions Partners in Health Scale instrument in the Mexican population. The instrument has been validated in Australia for use as a screening tool by primary healthcare professionals to assess the self-care skills and abilities of people with a chronic illness.
METHODS: Validation was conducted using baseline data for 552 people with diabetes, hypertension and cancer aged 18 or older who were users of healthcare centres in Tampico, Tamaulipas, Mexico.
RESULTS: Results show high reliability and validity of the instrument and three themes were identified: knowledge, adherence, and dealing with and managing side effects.
CONCLUSION: The findings suggest the scale is useful as a generic self-rated clinical tool for assessing self-management in a range of chronic conditions, and provides an outcome measure for comparing populations and change in patient self-management knowledge and behaviour. The authors recommend validating the scale in other Latin-American settings with more research into the effect of gender on self- management.

Related: Cancer Prevention and Risk Reduction
Facultad de Enfermería, Universidad Autónoma de Tamaulipas, Mexico.

Comrnejo-Juárez P, Espinosa-Altamirano A, Ibarra-del-Río M, et al.
Cystic echinococcosis: a disease mimicking cancer in a non-endemic country report of two cases.
West Indian Med J. 2013; 62(3):266-9 [PubMed] Related Publications
Echinococcosis is a parasitic disease that involves dogs as definitive host and sheep as intermediate host. Humans become infected incidentally through fecal-oral contact, particularly in the course of playful and close contact with an infected dog. Mexico is considered a region that is virtually free of cystic echinoccocosis. This manuscript describes two cases that were referred to a tertiary-care oncology hospital with a diagnosis of cancer. In one case, the presumptive diagnosis was liver cancer because abdominal ultrasonography revealed a low-density mass in the right hepatic lobe. Drainage was performed and cytologic examination of the fluid showed multiple Echinococcus cyst as well as prostoscolex. The case was resolved with percutaneous drainage and administration of albendazole for two months. In the second case, the patient was referred with a diagnosis of disseminated cervical cancer A cyst was identified in the upper right lung lobe; a diagnostic puncture was performed showing an Echinococcus cyst. This resolved solely with two months of albendazole administration.

Related: Liver Cancer Cervical Cancer
Department of Infectious Diseases, Instituto Nacional de Cancerologia (INCan), Secretaria de Salud (Ssa), Mexico City, Mexico.

Rodríguez-Acosta ED, Esquivel-Pedraza L, Saeb-Lima M, et al.
Borderline tuberculoid leprosy mimicking mycosis fungoides.
Skinmed. 2013 Nov-Dec; 11(6):379-81 [PubMed] Related Publications
A 65-year-old unemployed man, originally from Michoacán and currently living in Toluca, state of Mexico, presented for medical consultation for disseminated dermatosis in all body segments. The condition was limited to the head and neck, was bilateral and symmetrical, and was characterized by infiltrated and confluent erythematous-edematous plates of diverse diameter covering 90% of the upper and lower extremities (Figure 1). The ailment had 2 years' evolution and a progressive course. The patient was diagnosed in private practice as having atopic dermatitis. After exacerbation of symptoms, he was treated with deflazacort and hydroxychloroquine with no improvement. Results from lesion biopsies revealed sarcoidal granulomas and the patient was therefore referred to the dermatology department at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán for further study and treatment with the presumptive diagnosis of mycosis fungoides vs sarcoidosis.
Department of Dermatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.

Alías-Melgar A, Neave-Sánchez E, Suárez-Cuenca JA, Morales-Covarrubias J
Association of urine oncofetal fibronectin levels with urology's most common disorders.
Ann Clin Lab Sci. 2013; 43(4):420-3 [PubMed] Related Publications
UNLABELLED: Urine oncofetal fibronectin (OnfFN) has proven useful in the assessment of malignant diseases such as transitional cell carcinoma (TCC) of the bladder. This study aimed to explore whether OnfFN may identify benign and common urinary diseases.
METHODS: The urine OnfFN concentrations from patients who had bladder TCC (8 patients), benign urinary diseases (10 benign prostatic enlargement [BPE] patients, 10 urolithiasis patients), or controls (10 healthy individuals) were determined by ELISA and compared.
RESULTS: The urine OnfFN concentration was significantly higher in patients with bladder TCC and lithiasis (mean ± SE 0.43 ± 0.18 and 0.45 ± 0.23 ug/mL) than in patients with BPE and in healthy individuals (0.15 ± 0.06 and 0.10 ± 0.02 ug/mL, p<0.05). The urine OnfFN level (cutoff value 0.038 μg/mL), was able to identify 75% of patients with bladder TCC, 60% of patients with BPE and 80% of patients with urolithiasis, achieving a sensitivity of 0.75 for the recognition of either cancer or a urinary disorder. The OnfFN level had a high sensitivity (0.9) for the identification of urolithiasis.
CONCLUSION: The urine OnfFN level proved helpful in the identification of bladder TCC patients. However, it had a better performance for the identification of urolithiasis, highlighting the potential usefulness of OnfFN as a biomarker for urothelial inflammation and repair.

Related: Transitional Cell Cancer of the Renal Pelvis and Ureter Bladder Cancer Bladder Cancer - Molecular Biology
MD; Departamento de Urología, Centro Médico Nacional "20 de Noviembre", I.S.S.S.T.E. Avenida Félix Cuevas, número 540, Colonia Del Valle, Delegación Benito Juárez, México, D.F., México. Código Postal 03229; phone: 00(+5255)55583132; fax: 00(+5255)5135134...

Marván ML, Ehrenzweig Y, Catillo-López RL
Knowledge about cervical cancer prevention and psychosocial barriers to screening among Mexican women.
J Psychosom Obstet Gynaecol. 2013; 34(4):163-9 [PubMed] Related Publications
The objectives of this study were to evaluate: Mexican women's knowledge about cervical cancer prevention; psychosocial barriers to screening; and the relation of both to cervical cancer screening behavior. Three hundred and eighty-four rural and urban women who had achieved a basic or higher educational level were surveyed. Almost 80% of the women had a Pap test but rural women were less likely to have done so. Although most women had received their most recent Pap within the last three years, only 29% had had their first Pap in accordance with the official Mexican norm. Participants showed inadequate knowledge about the risk factors for cervical cancer, especially women with only a basic educational level, irrespective of residence in an urban or rural area. Factors associated with non-screening were poor knowledge about Pap testing and about the risk factors for cervical cancer, as well as the following barriers: believing that Pap testing is too embarrassing; believing that men do not want them to have a Pap test; and believing that the test is painful. In light of these socio-cultural influences, our findings could be helpful in designing effective programs to increase Pap screening.

Related: Cancer Screening and Early Detection Cervical Cancer Cervical Cancer Screening
Institute of Psychological Research, Universidad Veracruzana , Xalapa , México.

Deffis-Court M, Alvarado-Ibarra M, Ruiz-Argüelles GJ, et al.
Diagnosing and treating mixed phenotype acute leukemia: a multicenter 10-year experience in México.
Ann Hematol. 2014; 93(4):595-601 [PubMed] Related Publications
Mixed phenotype acute leukemia (MPAL) in adults represents nearly 2 to 5 % of all acute leukemia cases. There are two large studies throughout the world and only case reports and small series have been reported in Latin America. This study retrospectively analyses the clinical characteristics and survival of 27 patients with MPAL evaluated in three medical institutions of Mexico. All cases meet World Health Organization 2008 criteria; 70.3 % of patients had B lymphoid/myeloid lineage MPAL. Induction chemotherapy protocols included 7 + 3 hyper-CVAD, high-density schedules, and pediatric-like regimens such as New York II and total XI. Complete remission was achieved in 23/27 patients (85.2 %). Only one patient died due to chemotherapy-induced aplasia during remission induction (5.2 %). In 68 % of cases, we were able to administer maintenance therapy as a regimen in lymphoblastic leukemia. At the time of analysis, 70.4 % of the patients in the entire cohort had died mainly as result of disease progression (73.6 %). Disease-free survival was 13 months (95 % CI, 9.6-16.3 months) and overall survival was 14.8 months (95 % CI 13.4-16.27). Survival rates are low and standardized therapy for the management of this type of leukemia is still lacking. This is the largest series reported in Mexico and to the best of our knowledge in Latin America.
Clínica de Leucemia del Departamento de Hematología-Oncología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15 Sección XVI, Del Tlalpan, CP 14000, Mexico City, Federal District, Mexico.

Alvarado-Cabrero I, Hernández-Toriz N, Paner GP
Clinicopathologic analysis of choriocarcinoma as a pure or predominant component of germ cell tumor of the testis.
Am J Surg Pathol. 2014; 38(1):111-8 [PubMed] Related Publications
Although well recognized in the literature, the contemporary clinicopathologic data regarding choriocarcinoma (CC) as a pure or the predominant component of a testicular germ cell tumor (GCT) are limited. Herein, we present a series of pure CC and predominant CC in mixed GCT of the testis obtained from a single oncology institution. A comprehensive histologic review of 1010 orchiectomies from 1999 to 2011 yielded 6 (0.6%) pure CC and 9 (0.9%) mixed GCT cases with a predominant CC component. Patients' ages ranged from 20 to 39 years (median 29 y). All patients had markedly elevated serum β-hCG levels (median 199,000 IU/mL) at presentation. All tumors were unilateral and involved the right (9/15) and left (6/15) testis. The mean tumor size was 6.5 cm (range, 1.5 to 8 cm). Histology was similar for pure CCs and the CC component of mixed GCTs. CC commonly showed expansile hemorrhagic nodular cysts surrounded by variable layers of neoplastic trophoblastic cells (mononucleated trophoblasts and syncytiotrophoblasts). The syncytiotrophoblasts usually covered columns of mononucleated trophoblasts and occasionally formed plexiform aggregates and pseudovillous protrusions. Immunohistochemical stains suggested a mixture of cytotrophoblasts (p63+, HPL_) and intermediate trophoblasts (p63-, HPL weak +/-) in the columns of mononucleated cells. In the 9 mixed GCTs, CC comprised 50% to 95% (7/9 were ≥80% CC) of the tumor; 7 were combined with 1, and 2 were combined with 2 other GCT components. The non-CC components included teratoma (5/9), seminoma (2/9), yolk sac tumor (2/9), and embryonal carcinoma (2/9). Lymphovascular invasion, spermatic cord invasion, and tunica vaginalis invasion were present in 15/15, 5/15, and 1/12 cases, respectively. In mixed GCTs, these locally aggressive features were attributed to the CC component, except in 1 tumor in which it was also exhibited by the embryonal carcinoma component. Lymphovascular invasion was multifocal to widespread in 73% of tumors. The stages of the 15 tumors were: pT2 (10), pT3 (5); NX (1), N1 (4), N2 (5), N3 (5); and M1a (2) and M1b (13). Distant organ metastasis mostly involved the lungs (11) and liver (10). Follow-up information was available in 14 patients, all of whom received cisplatin-based chemotherapy. All 6 pure CC patients were dead of disease (range, 6 to 14 mo, median 9.5 mo). Follow-up of 8 patients with predominant CC (range, 10 to 72 mo, median 27 mo) showed that 5 died of the disease, and 1 was alive with disease and 2 were alive with no evidence of disease at 60 and 72 months of follow-up, respectively; these latter 2 patients were the only ones with M1a disease on presentation. This series confirms the proclivity for high-stage presentation including presence of distant metastasis, hematogenous spread, and poor outcome of testicular CC. Mixed GCT with a predominant CC component has similar tendency for high-stage presentation, marked elevation of serum β-hCG levels, and aggressive behavior compared with pure CC. This study also showed that distant metastasis by CC when only involving the lungs (M1a) may not be uniformly fatal with chemotherapy. The mononucleated trophoblastic columns in testicular CC appear to be a mixture of cytotrophoblasts and intermediate trophoblasts, similar to that described in gestational CC.

Related: Testicular Cancer
Departments of *Pathology †Urology, Mexican Oncology Hospital, IMSS, Mexico City, Mexico ‡Departments of Pathology and Surgery, Section of Urology, University of Chicago, Chicago, IL.

Arredondo-Garza T, Majluf-Cruz A, Vela-Ojeda J, et al.
Peri-infusional adverse reactions to rituximab in patients with non-Hodgkin's lymphoma.
Arch Med Res. 2013; 44(7):549-54 [PubMed] Related Publications
BACKGROUND AND AIMS: Rituximab is effective in the treatment of B-cell lymphoid malignances and some autoimmune diseases. Most patients receiving the first infusion of rituximab experience symptoms that decrease with subsequent infusions. It is assumed that the first dose of rituximab should be infused slowly during a 6-h period and during 4-h periods subsequently. The aim of the study was to evaluate the frequency and severity of adverse reactions to rituximab in patients with non-Hodgkin's lymphoma.
METHODS: This was an intensive pharmacovigilance prospective, observational, open labeled, multicenter cohort study conducted in 12 hospitals. Adults requiring treatment with rituximab (375 mg/m(2) body surface area) alone or with chemotherapy were included. Adverse reactions were graded according to the National Cancer Institute scale, whereas causality was established using the Naranjo algorithm. Infusions were classified as fast (0-90 min) and slow (>91 min). Fast infusions were used to analyze the associated adverse reactions.
RESULTS: We included 550 adult patients. Total infusion episodes were 1,749 and 52 adverse reactions were reported in 22 patients (4%). Thirty-one of 52 adverse reactions occurred during the first infusion. The risk of adverse reactions was lower with the fast infusions (10/52 adverse reactions [19.23%]). All adverse effects were mild. Twenty-three adverse effects were possibly related to rituximab.
CONCLUSIONS: Rituximab can be infused at a fast rate without an increase in adverse reactions. Peri-infusional adverse reactions are similar to those described for other populations but the incidence rate is lower. Rituximab has a favorable safety profile in patients with non-Hodgkin's lymphoma.

Related: Non Hodgkin's Lymphoma Rituximab (Mabthera)
Departamento de Farmacología, CINVESTAV, IPN, Mexico City, Mexico.

Alcazar-González GA, Calderón-Garcidueñas AL, Garza-Rodríguez ML, et al.
Comparative study of polymorphism frequencies of the CYP2D6, CYP3A5, CYP2C8 and IL-10 genes in Mexican and Spanish women with breast cancer.
Pharmacogenomics. 2013; 14(13):1583-92 [PubMed] Related Publications
AIM: Pharmacogenetic studies in breast cancer (BC) may predict the efficacy of tamoxifen and the toxicity of paclitaxel and capecitabine. We determined the frequency of polymorphisms in the CYP2D6 gene associated with activation of tamoxifen, and those of the genes CYP2C8, CYP3A5 and DPYD associated with toxicity of paclitaxel and capecitabine. We also included a IL-10 gene polymorphism associated with advanced tumor stage at diagnosis.
PATIENTS & METHODS: Genomic DNAs from 241 BC patients from northeast Mexico were genotyped using DNA microarray technology.
RESULTS: For tamoxifen processing, CYP2D6 genotyping predicted that 90.8% of patients were normal metabolizers, 4.2% ultrarapid, 2.1% intermediate and 2.9% poor metabolizers. For paclitaxel and the CYP2C8 gene, 75.3% were normal, 23.4% intermediate and 1.3% poor metabolizers. Regarding the DPYD gene, only one patient was a poor metabolizer. For the IL-10 gene, 47.1% were poor metabolizers.
CONCLUSION: These results contribute valuable information towards personalizing BC chemotherapy in Mexican women.

Related: Breast Cancer CYP2D6 Fluorouracil IL10 Paclitaxel Polymorphisms Capecitabine
Vitagenesis S.A. de C.V., Boulevard Puerta del Sol 1005, Colinas de San Jerónimo, Monterrey. N.L. C.P. 64630, Mexico.

Herrera-Goepfert R, Vela-Chávez T, Carrillo-García A, et al.
High-risk human papillomavirus (HPV) DNA sequences in metaplastic breast carcinomas of Mexican women.
BMC Cancer. 2013; 13:445 [PubMed] Free Access to Full Article Related Publications
BACKGROUND: Metaplastic carcinoma, an uncommon subtype of breast cancer, is part of the spectrum of basal-like, triple receptor-negative breast carcinomas. The present study examined 20 surgical specimens of metaplastic breast carcinomas, for the presence of high-risk Human papillomavirus (HPV), which is suspected to be a potential carcinogenic agent for breast carcinoma.
METHODS: Mastectomy specimens from patients harboring metaplastic breast carcinoma, as defined by the World Health Organization (WHO), and who attended the Instituto Nacional de Cancerologia in Mexico City, were retrieved from the files of the Department of Pathology accumulated during a 16-year period (1995-2008). Demographic and clinical information was obtained from patients' medical records. DNA was extracted from formalin-fixed, paraffin-embedded tumors and HPV type-specific amplification was performed by means of Polymerase chain reaction (PCR). Quantitative Real-time (RT) PCR was conducted in HPV positive cases. Statistically, the association of continuous or categorical variables with HPV status was tested by the Student t, the Chi square, or Fisher's exact tests, as appropriate.
RESULTS: High-risk HPV DNA was detected in eight (40%) of 20 metaplastic breast carcinomas: seven (87.5%) HPV-16 and one (12.5%) HPV-18. Mean age of patients with HPV-positive cases was 49 years (range 24-72 years), the same as for HPV-negative cases (range, 30-73 years). There were not striking differences between HPV + and HPV- metaplastic carcinomas regarding clinical findings. Nearly all cases were negative for estrogen, progesterone and Human epidermal growth factor receptor 2 (HER2), but positive for Epidermal growth factor receptor (EGFR).
CONCLUSIONS: High-risk HPV has been strongly associated with conventional breast carcinomas, although the subtle mechanism of neoplastic transformation is poorly understood. In Mexican patients, the prevalence of HPV infection among metaplastic breast carcinomas is higher than in non-metaplastic ones, as so the HPV viral loads; notwithstanding, HPV viral loads show wide variation and remain even lower than cervical and other non-cervical carcinomas, making it difficult to assume that HPV could play a key role in breast carcinogenesis. Further studies are warranted to elucidate the meaning of the presence of high-risk HPVDNA in breast carcinomas.

Related: Breast Cancer
Department of Pathology, Instituto Nacional de Cancerología México, México, Mexico.

Euscher E, Fox P, Bassett R, et al.
The pattern of myometrial invasion as a predictor of lymph node metastasis or extrauterine disease in low-grade endometrial carcinoma.
Am J Surg Pathol. 2013; 37(11):1728-36 [PubMed] Article available free on PMC after 01/11/2014 Related Publications
The purpose of this study was to examine predictors of lymph node (LN) metastases or extrauterine disease (ED) in low-grade (FIGO grade 1 or 2) endometrioid carcinoma (LGEC) in a multi-institutional setting. For LGEC with and without LN metastasis or ED, each of the 9 participating institutions evaluated patients' age, tumor size, myometrial invasion (MI), FIGO grade, % solid component, the presence or absence of papillary architecture, microcystic, elongated, and fragmented glands (MELF), single-cell/cell-cluster invasion (SCI), lymphovascular invasion (LVI), lower uterine segment (LUS) and cervical stromal (CX) involvement, and numbers of pelvic and para-aortic LNs sampled. A total of 304 cases were reviewed: LN(+) or ED(+), 96; LN(-)/ED(-), 208. Patients' ages ranged from 23 to 91 years (median 61 y). Table 1 summarizes the histopathologic variables that were noted for the LN(+) or ED(+) group: tumor size ≥2 cm, 93/96 (97%); MI>50%, 54/96 (56%); MELF, 67/96 (70%); SCI, 33/96 (34%); LVI, 79/96 (82%); >20% solid, 65/96 (68%); papillary architecture present, 68/96 (72%); LUS involved, 64/96 (67%); and CX involved, 41/96 (43%). For the LN(-)/ED(-) group, the results were as follows: tumor size ≥2 cm, 152/208 (73%); MI>50%, 56/208 (27%); MELF, 79/208 (38%); SCI, 19/208 (9%); LVI, 56/208 (27%); >20% solid, 160/208 (77%); papillary architecture present, 122/208 (59%); LUS involved, 77/208 (37%); CX involved, 24/208 (12%). There was no evidence of a difference in the number of pelvic or para-aortic LNs sampled between groups (P=0.9 and 0.1, respectively). After multivariate analysis, the depth of MI, CX involvement, LVI, and SCI emerged as significant predictors of advanced-stage disease. Although univariate analysis pointed to LUS involvement, MELF pattern of invasion, and papillary architecture as possible predictors of advanced-stage disease, these were not shown to be significant by multivariate analysis. This study validates MI, CX involvement, and LVI as significant predictors of LN(+) or ED(+). The association of SCI pattern with advanced-stage LGEC is a novel finding.

Related: Endometrial (Uterus) Cancer Endometrial Cancer USA
*The University of Texas, MD Anderson Cancer Center, Houston, TX †Wayne State University, Detroit, MI ‡Cedars-Sinai Medical Center, Los Angeles, CA ∥Penn State University, Hershey, PA ††Cleveland Clinic, Cleveland, OH §The Ottawa Hospital, University of Ottawa, Ot...
Research funded by:

Murillo-Zamora E, Moreno-Macías H, Ziv E, et al.
Association between rs2981582 polymorphism in the FGFR2 gene and the risk of breast cancer in Mexican women.
Arch Med Res. 2013; 44(6):459-66 [PubMed] Article available free on PMC after 01/11/2014 Related Publications
BACKGROUND AND AIMS: The rs2981582 single nucleotide polymorphism in the fibroblast growth factor receptor 2 gene has been consistently associated with an increased risk of breast cancer. We evaluated the effect of rs2981582 polymorphism in the FGFR2 gene on the risk of breast cancer and its interaction with non-genetic risk factors.
METHODS: A population-based case-control study was conducted in Mexico. Data from 687 cases and 907 controls were analyzed.
RESULTS: The T allele of the rs2981582 polymorphism was associated with an increased risk of breast cancer (ORper allele = 1.24, 95% CI 1.06-1.46). There was also an interaction between this polymorphism and alcohol consumption (p = 0.043). The effect of alcohol consumption on the risk of breast cancer varied according to the allelic variants of the rs2981582 polymorphism in the FGFR2 gene: OR = 3.97 (95% CI 2.10-7.49), OR = 2.01 (95% CI 1.23-3.29) and OR = 1.21 (95% CI 0.48-3.05) for genotypes CC, CT and TT, respectively.
CONCLUSIONS: This is the first study exploring the association between rs2981582 polymorphism in the FGFR2 gene and breast cancer risk in Mexican women. The interaction found may be of great public health interest because alcohol consumption is a modifiable breast cancer risk factor. Therefore, replication of this finding is of foremost importance.

Related: Breast Cancer FGFR2 gene
Departamento de Epidemiología, Hospital No. 4, IMSS, Tecomán, Colima, Mexico.
Research funded by:

López-Hernández D
Epidemiological association between body fat percentage and cervical cancer: a cross-sectional population-based survey from Mexico.
Arch Med Res. 2013; 44(6):454-8 [PubMed] Related Publications
BACKGROUND AND AIMS: Various studies have reported a direct association of cervical cancer risk with obesity and weight but not with the body fat percentage (BFP). The aim of this study was to analyze various anthropometric measures as potential risk factors for cervical cancer.
METHODS: A total of 20,236 women were included in a cross-sectional population-based survey. Obesity was defined according to the World Health Organization criteria, and central obesity was ≥80 cm; the BFP was defined using the Deurenberg equation (BFP = 1.2 [BMI] + 0.23 [age] - 10.8 [sex] - 5.4). The odds ratio (OR) was estimated from the chi square test and logistic regression models.
RESULTS: The prevalence of cervical cancer increased from 514 (95% confidence interval [CI] 321, 707) and 680 (95% CI 494, 866) to 732 (95% CI 535, 928) per 100,000 inhabitants in subjects with a normal weight, subjects who were overweight and subjects who were obese, respectively. Moreover, an association between cervical cancer and BFP (OR 1.027; CI 95% 1.006, 1.048; p = 0.012) was observed, and the risk increased with a BFP ≥45% (OR 2.369; CI 95% 1.284, 4.369; p = 0.006).
CONCLUSIONS: These data suggest a trend between the body mass index and the increasing prevalence of cervical cancer. In addition, the data showed a significant association between the BFP and cervical cancer, and this epidemiological association was higher as the BFP increased.

Related: Cervical Cancer
Centro de Investigación y de Educación Continua (CENINVEC), State of Mexico, Mexico. Electronic address:

Rinaldi S, Biessy C, Hernandez M, et al.
Circulating concentrations of insulin-like growth factor-I, insulin-like growth factor-binding protein-3, genetic polymorphisms and mammographic density in premenopausal Mexican women: results from the ESMaestras cohort.
Int J Cancer. 2014; 134(6):1436-44 [PubMed] Related Publications
The insulin-like growth factor (IGF) axis plays an essential role in the development of the mammary gland. High circulating levels of IGF-I and of its major binding protein IGFBP3 have been related with increased mammographic density in Caucasian premenopausal women. Some common single nucleotide polymorphisms (SNPs) in genes of the IGF pathway have also been suggested to play a role in mammographic density. We conducted a cross-sectional study nested within the large Mexican ESMaestras cohort to investigate the relation between circulating levels of IGF-I, IGFBP-3, the IGF-I/IGFBP-3 ratio, five common SNPs in the IGF-1, IGFBP-3 and IGF-1R genes and mammographic density in 593 premenopausal Mexican women. Mean age at mammogram was 43.1 (standard deviation, SD = 3.7) years, and average body mass index (BMI) at recruitment was 28.5 kg/m(2). Mean percent mammographic density was 36.5% (SD: 17.1), with mean dense tissue area of 48.3 (SD: 33.3) cm(2) . Mean IGF-I and IGFBP-3 concentrations were 15.33 (SD: 5.52) nmol/l and 114.96 (SD: 21.34) nmol/l, respectively. No significant associations were seen between percent density and biomarker concentrations, but women with higher IGF-I and IGF-I/IGFBP-3 concentrations had lower absolute dense (p(trend) = 0.03 and 0.09, respectively) and nondense tissue areas (p(trend) < 0.001 for both parameters). However, these associations were null after adjustment by BMI. SNPs in specific genes were associated with circulating levels of growth factors, but not with mammographic density features. These results do not support the hypothesis of a strong association between circulating levels of growth hormones and mammographic density in Mexican premenopausal women.

Related: Breast Cancer IGF1R
International Agency for Research on Cancer (IARC), Lyon, France.
Research funded by:

Quintanilla-Martinez L, Ridaura C, Nagl F, et al.
Hydroa vacciniforme-like lymphoma: a chronic EBV+ lymphoproliferative disorder with risk to develop a systemic lymphoma.
Blood. 2013; 122(18):3101-10 [PubMed] Related Publications
Hydroa vacciniforme-like lymphoma (HVLL) is an Epstein-Barr virus (EBV)-positive T-cell lymphoproliferative disorder of childhood that occurs mainly in Central and South America and Asia. We present the clinicopathological features of 20 Mexican children with HVLL with a median age of 8 years at diagnosis (range, 1-15). All patients presented with skin lesions involving sun-exposed areas, but not exclusively. Fever, lymphadenopathy, and hepatosplenomegaly were often observed. Most patients were treated with immunomodulators and/or immunosuppressive agents, resulting in temporary remission. For 13 patients follow-up was available for a median of 3 years (range, 1 month-13 years). Three patients with long follow-up (9-13 years) are alive with disease. Four patients died, 2 after developing systemic lymphoma. Histologically, the skin showed a predominantly angiocentric and periadnexal Epstein-Barr early RNA+ lymphoid infiltrate with variable atypia and subcutaneous involvement. Fifteen patients showed a T-cell phenotype (12, αβ; 2, γδ; 1, silent phenotype) and monoclonal T-cell receptor-γ rearrangements, whereas 6 exhibited a natural killer (NK)-cell phenotype. Four patients had hypersensitivity to mosquito bites. One patient showed both phenotypes. HVLL is an EBV-associated lymphoproliferative disorder of αβ-, γδ-, or NK-cell phenotype with a broad clinical spectrum, usually prolonged clinical course, and risk for progression to systemic disease.

Related: Cutaneous T-cell lymphoma Thalidomide
Institute of Pathology and Comprehensive Cancer Center, Eberhard-Karls-University of Tübingen, Tübingen, Germany;

Martinez ME, Wertheim BC, Natarajan L, et al.
Reproductive factors, heterogeneity, and breast tumor subtypes in women of mexican descent.
Cancer Epidemiol Biomarkers Prev. 2013; 22(10):1853-61 [PubMed] Article available free on PMC after 01/10/2014 Related Publications
BACKGROUND: Published data support the presence of etiologic heterogeneity by breast tumor subtype, but few studies have assessed this in Hispanic populations.
METHODS: We assessed tumor subtype prevalence and associations between reproductive factors and tumor subtypes in 1,041 women of Mexican descent enrolled in a case-only, binational breast cancer study. Multinomial logistic regression comparing HER2(+) tumors and triple-negative breast cancer (TNBC) to luminal A tumors was conducted.
RESULTS: Compared with women with luminal A tumors, those with a later age at first pregnancy were less likely to have TNBC [OR, 0.61; 95% confidence interval (CI), 0.39-0.95], whereas those with three or more full-term pregnancies were more likely to have TNBC (OR, 1.68; 95% CI, 1.10-2.55). A lower odds of TNBC was shown for longer menstruation duration, whether before first pregnancy (OR, 0.78; 95% CI, 0.65-0.93 per 10 years) or menopause (OR, 0.79; 95% CI, 0.69-0.91 per 10 years). Patients who reported breastfeeding for more than 12 months were over twice as likely to have TNBC than luminal A tumors (OR, 2.14; 95% CI, 1.24-3.68). Associations comparing HER2(+) with luminal A tumors were weak or nonexistent except for the interval between last full-term pregnancy and breast cancer diagnosis.
CONCLUSIONS: Findings show etiologic heterogeneity by tumor subtype in a population of Hispanic women with unique reproductive profiles.
IMPACT: Identification of etiologically distinct breast tumor subtypes can further improve our understanding of the disease and help provide personalized prevention and treatment regimens.

Related: Breast Cancer USA
Authors' Affiliations: Moores Cancer Center; Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California; Arizona Cancer Center, University of Arizona, Tucson; Department of Surgery, Maricopa Medical Center, Phoenix, Arizona; Department of Pediatrics, Dan...
Research funded by:

Badillo-Almaraz I, Zapata-Benavides P, Saavedra-Alonso S, et al.
Human papillomavirus 16/18 infections in lung cancer patients in Mexico.
Intervirology. 2013; 56(5):310-5 [PubMed] Related Publications
BACKGROUND/AIMS: Human papillomavirus (HPV) is an epitheliotropic, double-stranded DNA virus, and its high-risk genotypes are associated with human cancer. HPV genome has been detected in lung carcinomas in certain places around the world, including Mexico; however, the prevalence of this is unclear. In this study, we examine the frequency of high-risk HPV 16/18 in lung cancer tissues from a Mexican population.
METHODS: 39 lung cancer specimens were analyzed by polymerase chain reaction (PCR) using HPV GP5+/GP6+ primers and then were genotyped using specific primers to HPV 16/18. Additionally, in situ hybridization (ISH) was performed using BIO-labeled oligonucleotide probes.
RESULTS: Our results identified 15 positive cases (38.46%) for HPV 16 and 1 positive case (2.56%) for HPV 18 by PCR. ISH showed the presence of HPV DNA in 13 of 16 (81%) samples, in agreement with the PCR results.
CONCLUSIONS: In this study, we detected HPV 16/18 gene sequences in lung cancer samples obtained from Mexican patients by PCR and ISH. We found the highest prevalence of HPV 16 infection in lung adenocarcinomas, suggesting that HPV infection may be associated with lung cancer. However, further studies are needed to elucidate the role of HPV in lung carcinogenesis.

Related: FISH Lung Cancer
Universidad Autónoma de Nuevo León, Facultad de Ciencias Biológicas, Departamento de Microbiología e Inmunología, Ciudad Universitaria, San Nicolás de los Garza, Mexico.

Ortega-Cervantes L, Rojas-García AE, Robledo-Marenco Mde L, et al.
Morbidity of breast cancer and cervico-uterine cancer in women from the occidental region of Mexico.
Rev Invest Clin. 2013 May-Jun; 65(3):221-7 [PubMed] Related Publications
BACKGROUND: The incidences of breast cancer (BC) and cervico-uterine cancer (CC) vary widely from country to country. In Mexico, BC mortality has doubled in the last 20 years to become the second leading cause of death for women aged 30 to 54 years. CC is the most common cause of death from neoplasia in women over 25 years old. In 2006, the state of Nayarit had one of the highest mortality rates for these types of cancers in Mexico.
OBJECTIVE: To analyze and characterize the current demographics and morbidities associated with BC and CC in the state of Nayarit.
MATERIAL AND METHODS: In this retrospective study, the clinical histories of patients who were diagnosed with BC or CC at the State Cancer Center from January 2006 to December 2010 were analyzed.
RESULTS: A total of 406 patients with BC and 328 patients with CC were registered. The most common clinical stage for both cancer types was IIB. The municipalities of San Pedro Lagunillas and El Nayar presented the highest prevalences of BC and CC, respectively.
CONCLUISION: Our results suggest that women living in poorer and more marginalized regions have a higher possibility of developing BC and CC. Because BC and CC are preventable and treatable in their early stages, demographic information from population records for these cancers is helpful in determining the incidence rates and patterns and improving decision-making processes.

Related: Breast Cancer Cervical Cancer
Laboratorio de Contaminación y Toxicología Ambiental, Secretaría de Investigación y Posgrado. Universidad Autónoma de Nayarit, Tepic, Nayarit.

Ramos-Flores C, Romero-Gutiérrez T, Delgado-Enciso I, et al.
Polymorphisms in the genes related to angiogenesis are associated with uterine cervical cancer.
Int J Gynecol Cancer. 2013; 23(7):1198-204 [PubMed] Related Publications
INTRODUCTION: The expression of plasminogen activator inhibitor type 1 (PAI-1), vascular endothelial growth factor (VEGF), and transforming growth factor β1 (TGF-β1) participates in the angiogenesis of several cancer types. The goal of this study was to investigate polymorphisms in genes related to angiogenesis (PAI-1-675 4G/5G, VEGF C936T, and TGF-β1 G-800A) to evaluate the risk for developing uterine cervical cancer (UCC).
METHODS: In a case-control study, 100 healthy subjects and 100 patients with UCC from Mexico were included. We determined the genetic profile of the polymorphic markers, which were evaluated by polymerase chain reaction using a sequence-specific primer.
RESULTS: There was no statistical difference in the allele distribution from the intergroup comparisons of PAI-1 675 4G/5G and VEGF C936T data; however, a significant difference was observed within TGF-β1 G-800A. The linkage disequilibrium analysis revealed that PAI-1 -675 4G and TGF-β1 -800A pair-haplotype was in strong linkage disequilibrium with a significantly increased risk (odds ratio, 3.44; 95% confidence interval, 1.66-7.25) to UCC.
CONCLUSIONS: The polymorphisms in the genes related to angiogenesis -675 4G/5G PAI-1 and G-800A TGF-β1, segregated solely or combined, might contribute to the increased susceptibility to UCC in a Mexican population.

Related: Angiogenesis and Cancer TGFB1 Cervical Cancer VEGFA
Faculty of Medicine, University of Colima, Colima, México.

Torres-Jasso JH, Bustos-Carpinteyro AR, Marín ME, et al.
Analysis of the polymorphisms EGFR-r521K and ERBB2-I655V in Mexican patients with gastric cancer and premalignant gastric lesions.
Rev Invest Clin. 2013 Mar-Apr; 65(2):150-5 [PubMed] Related Publications
The proto-oncogenes epidermal growth factor receptor (EGFR) and erythroblastic leukemia viral oncogene homolog 2 (ERBB2), are involved in the development of diverse malignant tumors, including gastric cancer. We analyzed the association of SNPs EGFR-R521K and ERBB2-I655V with gastric cancer and premalignant gastric lesions in Mexican patients. Through restriction fragment length polymorphisms, we analyze both SNPs in the DNA from 155 patients with gastric cancer and premalignant gastric lesions, 121 controls, and 103 people from the Mexican general population. The frequencies of both SNPs did not differ significantly between any of the groups (chi2 p = NS); Odds ratio analysis showed that the alleles EGFR-521K and ERBB2-655V were not related to gastric cancer or premalignant gastric lesions in the Mexican population. Our data suggest that the EGFR-R521K and ERBB2-I655V polymorphisms are not suitable as markers for identifying individuals with a higher risk for developing gastric cancer in our population.

Related: Stomach Cancer Gastric Cancer
Genética Humana CUCS, Universidad de Guadalajara.

Kreimer AR, Pierce Campbell CM, Lin HY, et al.
Incidence and clearance of oral human papillomavirus infection in men: the HIM cohort study.
Lancet. 2013; 382(9895):877-87 [PubMed] Article available free on PMC after 07/09/2014 Related Publications
BACKGROUND: Oral human papillomavirus (HPV) infection causes a subset of oropharyngeal cancers. These cancers disproportionately affect men, are increasing in incidence, and have no proven prevention methods. We aimed to establish the natural history of oral HPV infection in men.
METHODS: To estimate incidence and clearance of HPV infections, men residing in Brazil, Mexico, and the USA who were HIV negative and reported no history of anogenital cancer were recruited into the HPV Infection in Men (HIM) cohort study. A subset of the cohort who provided two or more oral rinse-and-gargle samples with valid HPV results and who completed a minimum of 2 weeks of follow-up were included in this analysis. Oral rinse-and-gargle samples and questionnaire data were obtained every 6 months for up to 4 years. Samples were analysed for the presence of oncogenic and non-oncogenic HPV infections by the linear array method.
FINDINGS: 1626 men aged 18-73 years and with a median follow-up of 12·7 months (IQR 12·1-14·7) were included in the analysis. During the first 12 months of follow-up, 4·4% (95% CI 3·5-5·6; n=115 incident infections) of men acquired an incident oral HPV infection, 1·7% (1·2-2·5; n=53 incident infections) an oral oncogenic HPV infection, and 0·6% (0·3-1·1; n=18 incident infections) an oral HPV 16 infection. Acquisition of oral oncogenic HPV was significantly associated with smoking and not being married or cohabiting, but was similar across countries, age groups, and reported sexual behaviours. Median duration of infection was 6·9 months (95 % CI 6·2-9·3; n=45 cleared infections) for any HPV, 6·3 months (6·0-9·9; n=18 cleared infections) for oncogenic HPV, and 7·3 months (6·0-not estimable; n=5 cleared infections) for HPV 16. Eight of the 18 incident oral HPV 16 infections persisted for two or more study visits.
INTERPRETATION: Newly acquired oral oncogenic HPV infections in healthy men were rare and most were cleared within 1 year. Additional studies into the natural history of HPV are needed to inform development of infection-related prevention efforts.
FUNDING: US National Cancer Institute, Merck Sharp & Dohme.

Related: Oropharyngeal Cancer USA
National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
Research funded by:

López-Romero R, Iglesias-Chiesa C, Alatorre B, et al.
HPV frequency in penile carcinoma of Mexican patients: important contribution of HPV16 European variant.
Int J Clin Exp Pathol. 2013; 6(7):1409-15 [PubMed] Article available free on PMC after 07/09/2014 Related Publications
The role of human papillomavirus (HPV) infection in penile carcinoma (PeC) is currently reported and about half of the PeC is associated with HPV16 and 18. We used a PCR-based strategy by using HPV general primers to analyze 86 penile carcinomas paraffin-embedded tissues. Some clinical data, the histological subtype, growth pattern, and differentiation degree were also collected. The amplified fragments were then sequenced to confirm the HPV type and for HPV16/18 variants. DNA samples were also subjected to relative real time PCR for hTERC gene copy number. Some clinical data were also collected. Global HPV frequency was 77.9%. Relative contributions was for HPV16 (85%), 31 (4.4%), 11 (4.4%), 58, 33, 18, and 59 (1.4% each one). Sequence analysis of HPV16 identified European variants and Asian-American (AAb-c) variants in 92% and in 8% of the samples, respectively. Furthermore hTERC gene amplification was observed in only 17% of the cases. Our results suggest that some members of HPV A9 group (represented by HPV16, 58, and 31) are the most frequent among PeC patients studied with an important contribution from HPV16 European variant. The hTERC gene amplification could be poorly related to penile epithelial tissue.

Related: Penile (Penis) Cancer TERC
Laboratorio de Oncología Genómica, Unidad de Investigación Médica en Enfermedades Oncológicas, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México DF.

Núñez-Enríquez JC, Fajardo-Gutiérrez A, Buchán-Durán EP, et al.
Allergy and acute leukaemia in children with Down syndrome: a population study. Report from the Mexican inter-institutional group for the identification of the causes of childhood leukaemia.
Br J Cancer. 2013; 108(11):2334-8 [PubMed] Article available free on PMC after 07/09/2014 Related Publications
BACKGROUND: Allergies have been described as protective factors against the development of childhood acute leukaemia (AL). Our objective was to investigate the associations between allergy history and the development of AL and acute lymphoblastic leukaemia (ALL) in children with Down syndrome (DS).
METHODS: A case-control study was performed in Mexico City. The cases (n=97) were diagnosed at nine public hospitals, and the controls (n=222) were recruited at institutions for children with DS. Odds ratios (OR) were calculated.
RESULTS: Asthma was positively associated with AL development (OR=4.18; 95% confidence interval (CI): 1.47-11.87), whereas skin allergies were negatively associated (OR=0.42; 95% CI: 0.20-0.91).
CONCLUSION: Our findings suggest that allergies and AL in children with DS share biological and immune mechanisms. To our knowledge, this is the first study reporting associations between allergies and AL in children with DS.

Related: Acute Lymphocytic Leukemia (ALL) Childhood Acute lymphoblastic leukaemia (ALL) ALL - Molecular Biology
Unidad de Investigación Médica en Epidemiologia Clínica, Hospital de Pediatría, Centro Médico Nacional (CMN) Siglo XXI, Instituto Mexicano del Seguro Social, Avenida Cuauhtémoc 330, Delegación Cuauhtémoc, México D.F. 06720, México.

Rice MS, Biessy C, Lajous M, et al.
Metabolic syndrome and mammographic density in Mexican women.
Cancer Prev Res (Phila). 2013; 6(7):701-10 [PubMed] Related Publications
Metabolic syndrome has been associated with an increased risk of breast cancer; however, little is known about the association between metabolic syndrome and percent mammographic density, a strong predictor of breast cancer. We analyzed cross-sectional data from 789 premenopausal and 322 postmenopausal women in the Mexican Teacher's Cohort (ESMaestras). Metabolic syndrome was defined according to the harmonized definition. We measured percent density on mammograms using a computer-assisted thresholding method. Multivariable linear regression was used to estimate the association between density and metabolic syndrome, as well as its components by state (Jalisco, Veracruz) and menopausal status (premenopausal, postmenopausal). Among premenopausal women in Jalisco, women with metabolic syndrome had higher percent density than those without after adjusting for potential confounders including BMI [difference = 4.76; 95% confidence interval (CI), 1.72-7.81]. Among the metabolic syndrome components, only low high-density lipoprotein levels (<50 mg/dL) were associated with significantly higher percent density among premenopausal women in Jalisco (difference = 4.62; 95% CI, 1.73-7.52). Metabolic syndrome was not associated with percent density among premenopausal women in Veracruz (difference = -2.91; 95% CI, -7.19 to 1.38), nor among postmenopausal women in either state. Metabolic syndrome was associated with higher percent density among premenopausal women in Jalisco, Mexico, but was not associated with percent density among premenopausal women in Veracruz, Mexico, or among postmenopausal women in either Jalisco or Veracruz. These findings provide some support for a possible role of metabolic syndrome in mammographic density among premenopausal women; however, results were inconsistent across states and require further confirmation in larger studies.

Related: Breast Cancer
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
Research funded by:

Cantú de León D, González H, Pérez Montiel D, et al.
Uterine sarcomas: review of 26 years at The Instituto Nacional de Cancerologia of Mexico.
Int J Surg. 2013; 11(7):518-23 [PubMed] Related Publications
UNLABELLED: Uterine sarcomas are a group of uncommon tumors that account for approximately 1% of malignant neoplasms of the female genital tract and between 3 and 8.4% of malignant uterine neoplasms.
OBJECTIVE: To evaluate the factors associated with the clinical behavior of uterine sarcomas.
MATERIALS AND METHODS: In the period from October 1983 to December 2009, clinical files of patients with a confirmed diagnosis of uterine sarcoma at the National Institute of Cancerology of Mexico (INCan) were reviewed and evaluated.
RESULTS: We identified 77 cases with complete information; average age at presentation was 51.6 years (range, 14-78 years); most frequent histology was leiomyosarcoma (LMS) in 53/77 (68.8%) cases; most frequent symptom reported at the time of diagnosis was abnormal vaginal bleeding in 36/77 (46.7%) cases, and the most frequent clinical stage was clinical stage (CS) I in 31/77 (40.2%) cases. Initial treatment was total abdominal hysterectomy (TAH) and bilateral salpingo-oophrectomy (BSO) in 53/77 (68.9%) cases. Disease-free period was 27.8 months (range, 0-184 months), with disease recurrence in 33/77 (42.85%) cases, most frequent site as lung in 13/33 (39.39%) cases. Management of recurrences was surgery and chemotherapy (CT) in 5/33 (15.15%) and CT in 10/33 (30.30%) of cases. At present, 40.3% of the patients (31/77) are found to be Disease-free.
CONCLUSION: Notwithstanding that uterine sarcomas are aggressive neoplasms, most accepted management to date is TAH + BSO, observing that the fact that this procedure is not performed by oncologists does not affect the DFP nor OS, contrary to what occurs in other gynecological neoplasms.

Related: Soft Tissue Sarcomas Uterine Sarcoma
Departamento de Ginecología Oncológica, Instituto Nacional de Cancerología de México, Av. San Fernando # 22 Col. Sección XVI, México Distrito Federal 14080, Mexico.

Lana A, del Valle MO, López S, et al.
Study protocol of a randomized controlled trial to improve cancer prevention behaviors in adolescents and adults using a web-based intervention supplemented with SMS.
BMC Public Health. 2013; 13:357 [PubMed] Article available free on PMC after 07/09/2014 Related Publications
BACKGROUND: The overall number of cancer cases is increasing and, therefore, strengthening cancer prevention has become a priority. The institutions responsible for its control establish guidelines for primary prevention. These include recommendations, such as: not smoking, following a healthy diet, doing daily physical exercise or avoiding overweight. Adolescence is a period of adoption and/or consolidation of health behaviors, and both school- and family-based interventions have proven effective to improve them. Furthermore, online and mobile phone educational interventions are encouraging. Consequently, the main aim of this study is to assess the efficacy of an intervention in which these requirements (school, family, the Internet and SMS) are combined to prevent behavioral cancer risk.
METHODS: This protocol describes the design and implementation of a complex online program that includes a randomized controlled trial put into practice in two countries: Spain and Mexico. Adolescents and adults of their environment (relatives and teachers) who voluntarily participate will be randomly assigned to the experimental group or to the control group once they have completed the online pre-test. The experimental group members will have free access to a tailor-made and interactive website ( During the academic year, this website will be periodically updated with different school and leisure activities related to the avoidance of risk behaviors. To encourage participation, the program includes a competition that gives rewards to the winners. SMS are also sent to students to stimulate the adoption of healthy behaviors and as a reminder of participation. Finished the intervention, an online post-test is performed in both groups and the impact on the risk behaviors is therefore assessed.
DISCUSSION: The program is pioneer, since it combines many components which have already proven effective in previous researches. Moreover, it aims to compare efficacy in two countries with different socio-economic levels to find out if these approaches are equally effective in countries with a lower income level. However, the vertiginous evolution of the Internet and mobile phones may make this tool less attractive for adolescents, who may prefer social networks and other mobile phone applications which are nowadays massively used by their peers.

Related: Cancer Prevention and Risk Reduction Children's Cancer Web: Home Page
University Institute of Oncology of Asturias, Central University Hospital of Asturias, C/Emilio Rodríguez Vigil s/n, 33006 Oviedo, Spain.

Gómez-Martínez R, Rosales-Gradilla ME, Silva-Padilla N, Corona-Macías A
Differentiation in retinoblastoma and histopathological risk factors in Mexico.
J Pediatr Ophthalmol Strabismus. 2013 May-Jun; 50(3):174-7 [PubMed] Related Publications
PURPOSE: To describe the relationship between retinoblastoma differentiation, histopathological risk factors, age at enucleation, laterality, and genetic type (hereditary or sporadic) in a series of enucleated eyes in a referral hospital. The criteria used in other studies to classify retinoblastoma differentiation are discussed.
METHODS: The authors retrospectively studied histopathological preparations of eyes with retinoblastoma treated with primary enucleation. Tumors were classified as well differentiated, undifferentiated, and moderately differentiated. Patient age at enucleation, laterality of disease, genetic form (hereditary or sporadic), and presence of histopathological risk factors (massive choroidal infiltration, postlaminar optic nerve invasion, tumor in optic nerve cut, scleral invasion, and involvement of orbital soft tissues) were analyzed. The chi-square test was used for categorical variables and analysis of variance for test mean differences.
RESULTS: Histopathological risk factors were present in 23 (36%) of 63 eyes. Moderately differentiated tumors occurred at advanced ages and were more frequently associated with histopathological risk factors.
CONCLUSIONS: A consensus is needed to establish the histopathological criteria of retinoblastoma differentiation. The value of rosettes as a marker of cell differentiation should be reviewed.[J Pediatr Ophthalmol Strabismus 2013;50(3):174-177.].

Related: Retinoblastoma
Department of Oncology, UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.

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