Epidemiological Trends and Geodemographic Distribution of Cancer in Paraguay, 2015–2023: An Analysis Based on National Registries
DOI:
https://doi.org/10.66201/ss.v1.17Keywords:
Cancer, Epidemiology, Paraguay, Incidence, Cancer Registries, Geographical Disparities, TCAC, Cancer SurveillanceAbstract
Background: Cancer is a leading cause of morbidity and mortality worldwide, with a growing burden in low- and middle-income countries (LMICs). Paraguay has historically lacked a detailed epidemiological overview. This studycharacterizedtemporal trends, geographical distribution and demographic profiles of cancer in the country (2015–2023) using national registries.
Methods: A quantitative, descriptive, and retrospective study was conducted, analyzing 164,381 cancer cases registered in 17 departments and Asunción (2015–2023). Absolute frequencies, crude incidence rates (per 100,000 inhabitants), and the Compound Annual Growth Rate (CAGR) were calculated by department to assess geographic dynamics.
Results: A sustained increase in annual cases was observed (79.7% between 2015 and 2023), and the national crude rate rose to 56.1%. Geographically, 51.2% of cases were concentrated in the Central, Capital, and Alto Paraná departments; Asunción had the highest incidence rate. Itapúa and Cordillera registered the highest CAGRs, identifying emerging "hot spots." There was a predominance of females (56.1%) and older adults (45.3% in the ≥ 60 age group). The gender pattern reverses with age: women predominate between 20 and 59 years, but men outnumber cases in the 60 and over age group.
Conclusions: The increase suggests a real rise and improvement in the health system's detection and reporting capacity. The urban concentration reflects a detection bias, while emerging hotspots indicate the need to investigate subnational environmental or occupational risk factors.
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
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209–49. doi:10.3322/caac.21660
Shafir M. The Rising Cancer Pandemic in Latin America: Major Cancer Problems and Prospects for Prevention. J Moral Theol. 2022;2(CTEWC Book Series 2). doi:10.55476/001c.38705
Sierra MS, Soerjomataram I, Antoni S, Laversanne M, Piñeros M, Vries E d., et al. Cancer Patterns and Trends in Central and South America. Cancer Epidemiol. 2016;44:S23–42. doi:10.1016/j.canep.2016.07.013
Aggarwal A, Unger‐Saldaña K, Lewison G, Sullivan R. The Challenge of Cancer in Middle-Income Countries With an Ageing Population: Mexico as a Case Study. Ecancermedicalscience. 2015;9. doi:10.3332/ecancer.2015.536
Pilleron S, Cabasag CJ, Ferlay J, Bray F, Luciani S, Almonte M, et al. Cervical Cancer Burden in Latin America and the Caribbean: Where Are We? Int J Cancer. 2020;147(6):1638–48. doi:10.1002/ijc.32956
Rolón PA, Smith JS, Muñoz N, Klug SJ, Herrero R, Bosch X, et al. Human Papillomavirus Infection and Invasive Cervical Cancer in Paraguay. Int J Cancer. 2000;85(4):486–91. doi:10.1002/(sici)1097-0215(20000215)85:4%3C486::aid-ijc7%3E3.0.co;2-s
León SJA, Agüero MA, Gauna C, León MA. Etiological Factors and Characterization of Patients With Lung Cancer at the National Cancer Institute, Paraguay. Rev Virtual Soc Paraguaya Med Interna. 2020;7(1):56–65. doi:10.18004/rvspmi/2312-3893/2020.07.01.56-065
Correa AJH, Freiberg ED, Birnenbaum SJ, Avancini C, Popielik NA, Regazzoni CJ. Colorectal Cancer Deaths in South America: Time-Series Analysis. 2023. doi:10.21203/rs.3.rs-3001420/v1
Parkin DM. The Role of Cancer Registries in Cancer Control. Int J Clin Oncol. 2008;13(2):102–11. doi:10.1007/s10147-008-0762-6
Jedy‐Agba E, Oga E, Odutola MK, Abdullahi Y, Popoola A, Achara P, et al. Developing National Cancer Registration in Developing Countries – Case Study of the Nigerian National System of Cancer Registries. Front Public Health. 2015;3. doi:10.3389/fpubh.2015.00186
Parkin DM, Bray F, Ferlay J, Jemal A. Cancer in Africa 2012. Cancer Epidemiol Biomarkers Prev. 2014;23(6):953–66. doi:10.1158/1055-9965.epi-14-0281
Stillman F, Kaufman MR, Kibria N, Eser S, Spires M, Pustu Y. Cancer Registries in Four Provinces in Turkey: A Case Study. Glob Health. 2012;8(1):34. doi:10.1186/1744-8603-8-34
Zahnd WE, James AS, Jenkins WD, Izadi S, Fogleman A, Steward DE, et al. Rural–Urban Differences in Cancer Incidence and Trends in the United States. Cancer Epidemiol Biomarkers Prev. 2018;27(11):1265–74. doi:10.1158/1055-9965.epi-17-0430
Henao-Rodríguez C, Lis-Gutiérrez JP, Lis-Gutiérrez M. Inequality in Access to Healthcare: A Latin American Perspective. Salud Cienc Tecnol. 2023;3:355. doi:10.56294/saludcyt2023355
Liu X, Fluchel M, Kirchhoff AC, Zhu H, Onega T. Geographic Access to Pediatric Cancer Care in the US. Jama Netw Open. 2023;6(1):e2251524. doi:10.1001/jamanetworkopen.2022.51524
Nuche‐Berenguer B, Sakellariou D. Socioeconomic Determinants of Cancer Screening Utilisation in Latin America: A Systematic Review. Plos One. 2019;14(11):e0225667. doi:10.1371/journal.pone.0225667
Large C, Wei Y. Geographic Variations in Female Breast Cancer Incidence in Relation to Ambient Air Emissions of Polycyclic Aromatic Hydrocarbons. Environ Sci Pollut Res. 2017;24(21):17874–80. doi:10.1007/s11356-017-9395-5
Li Y, Li H, Liu Z, Miao C. Spatial Assessment of Cancer Incidences and the Risks of Industrial Wastewater Emission in China. Sustainability. 2016;8(5):480. doi:10.3390/su8050480
Bidoli E, Barbone F, Collarile P, Valent F, Zanier L, Daris F, et al. Residence in Proximity of an Iron Foundry and Risk of Lung Cancer in the Municipality of Trieste, Italy, 1995–2009. Int J Environ Res Public Health. 2015;12(8):9025–35. doi:10.3390/ijerph120809025
Ortega-García JA, Hernández FAL, Cárceles-Álvarez A, Fuster-Soler JL, Sotomayor DI, Ramis R. Childhood Cancer in Small Geographical Areas and Proximity to Air-Polluting Industries. Environ Res. 2017;156:63–73. doi:10.1016/j.envres.2017.03.009
Vaccarella S, Laversanne M, Ferlay J, Bray F. Cervical Cancer in Africa, Latin America and the Caribbean and Asia: Regional Inequalities and Changing Trends. Int J Cancer. 2017;141(10):1997–2001. doi:10.1002/ijc.30901
Butler EN, Kelly SP, Coupland VH, Rosenberg PS, Cook MB. Fatal Prostate Cancer Incidence Trends in the United States and England by Race, Stage, and Treatment. Br J Cancer. 2020;123(3):487–94. doi:10.1038/s41416-020-0859-x
Teoh JY, Hirai HW, Ho MW, Chan FC, Tsoi K, Ng C. 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
Conway DI, Hovanec J, Ahrens W, Ross A, Holcátová I, Lagiou P, et al. Occupational Socioeconomic Risk Associations for Head and Neck Cancer in Europe and South America: Individual Participant Data Analysis of Pooled Case–control Studies Within the INHANCE Consortium. J Epidemiol Community Health. 2021;75(8):779–87. doi:10.1136/jech-2020-214913
Moradi N, Doshantapeh AG, Sangi S, Aligholizadeh M, Asadian A, Abdolmohammadi G, et al. An Ecological Study of the Incidence and Mortality Rates of Pancreatic Cancer in 2020: Exploring Gender Disparities Worldwide. J Ren Endocrinol. 2023;9:e25137. doi:10.34172/jre.2023.25137
Fattore G, Bobini M, Meda F, Pongiglione B, Baldino L, Gandolfi S, et al. Reducing the Burden of Travel and Environmental Impact Through Decentralization of Cancer Care. Health Serv Manage Res. 2024;38(1):1–9. doi:10.1177/09514848241229564
Ho J, Byrne A, Nguyen L, Jaramillo E, Fox GJ. Decentralized Care for Multidrug-Resistant Tuberculosis: A Systematic Review and Meta-Analysis. Bull World Health Organ. 2017;95(8):584–93. doi:10.2471/blt.17.193375
Jojo LW, Nkutu NT. Experiences of Patients on Cancer Treatment Regarding Decentralization of Oncology Services at a Tertiary Hospital in the Eastern Cape. BMC Cancer. 2023;23(1). doi:10.1186/s12885-023-10876-5
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Copyright (c) 2026 Óscar Darío Aquino Martínez, Rubén Darío Ibarrola Valenzuela, Marlene Concepción Espínola Zárate, Héctor Adrián Franco, Noelia Teresa Pérez Sosa, Cristian Armando Gauto Martínez, Alma Graciela González de Lamas, Federico Francisco Schrodel Romero (Autor/a)
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