Sex Differences in Gastric Cancer Mortality in Ecuador: A Joinpoint Regression Analysis

Area of Science:

• Epidemiology
• Public Health
• Cancer Research

Background:

• Gastric cancer (GC) is a major global cause of cancer mortality.
• Ecuador experienced GC as the leading cause of cancer death until 2013.
• Persistent regional and sex-based disparities in GC mortality exist despite overall declines.

Purpose of the Study:

• To analyze gastric cancer mortality trends by sex in Ecuador from 2004 to 2021.
• To identify regional variations and specific high-mortality provinces.
• To investigate the annual percentage change (APC) in GC mortality rates.

Main Methods:

• Analysis of national GC mortality data (2004-2021) from Ecuador's National Institute of Statistics and Censuses (INEC).
• Calculation of age-standardized mortality rates (ASMR) using the SEGI world standard population.
• Application of Joinpoint regression to determine mortality trends and annual percentage changes (APC).

Main Results:

• National GC mortality rates decreased by 1.9% annually in men and 2.2% in women.
• Significant regional disparities were observed; men in the Coastal region showed no significant decline.
• Esmeraldas province exhibited an increasing GC mortality trend (2.8% annually).

Conclusions:

• Overall GC mortality is declining in Ecuador, but regional and sex disparities remain.
• The faster decline in female GC mortality suggests potential differences in risk factors, healthcare access, or early detection.
• Targeted public health interventions are needed to address persistent regional inequalities in gastric cancer outcomes.