Objective. To estimate prostate cancer (PC) survival in Mexico and explore survival disparities according to the marginalization level of residence place. Materials and methods. A nationwide administrative claims database (4 110 men) whose PC treatment was financed by Seguro Popular between 2012-2016, was cross-linked to the National Mortality Registry up to December 2019. Patients were classified according to their oncological risk at diagnosis and the marginalization level of the residence municipality. Cox proportional hazards regression was used to estimate multivariable survival functions. Results. Five-years PC survival (69%; 95%CI: 68,71%) ranged from 72% to 54% at very low and very high marginalization, respectively (p for trend<0.001). The lowest PC survival was observed in men with high-risk PC (47%; 95%CI: 33,66%) residents in very high marginalization municipalities. Conclusions. Overall, PC survival was lower than that reported in other Latin American countries. The distribution of oncologic risk and survival differences across marginalization levels suggests limited early detection and cancer health disparities.

Objetivo. Estimar la supervivencia a cinco años por cáncer cervicouterino y sus factores asociados en pacientes mexica­nas, cuya atención fue financiada por el Fondo de Protección contra Gastos Catastróficos (FPGC) del Seguro Popular durante el periodo 2006-2014. Material y métodos. Se analizó la base de datos de las pacientes mencionadas y se vinculó con el Subsistema Epidemiológico y Estadístico de Defunciones. Se hizo un análisis de supervivencia a cinco años por etapa clínica y factores asociados, mediante el método de Kaplan-Meier y los modelos de riesgos proporcionales de Cox. Resultados. La supervivencia global por cáncer cervicouterino a los cinco años fue de 68.5%. Los factores asociados fueron la etapa clínica (locoregional [HR=2.8 IC95% HR: 2.6,3.0] y metastásica [HR=5.4 IC95% HR: 4.9,5.9]) com­parada con la etapa temprana y la edad (HR=1.003 IC95% HR:1.001,1.004). Conclusiones. Las mujeres que lograron el acceso a la atención del cáncer cervical financiadas por el FPGC tuvieron una supervivencia ligeramente superior a las reportadas en otros estudios.

The principal purpose of this study is to determine the prevalence of peripheral arterial disease (PAD), as well as the principal associated risk factors, in patients registered in the IDON-PAD database. PAD is a condition characterized by the narrowing or blockage of arteries in the body’s extremities due to plaque buildup, leading to reduced blood flow and tissue ischemia. While PAD primarily affects the lower extremities, it can lead to symptoms such as intermittent claudication and, in severe cases, ulcers and amputations. Risk factors for PAD are numerous and cumulative, including smoking, age over 50, type 2 diabetes mellitus, and hypertension. The prevalence of PAD increases with age, with rates ranging from 2.5% in those over 50 to 60% in those over 85, varying by ethnicity and study population. Diabetic patients face a higher risk of PAD-related complications and have lower success rates with revascularization procedures. The diagnosis of PAD traditionally relied on physical examination and symptoms, but the Ankle–Brachial Index is now a standard diagnostic tool due to its non-invasive nature and reliability. In Mexico, the prevalence of PAD is estimated at 10%, with significant risk factors being the duration of diabetes, hypertension, hypertriglyceridemia, and smoking. Notably, 70% of PAD cases are asymptomatic, emphasizing the importance of proactive screening. This study aimed to determine the prevalence of PAD and associated risk factors in diabetic patients aged 40 and above. The prevalence was found to be 11.2%, with high-risk waist circumference, elevated triglycerides, positive Edinburgh questionnaire, and weak pulses as significant predictors. The detection and management of PAD in diabetic patients require a comprehensive approach, including lifestyle modifications and regular screenings. Prevention strategies should focus on controlling risk factors, including obesity, hypertension, and dyslipidemia. In conclusion, PAD is a prevalent yet underdiagnosed condition in diabetic patients, necessitating proactive screening and comprehensive management to mitigate associated risks and improve patient outcomes. The principal limitation of this study is that, as it uses a cross-sectional methodology and is not an experimental study, although we can establish the prevalence of PAD as well as the associated risk factors, we cannot define causality or determine the hazard ratio for each of these factors. Special thanks to Dr. Leobardo Sauque Reyna and all participants for their contribution to this research.

Objective. To estimate survival outcomes in a population living with diabetes, screened for chronic kidney disease (CKD) and to describe characteristics associated with premature mortality using data from an administrative cohort in Jalisco, Mexico. Materials and methods. Using an administrative cohort design, we investigated the 8-year cumulative mortality associated with CKD. We linked screening with mortality data and described population characteristics by CKD stage, computed years of life lost (YLL), and performed Kaplan-Meier curves and Cox proportional hazard models to analyze survival and mortality risk factors. Results. At screening, 44% of the cohort exhibited impaired renal function. The mortality rate stood at 14%, 2.5% linked to CKD; 8.7% were premature deaths, accumulating 8 036 YLL. Eight-year survival was 93% for individuals with normal renal function at screening, decreasing to 41% for those with glomerular filtration rate below 30 mL/min/1.73m², albumin-creatinine ratio >300 mg/dl, increased years since diabetes diagnosis, hypertension, amputations, retinopathy, and smoking were associated with higher mortality risk; female sex and obesity with a lower risk. Conclusion. The high prevalence of renal impairment in this cohort and its association with high mortality underscores the critical importance of timely detection and protocolized intervention for CKD to mitigate this burden.

We aimed to measure survival of children with acute lymphoblastic leukaemia (ALL) under Mexico’s public health insurance for the population without social security, and explore patient groups that may be at risk for increased mortality. We conducted a retrospective cohort study using claims data from Mexico’s Seguro Popular program, covering cancer treatment in people without social security, 2005-15. We estimated 5-year national and state-specific survival for children with ALL across Mexico who initiated cancer treatment under this public healthcare insurance scheme. 8,977 children with ALL were treated under Seguro Popular in 2005-15. Under this financing scheme, treated children doubled from 535 in 2005 to 1,070 in 2015, and their 5-year survival was 61.8% (95%CI 60.8, 62.9). Estimates for 5-year survival remained constant over time. We observed wide gaps in risk-standardized 5-year survival among states ranging from 74.7% to 43.7%. We found a higher risk of mortality for children who received treatment in a non-paediatric specialty hospital (Hazards Ratio, HR=1.18; 95%CI 1.09, 1.26), facilities without a paediatric oncology/haematology specialist (HR=2.17; 95%CI 1.62, 2.90), and hospitals with low patient volume (HR=1.22; 95%CI 1.13, 1.32). In a decade Mexico’s Seguro Popular doubled access to ALL treatment for children without social security and by 2015 financed the vast majority of estimated ALL cases for that population. While some progress in ALL survival may have been achieved, nationwide 5-year survival was unsatisfactory and did not improve over time. Our results provide lessons for Mexico’s evolving health system and for countries moving towards universal health coverage. Novelty and impact: There has been no comprehensive assessment of the health outcomes of Mexico’s policy for financing high-cost cancer treatments that was part of Seguro Popular , health reform aimed at providing care to the population without social security. The study identified several factors amenable to intervention that could improve survival for childhood ALL in Mexico and reduce the observed disparities. Decision could consider administrative databases as a source of clinical outcomes to ensure the quality their systems.