title: Temporal trends and regional variations in gastrointestinal cancer mortality in Peru, 2005-2014.
abstract: OBJECTIVE
  To estimate and analyze the evolution of mortality rates of gastrointestinal (GI) cancer in Peru and its regions between 2005-2014.
  
  
  METHODS
  We performed a nationwide secondary analysis of Peru's Health Ministry registry of deaths during the period 2005-2014, with a focus on regional differences. Deaths registered with codes C15 to C25 (malignant neoplasms of digestive organs) from the ICD-10 were included. Calculation of age-standarized mortality rates and years of life lost (YLL) due to GI cancer per 100,000 habitants were also performed.
  
  
  RESULTS
  Data of 67,527 deaths from GI cancers was analyzed, 35,055 (51.91%) were women. In 2005, the number of GI cancer deaths was 6,484, for 2014, 7,532 cases were recorded. The GI cancer age-standarized mortality rates at the country level showed a decrease of 12.70% between 2005-2014. Stomach cancer presented the highest age-standarized mortality rate despite showing a downward trend in the last years, equal for gallbladder, liver and biliary tract, and esophagus cancer. Colorectal, small intestine and anus cancer show a progressive increase. In 2014, Callao (48.8), Huancavelica (48.5), La Libertad (39.6), Lambayeque (40.5) and Huanuco (38.9) had the highest rates. The three types of GI cancers with the highest rates of YLL in 2014 were stomach cancer (118.51), followed by liver and biliary tract cancer (58.68) and colorectal (44.86).
  
  
  CONCLUSIONS
  GI cancer mortality in Peru is high and a priority issue in regions like Huancavelica, Huanuco, Callao, La Libertad and Lambayeque. Stomach cancer remains the most frequent GI cancer, but with a downward trend in the study period.
authors.affiliation: Universidad de Buenos Aires. Buenos Aires, Argentina.
authors.forename: Akram
authors.initials: A
authors.lastname: Hernández-Vásquez
authors.affiliation: Facultad de Salud Pública y Administración. Universidad Peruana Cayetano Heredia. Lima, Peru.
authors.forename: Guido
authors.initials: G
authors.lastname: Bendezú-Quispe
authors.affiliation: Instituto de Investigación, Universidad Católica los ángeles de Chimbote. Chimbote, Peru.
authors.forename: Diego
authors.initials: D
authors.lastname: Azañedo
authors.affiliation: Oficina General de Información y Sistemas, Instituto Nacional de Salud. Lima, Peru.
authors.forename: Bertha
authors.initials: B
authors.lastname: Huarez
authors.affiliation: Universidad de Buenos Aires. Buenos Aires, Argentina.
authors.forename: Belén
authors.initials: B
authors.lastname: Rodríguez-Lema
mesh_terms: D005260:Female; D005770:Gastrointestinal Neoplasms / Q000401:mortality*; D006801:Humans; D008017:Life Expectancy; D008297:Male; D010568:Peru / Q000453:epidemiology; D012042:Registries