Across Culture and Health Systems: Argentina
Argentina is a developing country with unevenly distributed health resources and no professionals trained to perform genetic counseling for hereditary cancer. According to the available data, cancer represents a 20.7% of all causes of death and it is the second leading cause of death after cardiovascular diseases in both sexes. Colorectal cancer (CRC) is the third commonest tumor only overtaken by breast and cervical cancer uteri cancers in women, and lung and prostate cancers in men. According to the International Agency for Research on Cancer there are 10,900 new cases of colorectal cancer diagnosed each year leading to incidence rates per 100,000 of 30.1 for males and 19.1 for females As most of the countries in South America, Argentina does not have a national cancer registry. Experience in counseling for hereditary cancer is limited to the only 3 Argentine registries which are concentrated in urban centers and have a restricted scope, determined largely by the interest of individual clinicians and researchers and by resource limitations. Data from our Registry (ProCanHe) showed 79% of the individuals were aware of their risk when a close relative died from (34.5%) or were diagnosed with (44.5%) CRC. Only 1.2% was warned by a physician. Eighty-one percent of them had received surveillance recommendations. However, this occurred at a mean age of 29 years. Before counseling, up to 73% of participants had heard little or nothing about genetic testing for cancers.
In this scenario, international collaboration allowed the implementation of genetic testing with a high degree of satisfaction. In 2004, in Buenos Aires, a Regional Meeting of the Collaborative Group of the Americas on Inherited Colorectal Cancer was held with the attendance of the South American leaders. Two years later, in Sao Paulo, a South American group called “Grupo de Estudio de Tumores Hereditarios (GET) was founded on the initiative of Benedito Rossi. Currently, the first collaborative study is ongoing.
However, support for continued surveillance and counseling is still limited, which makes it difficult to appropriately run the registries.
KeywordsLynch Syndrome Colorectal cancer Developing country Health system Cancer mortality Genetic counseling Hereditary cancer registry
The authors thank Henry T. Lynch and Paivi Peltomaki for their continued support, Esteban Langlios, MD from the Department of Internal Medicine and Plan de Salud for his help to describe the health situation section, and all the people who help to our Registry.
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