Durante la primera mitad del siglo XX las principales causas de muerte se relacionaban con enfermedades infecciosas y parasitarias, muchas de ellas, prevenibles. Con la llegada de los nuevos tratamientos y el avance de la medicina en general, junto al incremento de mejora en las condiciones de higiene, el perfil de muertos estaba relacionado con las enfermedades cardiovasculares, la diabetes, los trastornos neurológicos y el cáncer, reseñó Infobae.
Según el informe del Estudio de la Carga Global de Enfermedades, Lesiones y Factores de Riesgo “GBD 2019? publicado por The Lancet sobre la carga mundial de 369 enfermedades y lesiones en 204 países entre 1990-2019, en Chile el número de muertes pasó de 91.372 a 113.086 en ese periodo y, de ellas, el 85,8% corresponde a las llamadas enfermedades no transmisibles, siendo la principal causa de muerte en ese periodo la cardiopatía isquémica o enfermedad coronaria, que se produce cuando las arterias que suministran sangre al corazón se obstruyen.
Esto marcó por varias décadas, la principal causa de muerte en el país. En 2016, por ejemplo, según el Instituto Nacional de Estadísticas (INE), representaron un 27,1% del total de las defunciones (principalmente accidente cerebrovascular e infarto agudo al miocardio), seguido de tumores malignos (25%) y de enfermedades del sistema respiratorio (9,5%). Hace dos décadas, según las Estadísticas Vitales 2001, los tumores malignos representaban el 22,5% (18.394) del total de defunciones. Las enfermedades del aparato circulatorio predominaban con el 27,6% (22.666).
Pero según las Estadísticas Vitales de 2019, publicadas el pasado 3 de diciembre por el INE, por primera vez desde que hay registros en el país, el cáncer se convirtió en la principal causa de muerte entre los chilenos. De acuerdo a este informe, las muertes por tumores (neoplasias) desplazaron a las enfermedades del sistema circulatorio como las más responsables de la muerte entre los chilenos. Según este registro, las primeras representaron 28.492 defunciones (26%), mientras que las enfermedades del sistema circulatorio fueron 28.079 (25,6%). Entre ambas agrupan más del 50 % de las muertes del año.
Luego, en tercer y cuarto lugar figuran las enfermedades del sistema respiratorio, con 13.864 muertes (12,6%), y las causas externas de morbilidad y de mortalidad, con 8.065 muertes (ver infografía). Pese al avance del cáncer, los especialistas estiman que en 2020-2021 podría haber una distorsión de las cifras provocada por la pandemia, que ha generado una inusual muerte por COVID y un subdiagnóstico de los tumores.
Avance preocupante
Según explica el director médico del Instituto del Cáncer UC y presidente de la Fundación ChilesinCáncer, Bruno Nervi a La Tercera, varios aspectos tienen que ver con que el cáncer se haya transformado por primera vez en la principal causa de muerte en el país, donde el envejecimiento de la población es uno de los más relevantes.
“Las personas viven más tiempo y tienen más oportunidad de desarrollar una enfermedad asociada al envejecimiento, como es el cáncer. Por ejemplo, en 1970 la expectativa de vida de los chilenos era cercana a los 64 años, y actualmente bordea los 80 años”, afirmó Nervi, que también se desempeña como profesor del Magíster en Enfermería de Práctica Avanzada Mención Oncología de la UC. En Chile, la esperanza de vida al nacer se ha triplicado. En 1900, señala el INE, se estimaba en 23,6 años para las mujeres y 23,5 años para los hombres. Para el periodo 2015-2020, subió a 82,1 para las mujeres y 77,3 para los hombres.
El doctor Mauricio Burotto, oncólogo del Centro de Cáncer de Clínica Universidad de los Andes, añade que ese aumento en las expectativas de vida trae consigo una mayor posibilidad de desarrollar un cáncer. “Esto aumenta la incidencia”, indica. Otro factor es el mejor control de algunas enfermedades cardiovasculares que antes eran causa importante de muerte, como presión alta y diabetes. Así, dice Burotto, han disminuido un poco la tasa de infartos y accidentes cerebrales vasculares. Entonces, “también hay un grado de control, disminución o estabilización de la enfermedad cardiovascular”.
Cáncer y envejecimiento van de la mano. “Mientras más edad tengamos, más posibilidades tenemos de albergar algún cáncer en el cuerpo”, explica Nervi. Esto se debe a que, con el paso de los años, las células van acumulando más y más mutaciones en su ADN que las hacen más proclives a convertirse en malignas. Las personas mayores de 75 años tienen un 28,3% más riesgo de morir de cáncer. Así lo establecen cifras del Observatorio Global del Cáncer, plataforma web de la Organización Mundial de la Salud que presenta estadísticas globales sobre el cáncer de 185 países.
Chile enfrenta una epidemia de sedentarismo y obesidad nunca antes vistaChile enfrenta una epidemia de sedentarismo y obesidad nunca antes vista
Incremento del sedentarismo y la obesidad
Los nuevos hábitos alimenticios y el estresante y frenético ritmo de vida actual también han impactado en el crecimiento del cáncer. Las enfermedades del sistema digestivo y del sistema respiratorio también perdieron el peso relativo que tenían antes. La obesidad, que ha aumentado significativamente en los últimos años, sitúa a Chile como uno de los países de mayor sobrepeso y obesidad entre los miembros de la Ocde, lo que también ha contribuido al alza en el cáncer.
Los hábitos de alimentación y estilo de vida son claves a la hora de promover la salud y prevenir este tipo enfermedades. “La obesidad y el sedentarismo son los factores de riesgo más importantes, e influyen en el 60% de todos los cánceres”, apuntó Nervi. “En términos generales, hay un grado de influencia de esos factores, pero no se sabe cuánto es, “depende del tipo de cáncer”, destacó Burotto. Por ejemplo, el de colon se asocia a consumo de grasas y carnes rojas. “En algunas partes de Chile hay bastante incidencia de cáncer digestivo gástrico en el que se piensa que tiene que ver la dieta. El sedentarismo, obesidad y tabaco también inciden en el cáncer de mama, por ejemplo”, agregó.
Otros factores de riesgo asociados son el alza del tabaquismo y del consumo de alcohol, “donde nuevamente los chilenos destacan entre los países de la Ocde”, advierte el especialista UC. Un gran porcentaje de la carga por cáncer puede ser prevenida, promoviendo estilos de vida saludables y estableciendo programas más agresivos contra el tabaco. Esto, además de fomentar estrategias como la vacuna contra el virus papiloma humano. “Favoreciendo la detección precoz y el acceso a tratamientos oportunos”, concluyó Nervi.
Por Agencia
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