Chirlaque López, María Dolores

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Chirlaque López, María Dolores

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Chirlaque López, María Dolores

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Universidad de Murcia. Departamento de Ciencias Sociosanitarias

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Open Access
Supervivencia del cáncer en la población de la Región de Murcia, 1990 - 2015
(Universidad de Murcia, 2018-11-13) Chirlaque López, María Dolores; Torres Cantero, Alberto Manuel; Navarro Sánchez, Carmen; Escuela Internacional de Doctorado
Introducción Analizar la supervivencia a los 5 años del diagnóstico de casos incidentes de cáncer, periodo 1990-2010, en adultos de la Región de Murcia. Material y método Se incluyen casos de cáncer del Registro de Cáncer de Murcia, clasificados en CIE-10 (tumores sólidos) y OMS (hematológicos). Se obtiene la supervivencia observada, neta y neta ajustada por edad tras 5-años del diagnóstico. Análisis estratificado por sexo, tipo de tumor, grupo de edad y periodo. Resultados 89713 casos incluidos, 50% varones, con supervivencia neta entre 6,2% (páncreas) y 94,3% (testículo). Supervivencias elevadas se obtienen en cáncer de tiroides, leucemia linfática crónica y melanoma cutáneo; y bajas en cáncer de páncreas y mesotelioma. La supervivencia ha aumentado un 9,7% entre periodos y es un 8,6% más elevada en mujeres. Conclusiones La supervivencia es diferente según el tipo de cáncer, más elevada en mujeres, en el periodo más reciente y en adultos-jóvenes. La monitorización de la supervivencia contribuye al control del cáncer.
Open Access
Características sociales y de género en el ámbito de contagio de COVID-19 en una región mediterránea
(Ministerio de Sanidad y Consumo, 2022-12-19) Soriano López, Jesús; Salmerón Martínez, Diego; García Pina, Rocío; Humberto Gómez, Jesús; Sánchez Rodríguez, Inés; Ballesta Ruiz, Mónica; Chirlaque López, María Dolores; Ciencias Sociosanitarias; Facultad de Enfermería
BACKGROUND // Knowledge of social and gender determinants, which influence the places where people are exposed to COVID-19, may be relevant in the development of preventive and control strategies. The aim of this paper was to determine the context in which COVID-19 cases were infected (household, work/labor, health, social-health, and social-leisure settings) according to country of origin,occupational social class and gender, which is essential in order to designing public health strategies. METHODS // A cross-sectional study of an epidemiological registry of 56,628 COVID-19 incident cases was made, whose exposure/contagion setting was studied according to the previous variables from June 15 to December 23, 2020, in the Region of Murcia (Spain). An exact Fisher test was used to study the distribution of COVID-19 cases based on the above variables. RESULTS // The cumulative incidence was higher in people from Africa (5,133.5 cases/100,000 inhabitants) and Latin America (11,351.1) than in non-immigrants (3,145.7). It was also higher in women (3,885.6) than in men (3,572.6). It is noteworthy, that 53.3% of the cases with employment were workers in industry or construction, artisans, agricultural workers, or elementary occupations. In contrast, during the second semester of 2020, 41.3% of the employed population in the Region of Murcia performed such jobs. The household was the main exposure setting (56.5% of cases with a known setting), followed by social-leisure (20.7%) and work/labor (18.2%). The labor settings were more important in immigrants from Africa (28.4%) and Latin America (35.7%) than in non-immigrants (12%), inversely to social-leisure settings. Labor context was more important in women (19.6%) than in men (16.5%) and in manual workers (44.1%) than in non-manual workers (26.6%). CONCLUSIONS // The context in which COVID-19 cases were infected is different according to social inequalities related to country of origin, gender and occupational social class.
Open Access
Partial contributions and temporal trends of leading causes of death during the last four decades in Spain
(Elsevier, 2020-12) Cirera, L; Márquez-Calderón, S; Saez, M; Salmerón, D; Ballesta Ruiz, Mónica; Chirlaque López, María Dolores; Ciencias Sociosanitarias
Objectives: The study was conducted to assess time trend shifts of leading causes of death and their partial contributions over the years 1975-2016 in Spain. Study design: A longitudinal ecological epidemiologic design was conducted to analyse linear trend period shifts using joinpoint regression as the annual percentage of change (APC) in the period 1975-2016. The partial contributions were illustrated as the rate ratio of a singular-cause to their major-cause shift periods. Results: HIV/AIDS shaped the increasing trend period of infectious diseases in 1989-1995 (APC = 25.3, P < 0.05) and the decreasing trend in 1995-1999 and 1999-2016. Lung cancer fell gradually from 1994 in men (-0.4, P < 0.05); however, in women, the condition continued increasing from 1990 (P < 0.05). Dementia types influenced mental and neurological disease drifts. The recent trend for circulatory periods (1980-2016) was mainly modulated by cardiac ischaemia, with increased partial contributions (25%, 32% and 30%). Traffic accidents defined the descending tendency of external causes. Conclusions: Spain showed a Western pattern in descended rates, including non-decreasing trends in mental and neurological diseases, pancreatic cancer, drug abuse and suicide. Trend shifts and partial contributions illustrated targets for further mortality reduction.
Open Access
Increasing Therapy Related Myeloid Neoplasms in Multiple Myeloma
(Wiley, 2018-11-13) Fernández-Caballero, M; Salmerón, D; Chen-Liang, TH; Hurtado, AM; García Malo, MD; Ortuño, FJ; Roldán, V; Vicente, V; Jerez, A; De Arriba, F; Chirlaque López, María Dolores; Ciencias Sociosanitarias
Background: Despite the longer survival achieved in multiple myeloma (MM) patients due to new therapy strategies, a concern is emerging regarding an increased risk of secondary primary malignancies (SPMs) and how to characterize those patients at risk. We performed a retrospective study covering a 28‐year follow‐ up period (1991‐2018) in a tertiary single institution. Material and Methods: Data of 403 MM patients were recorded and compared with the epidemiologic register of the population area covered by our centre, calculating the standardize incidence ratio (SIR) for the different types of SPMs diagnosed in the MM cohort. Fine and Gray regression models were used to identify risk factors for SPMs. Results: Out of the 403 MM patients, 23 (5.7%) developed SPMs: 13 therapyrelated myeloid (TRM) malignancies (10 of them (77%) myelodysplastic syndrome (MDS), 1 acute lymphoid leukaemia and 9 solid neoplasms. In the MM cohort, the relative risk of MDS was significantly higher than in the general population. Survival of patients with TRM malignancies was poor with a median of 4 months from the diagnosis, and most of them showed complex karyotype. Within the MM subset, multivariable analysis showed a higher risk of TRM malignancies in patients that previously received prolonged treatment with lenalidomide (>18 months). Conclusions: Though the improvement in MM outcome during the last decades is an unprecedented achievement, it has been accompanied by the rise in TRM malignancies with complex cytogenetic profile and poor prognosis that are in the need of an improved biologic and therapeutic approach.
Open Access
Cancer Survival in Adults in Spain: A Population-Based Study of the Spanish Network of Cancer Registries (REDECAN)
(MDPI, 2022-05-15) Guevara, M; Molinuevo, A; Salmerón, D; Marcos-Gragera, R; Carulla, M; Rodríguez Camblor M; Alemán, A; Rojas, D; Vizcaíno Batllés, A; Chico, M; Jiménez Chillarón, R; López de Munain, A; de Castro, V; Sánchez, MJ; Ramalle-Gómara, E; Franch, P; Galceran, J; Ardanaz, E; Chirlaque López, María Dolores; Ciencias Sociosanitarias
The assessment of cancer survival at the population level is essential for monitoring progress in cancer control. We aimed to assess cancer survival and its trends in adults in Spain. Individual records of 601,250 adults with primary cancer diagnosed during 2002-2013 and followed up to 2015 were included from 13 population-based cancer registries. We estimated net survival up to five years after diagnosis and analyzed absolute changes between 2002-2007 and 2008-2013. Estimates were age-standardized. Analyses were performed for 29 cancer groups, by age and sex. Overall, age-standardized five-year net survival was higher in women (61.7%, 95% CI 61.4-62.1%) than in men (55.3%, 95% CI 55.0-55.6%), and ranged by cancer from 7.2% (pancreas) to 89.6% (prostate) in men, and from 10.0% (pancreas) to 93.1% (thyroid) in women in the last period. Survival declined with age, showing different patterns by cancer. Between both periods, age-standardized five-year net survival increased overall by 3.3% (95% CI 3.0-3.7%) in men and 2.5% (95% CI 2.0-3.0%) in women, and for most cancer groups. Improvements were greater in patients younger than 75 years than in older patients. Chronic myeloid leukemia and myeloma showed the largest increases. Among the most common malignancies, the greatest absolute increases in survival were observed for colon (5.0%, 95% CI 4.0-6.0%) and rectal cancers (4.5%, 95% CI 3.2-5.9%). Survival improved even for some cancers with poor prognosis (pancreas, esophagus, lung, liver, and brain cancer). Further investigation of possible sociodemographic inequalities is warranted. This study contributes to the evaluation of cancer control and health services' effectiveness.
Open Access
The adolescent problem gambling prevalence associated with leisure‑time activities and risky behaviors in Southern Spain
(Springer, 2022-11-18) Moñino García, Miriam; Ballesta Ruiz, Mónica; Huerta, J.M.; Correa‑Rodríguez, J.F.; Cabrera‑Castro, N.; Llorens, N.; Chirlaque López, María Dolores; Ciencias Sociosanitarias; Facultad de Enfermería
Gambling addiction is increasing and is becoming a public health concern due to the rise of gambling-related harms affecting the youth. Previous studies suggest a strong link between problem gambling (PG) and substance use and psychosocial and familial factors. Our main objective was to analyze the association between PG and factors like sport, leisure-time activities, and risk-taking behaviors in adolescents. A survey on substance use and addictive behaviors was performed in 2019 on a representative sample of 2240 subjects (14–18 years) from the Southern Spain Region. Data variables like socio-demographic characteristics, sport, leisure and free time activities, family environment, PG (Lie-Bet Scale), compulsive internet use (CIUS Scale), and consumption of alcohol and cannabis were collected using a standardized questionnaire. Weighted PG prevalence was estimated in either sex, as well as the differences between various levels of PG using chi-square tests. Crude and adjusted weighted logistic regression models were used to identify predictors associated with PG. The prevalence of PG was associated with shopping frequency, compulsive internet use, cannabis use in the previous month, higher family economic status, and having a homemaker father which increased the likelihood of PG. On the contrary, cultural hobbies such as playing an instrument, painting, singing, and writing, and having a working mother were inversely associated with PG. Our results suggest that encouraging participation in creative activities along with supervised shopping and monitoring compulsive internet use and cannabis consumption may contribute some protection against adolescent PG.
Open Access
Incidence and trend of type I and II endometrial cancer in women from two population-based european cancer registries (1998–2012)
(MDPI, 2022-03-23) Rodríguez-Palacios, Daniel Ángel; Colorado-Yohar, Sandra M.; Velten, Michel; Vaamonde-Martín, Ricardo J.; Ballesta Ruiz, Mónica; Chirlaque López, María Dolores; Ciencias Sociosanitarias; Facultad de Enfermería
Endometrial cancer (EC) is the most frequent female genital tract cancer in Europe. This cohort study aimed to determine age-standardised incidence rates and long-term trends of type I and II endometrial cancer in women from population-based cancer registries in the Region of Murcia (Spain) and the Bas-Rhin area (France). Data of new cases of endometrial cancer between 1998 and 2012 were obtained from the Murcia and Bas-Rhin cancer registries. In that period, 3756 cases of endometrial cancer were recorded, with 3270 corresponding to type I EC and 486 corresponding to type II EC. The Bas-Rhin area presented higher age-adjusted incidence rates than those in the Region of Murcia for both type I EC (24.2 and 19.3 cases/100,000 person-years (py), respectively) and type II EC (4.4 and 2.3 cases/100,000 py, respectively). Joinpoint regression showed no changes in trends. In both populations, there was an increasing trend for both EC types, but the trend was steeper in the Region of Murcia and larger overall for type II EC. Finally, a significant increase was observed in the annual trend of type II EC. Further studies are warranted to determine the potential risk factors, and continued efforts are needed to improve the recording and monitoring of EC types.
Open Access
Epidemiología del melanoma en la Región de Murcia
(Consejería de Salud. Región de Murcia. Fundación para la Formación e Investigación Sanitarias de la Región de Murcia, 2023) Sánchez Gil, Antonia; Ballesta Ruiz, Mónica; Chirlaque López, María Dolores; Ciencias Sociosanitarias; Facultad de Enfermería
Open Access
Heterogeneidad en el perfil profesional y las actividades de los registros de mortalidad en España
(Elsevier, 2022-05-28) Cirera, Lluís; Ballesta Ruiz, Mónica; Arana, Bárbara María; Chirlaque López, María Dolores; Grupo de Trabajo de Mortalidad de la Sociedad Española de Epidemiología; Ciencias Sociosanitarias; Facultades de la UMU::Facultad de Enfermería
Objective: The mortality registries (MR) code death causes for the elaboration of the mortality statistics of the Spanish National Institute of Statistics (INE). Documentary research and medical training can improve this activity. Our objective was to analyse the professional profile and activities of the MR. Method: A survey was designed and distributed in February 2021. Professional profile, quality activities, medical training, and regular publications were the major topics. 16/18 MR participated. A cluster analysis was performed. Results: Eleven registries belong to Public Health. Five have an INE agreement, 39% provided training, and 56% made regular publications. Ten improved the causes of death, and 17% reviewed the automatic coding. The cluster analysis started from 5/16 groups of registries. Conclusions: The MR were heterogeneous in professionals, quality and publications. Homogeneity implies documentary search, a sole INE agreement, and providing systemic medical training.
Open Access
Mortality attributable to modifiable lifestyle factors in the Spanish cohort of the European prospective investigation into cancer and nutrition (EPIC) study
(BioMed Central, 2025-11-26) Cirera, Lluis; Huerta, José María; Moreno-Iribas, Conchi; Jiménez, Ana; Mokoroa, Olatz; Guevara, Marcela; Andueza, Naroa; Sánchez, María José; Petrova, Dafina; Luján-Barroso, Leila; Salmerón Martínez, Diego; Chirlaque López, María Dolores; Ciencias Sociosanitarias
Background There is consistent evidence on the relationship of unhealthy habits with mortality risk. The population attributable fraction (PAF) is a useful quantifier of the number of new disease cases attributable to modifiable risk factors. Our objective was to obtain the hazard ratios (HRs) and the PAFs for the major individual lifestyle factors of mortality in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods Prospective study which included 40 307 EPIC-Spain participants (62.5% women). A total of 7 262 cases of all-cause mortality (53.9% were men) occurred during an average follow-up of 25.1 years. We calculated PAFs separately for men and women, using adjusted HRs of mortality (and 95% CI) from multivariate Cox regression models for binary categories of smoking, high alcohol consumption, obesity markers, poor Mediterranean diet adherence, and low physical activity. Results Most lifestyle factors studied were significantly associated with mortality in the study cohort. In final multivariate analyses, smoking registered the largest PAFs in men (21.0%, 95%CI 19.1–22.7%), while general obesity (BMI) accounted for the largest PAF in women (10.8%, 7.5–13.8%). Attributable fractions were similar in both sexes for poor adherence to the Mediterranean diet, whereas the lowest PAFs were estimated for physical activity. High alcohol consumption and central obesity did not pose a risk in women. Conclusions Shifting from any risk factor to a healthier lifestyle would reduce mortality in both sexes. However, in women, alcohol consumption did not influence mortality risk and only BMI was associated with mortality risk attributable body adiposity. Key messages What is already known on this topic: modifiable lifestyle risk factors affect the occurrence of chronic disease incidence and mortality, but most studies provide relative measures of risk. What this study adds: this study quantifies the proportion of overall deaths attributable to a combination of major lifestyle risk factors in a large population sample from the EPIC-Spain study. How the study might affect research, practice or policy: the results would assist public health professionals and policy makers in identifying priorities and setting goals for intervention at the population level in order to prevent avoidable premature mortality in the population.