Regional and gender disparities in lung cancer mortality in Guatemala.

Abstract

8074 Background: Lung cancer is the leading cause of cancer-related deaths worldwide and a major contributor in Latin America, where rates are generally lower. To date, there are no published population analyses describing lung cancer trends in Guatemala. Methods: Secondary analysis of publicly available national mortality data (Guatemala’s National Institute of Statistics), extracting lung cancer deaths from 2012 to 2022. Deaths were summarized by region, department, year, and sex. Annual crude mortality rates (deaths per 100,000 inhabitants) using corresponding population denominators. Results: Between 2012 and 2022 Guatemala recorded 4273 lung cancer deaths (mean age 66,SD:16.17), concentrated in three regions (66.58%,n=2845): Metropolitan, Southwest and Central with the highest department-level counts in Guatemala (37.66%,n=1609), Quetzaltenango (6.53%,n=279), Huehuetenango (5.41%,n=231), San Marcos (5.24%,n=224) and Escuintla (5.29%,n=226). Crude lung cancer mortality ranged from 2.24 to 2.66 deaths per 100,000 inhabitants—highest in 2019 and 2020. Deaths were more frequent among men (54%,n=2,317), but deaths among women increased throughout the study period, resulting in a male-to-female ratio decline from 1.53 in 2012 to 1.07 in 2022. Conclusions: Guatemala’s lung cancer mortality rates were lower compared to global estimates with nearly two-thirds of deaths concentrated in three regions —especially in Guatemala department— reflecting the concentration of health services in this region. Globally, lung cancer deaths show a marked sex disparity, with men accounting for about 68%. In contrast, Guatemala demonstrated a narrowing sex gap, with male-to-female mortality of nearly 1:1 by 2022, with rising mortality among women. These differences may reflect variations in smoking prevalence, access to early diagnosis, and health system capacity, with post-2020 shifts possibly influenced by COVID-19-related disruptions in diagnosis, treatment, referral pathways, or cause of death-of-death reporting. Lung cancer deaths. Region(Departments) 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 No(%) Metropolitan(Guatemala) 132 129 121 125 144 148 156 175 182 146 151 1609(37.66) North(Baja Verapaz, Alta Verapaz) 14 16 8 15 16 14 20 12 14 12 15 156(3.65) Northeast(Izabal, Zacapa, Chiquimula, El Progreso) 27 32 37 28 44 32 36 35 25 42 30 368(8.61) Southeast(Jalapa, Jutiapa) 50 33 41 39 33 27 32 45 40 30 33 403(9.43) Central(Sacatepequez, Chimaltenango, Escuintla) 37 32 54 31 43 42 41 47 56 52 54 489(11.44) Southwest(Solola, Totonicapan, Quetzaltenango, Suchitepequez, Retalhuleu, San Marcos) 45 70 52 64 82 67 74 70 79 76 68 747(17.48) Northwest(Huehuetenango, Quiche) 21 28 34 37 29 32 40 43 41 38 28 371(8.68) Petén 11 8 15 10 13 13 10 15 10 16 9 130(3.04) Deaths(Mortality x 100k hab) 337(2.28) 348(2.31) 362(2.37) 349(2.24) 404(2.55) 375(2.33) 409(2.50) 442(2.66) 447(2.65) 412(2.41) 388(2.24) 4273