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M Hernández Avila

Publications and source records attributed to M Hernández Avila.

13 recordsLinked to original sources
PubMed2000

Breast cancer in Mexican women: an epidemiological study with cervical cancer control.

INTRODUCTION: In Mexico, breast cancer (BC) is one of the main causes of cancer deaths in women, with increasing incidence and mortality in recent years. Therefore, the aim of the study is identify possible risk factors related to BC. METHODS: An epidemiological study of hospital cases of BC and controls with cervical uterine cancer (CUCA) was carried out at eight third level concentration hospitals in Mexico City. The total of 353 incident cases of BC and 630 controls with CUCA were identified among women younger than 75 years who had been residents of the metropolitan area of Mexico City for at least one year. Diagnosis was confirmed histologically in both groups. Variables were analyzed according to biological and statistical plausibility criteria. Univariate, bivariate and multivariate analyses were carried out. Cases and controls were stratified according to the menopausal hormonal status (pre and post menopause). RESULTS: The factors associated with BC were: higher socioeconomic level (OR= 2.77; 95%CI = 1.77 - 4.35); early menarche (OR= 1.32; 95%CI= 0.88 - 2.00); old age at first pregnancy (>31 years: OR= 5.49; 95%CI= 2.16 - 13.98) and a family history of BC (OR= 4.76; 95% CI= 2.10 - 10.79). In contrast, an increase in the duration of the breastfeeding period was a protective factor (>25 months: OR= 0.38; 95%CI= 0.20 - 0.70). CONCLUSIONS: This study contributes to the identification of risk factors for BC described in the international literature, in the population of Mexican women. Breastfeeding appears to play an important role in protecting women from BC. Because of changes in women's lifestyles, lactation is decreasing in Mexico, and young women tend not to breastfeed or to shorten the duration of lactation.

Adult↗
PubMed1998

Proposal to institutionalize criteria and quality standards for cervical cancer screening within a health care system.

The uterine cervix is the most common cancer site for females. Approximately 52,000 new cases occur annually in Latin America, thus the need to improve efficiency and effectiveness of Cervical Cancer Screening Programs (CCSP) is mandatory to decrease the unnecessary suffering women must bear. This paper is addressing essential issues to revamp the CCSP as proposed by the Mexican official norm. A general framework for institutionalizing CCSP is outlined. Furthermore, strategies to strengthen CCSP performance through managerial strategies and quality assurance activities are described. The focus is on the following activities: 1) improving coverage; 2) implementing smear-taking quality control; 3) improving quality in interpretation of Pap test; 4) guaranteeing treatment for women for whom abnormalities are detected; 5) improving follow-up; 6) development of quality control measures and 7) development of monitoring and epidemiological surveillance information systems. Changes within the screening on cervical cancer may be advocated as new technologies present themselves and shortcomings in the existing program appear. It is crucial that these changes should be measured through careful evaluation in order to tally up potential benefits.

Adult↗
PubMed1996

Factors associated with Mexican women's familiarity with the purpose of the Pap test.

Use of health services is usually associated with a variety of factors, including the socioeconomic characteristics of the users, their familiarity with the usefulness of the services provided, and the acceptability and accessibility of those services. To study the factors associated with women's familiarity with the Pap test, a population-based study was carried out in Mexico City and two rural areas in the state of Oaxaca by means of household interviews. The sample consisted of 4208 women 15 to 49 years of age. Univariate, bivariate, and multivariate analyses were done using unconditional logistic regression; the independent variables were access to social security health services, age, education, housing quality, and place of residence (urban or rural); the dependent variable was the interview subject's familiarity with the purpose of the Pap test. The results were expressed as odds ratios with 95% confidence intervals. It was found that 41.5% of the women surveyed did not know the purpose of the Pap test, and that within this latter group, 97% had never had one. Factors found to be associated with not knowing the test's purpose were lack of access to the social security health services (OR = 1.9; 95% CI: 1.5-2.3); illiteracy (OR = 36.1; 95% CI: 17.9-72.7); and low socioeconomic level (OR = 2.9; 95% CI: 2.3-3.7). Also, rural dwellers had less familiarity with the Pap test than urban dwellers (OR = 0.5; 95% CI: 0.4-0.7). These results highlight the need to develop strategies for making the benefits of the Pap test known, bearing in mind the socioeconomic and cultural diversity of the populations involved.

Adolescent↗
PubMed1994

Chili pepper consumption and gastric cancer in Mexico: a case-control study.

Laboratory studies indicate that capsaicin, the hot-tasting component of chili peppers, may be carcinogenic. A population-based case-control study was conducted in Mexico City during 1989-1990 to evaluate the relation between chili pepper consumption and gastric cancer risk. The study included 220 incident cases and 752 controls randomly selected from the general population. Information was collected by interview. Chili pepper consumers were at high risk for gastric cancer compared with nonconsumers (age- and sex-adjusted odds ratio = 5.49, 95% confidence interval (CI) 2.72-11.06). Among consumers, there was a highly significant trend of increasing risk with increasing self-rated level of consumption (low, medium, and high) (p = 2 x 10(-7). The odds ratio for high-level consumers compared with nonconsumers was 17.11 (95% CI 7.78-37.59). However, when consumption was measured as frequency per day, a significant trend among consumers was not observed. Multivariable adjustment increased the magnitude of the chili pepper-gastric cancer association, but a significant trend among consumers (measured as frequency per day) was still not observed. Chili pepper consumption may be a strong risk factor for gastric cancer, but further studies are needed to test this hypothesis.

Adenocarcinoma↗
PubMed1994

[Cancer of the uterine cervix. Historical perspective].

This paper describes the existing etiological paradigms which explain the development of cervical cancer (CACU), and particular, is a review of the historical attempts to explain the occurrence of the disease. Previous analysis concerning the prevalence of CACU in populations has been based on empirical work which can be summarized in several public health models, including: biomedical, hygienist-preventive, epidemiologic, ecologic, and social medical. We conclude that the existing paradigms must be reoriented in order to formulate organized social responses for the control of CACU.

Carcinoma in Situ↗
PubMed1990

Reproductive factors, smoking, and the risk for rheumatoid arthritis.

Risk factors for rheumatoid arthritis were examined in a cohort of 121,700 female nurses aged 30-55, followed in the Nurses' Health Study. Baseline information on reproductive variables, cigarette smoking, obesity, and other variables was obtained in 1976 and updated every 2 years. Cases of rheumatoid arthritis were defined by standardized questionnaire and review of medical records. During 883,187 person-years of follow-up, 217 new cases of rheumatoid arthritis were identified (115 had definite rheumatoid arthritis and 102 had "undifferentiated polyarthritis"). When compared with women who experienced menarche at age 13 years, the age-adjusted relative risk of rheumatoid arthritis among women with early menarche was 1.9 (95% confidence interval, 0.9-2.4). There were, however, no significant associations between parity, age at birth of the first child, menopause, or obesity and the incidence of rheumatoid arthritis. Cigarette smokers had a slight apparent increase in the risk of rheumatoid arthritis. Among current smokers, the age-adjusted relative risk for RA rheumatoid arthritis was 1.3 (0.9-2.1); among former smokers, the relative risk was 1.5 (0.9-2.3).

Adult↗
PubMedDate not supplied

Cervical cancer screening in developing countries: why is it ineffective? The case of Mexico.

BACKGROUND: Mexico established a national cervical cancer-screening program in 1974. Despite the implementation of the program, there was a steady mortality trend of 16 per 100,000 women over 15 years. METHODS: A diagnostic procedure of the pitfalls was applied to the following steps of the screening procedure: Pap sampling quality; cytological diagnosis validity; compliance of women; and determinants of non-participation. RESULTS: The low effectiveness of screening on cervical cancer is principally due to factors associated with quality and coverage. Pap quality is deficient; 64% of a random sample of specimens lacked endocervical cells. Reading centers presented false negative indices of between 10 and 54%. Women seek screening in a late stage of disease (55% with cervical cancer seek care because they have symptoms). In addition, coverage is low; in women between 15 and 49 years of age in Mexico City, 64.2% have a history of Pap, compared with 30% in rural areas. Knowledge of what the Pap is used for strongly determines the use of screening. In rural areas, only 40% of women are informed about the purpose of the Pap test. CONCLUSIONS: A proposal to reorganize Mexico's screening program includes the following five main strategies: (a) increased coverage; (b) improved quality control of how cervical smears are taken; (c) better interpretation of Pap tests; (d) guaranteed treatment for those whose tests show abnormalities, and (e) improved follow-up.

Adolescent↗