Abstract P4-03-04: The first population level description of all women diagnosed with breast cancer in Costa Rica from 2008 to 2012 using data from the National Tumor Registry
Authors: Guzman Percy G. , Ramirez-Pena Esmeralda 
Published: March 2023

Abstract
Background: Introduction: Cancer is the second leading cause of death worldwide. Every year 10 million cancer deaths are reported, 70% of which occur in low- and middle-income countries (LMICs). Breast cancer in the world is the second in incidence and the second in mortality. In Costa Rica cancer incidence occupies first place in incidence and fourth place in deaths. The Costa Rican health system is a public and universal system called the Costa Rican Social Security Fund (CCSS) and information on cancer is collected by the National Tumor Registry (RNT) which is governed by the Ministry of Health. Objectives: We sought to develop the first population-based description of the characteristics of women diagnosed with breast cancer in Costa Rica. This analysis allows us to measure the burden of breast cancer in Costa Rica and will enable assessments of quality of prevention, treatment, and care. These data will also inform how the burden of breast cancer in Costa Rica compares to other nations. Methods: Data from all patients registered in the CCSS with breast cancer was collected between January 2008 and December 2012. We evaluated sociodemographic, clinical, and treatment related characteristics. In this analysis we performed using SPSS, STATA version 17, and infostat. Results: In the CCSS, we identified 4,775 women of which 3,836 were diagnosed and 391 did not have clinical records. A total of 3,160 women were analyzed in the study. The mean age of diagnosis was 59.1 years old, 32.5% diagnosed were older than 65 years. 50.6% of the tumors originated in the left breast and 46.9% in the right breast. 50.7% of the tumors were in the superior outer quadrant. For diagnosis, core needle biopsies were used in 46.5% of the cases. About 60% of cases were diagnosed in early stages (IA, IIA, IIB), and 1.7% of cases in metastatic stages. Less than 40% of cases have positive lymph nodes and 76% of cases were infiltrating ductal carcinoma. Moderately differentiated tumors (40.7%) prevailed over poorly or well differentiated tumors. The most frequently affected site by metastasis was bone (3.0%). Most tumors did not have vascular (63.0%) or lymphatic invasion (52.5%) 80% are Ki-67 negative. We measured treatment-related characteristics and found that the average waiting time between diagnosis and surgery was 72 days, 77.9% waited less than 90 days for their treatment and the rest waited &gt;90 days. 88.7% received surgery as the first treatment, 54.4% received some type of adjuvant and the combination of treatments was used in 58.3% of the patients. 85.6% of the patients successfully completed their treatment. Discussion: This study is the first to describe the population with breast cancer in Costa Rica using data from the National Tumor Registry. Currently, only 3 of Latin American (LATAM) countries have high quality cancer registries and 20 of LATAM nations have a national registry. Some of the findings coincide with what is described in the world literature. We also identified novel information such as the impact of insurance type, occupation, and age on breast cancer that will inform the CCSS how the existing protocols for the care of breast cancer in Costa Rica can be improved.
Citation Format: Percy G. Guzman, Esmeralda Ramirez-Pena. The first population level description of all women diagnosed with breast cancer in Costa Rica from 2008 to 2012 using data from the National Tumor Registry. [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-03-04.