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Published in: The European Journal of Health Economics 1/2010

Open Access 01-01-2010 | Original Paper

Colorectal cancer in Mexico: should a middle income country invest in screening or in treatment?

Authors: Emma Verastegui, Alejandro Mohar

Published in: The European Journal of Health Economics | Special Issue 1/2010

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Abstract

Mexico, like many other middle-income countries, is experiencing a demographic and epidemiological transition resulting in an older population suffering from chronic diseases. At the present time, cancer is the second cause of death in the country. Until recently, cervical carcinoma was the most frequent type of cancer in the country, however, the incidence of breast, prostate and colon cancers is growing. The demand for health care and health expenditure represented by cancer treatment challenges the limited resources the country has, particularly as patients seek treatment in advanced stages of the disease. Interestingly enough, these types of cancers could be detected in the early stages with rather simple screening procedures. The purpose of this paper is to describe the Mexican health system, and the impact of its fragmentation on access to medicines. Focusing on colorectal cancer (CRC), we describe its epidemiology, screening procedures and the inequities in health care access for these patients.
Footnotes
1
Mexico’s health system is decentralised, each state has its own secretariat of health and provides only for their region. This paper will use generically the MoH, but this will also cover state services.
 
2
Mexico's current population is approximately 109 million people, and by 2025, almost 10% of the Mexican population is estimated to be over 65; this percentage is expected to double by 2050.
 
3
However, in states with lower levels of socio-economic development and in rural areas, a considerable epidemiological backlog remains.
 
4
The burden of chronic diseases has increased, and cancer is the second cause of mortality after cardiovascular diseases.
 
5
The type of cancers diagnosed have changed during the last decade, the incidence of cervical carcinoma has decreased and breast, prostate and colon cancer incidences have increased.
 
6
The Popular Insurance Scheme provides health coverage through voluntary public insurance for persons not covered by social security (IMSS, ISSSTE). It currently provides coverage for 266 medical operations listed in the Universal Health Service Catalogue. A trust was created to fund treatments which can cause catastrophic expenditures, including childhood cancers, breast and cervical cancer.
 
7
However, often these patients are treated by general physicians for several months before their referral to the Institute.
 
8
Oral versions of traditional 5-fluorouracil therapy (Capecitabine, UFT), additional cytotoxic chemotherapy (Irinotecan, Oxaliplatin), and new targeted biological treatments (Cetuximab, Bevacizumab).
 
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Metadata
Title
Colorectal cancer in Mexico: should a middle income country invest in screening or in treatment?
Authors
Emma Verastegui
Alejandro Mohar
Publication date
01-01-2010
Publisher
Springer-Verlag
Published in
The European Journal of Health Economics / Issue Special Issue 1/2010
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-009-0190-1

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