Inequidades territoriales en la mortalidad por cáncer y gestión sanitaria en Huánuco, Perú

Vollständiger Abstract

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Objective: To analyze territorial inequalities in mortality from cervical, gastric, and colorectal cancer in the provinces of the Department of Huanuco, Peru, and their relevance to territorial sanitary management. Materials and methods: A cross-sectional ecological study was conducted across the 11 provinces of Huanuco during the 2018–2023 period. Mortality records from the National Death Information System and population projections from the National Institute of Statistics and Informatics were used. Mortality rates per 100,000 inhabitants were calculated. Poverty, rurality, access to water, sanitation, illiteracy, and access to health services were evaluated as social determinants. Inferential analysis was applied using Pearson correlation and simple linear regression, alongside territorial risk classification based on rate quartiles. Results: The poverty and rurality were significantly and inversely associated with gastric and colorectal cancer mortality. Access to health services showed a positive association with colorectal cancer mortality. No significant associations were identified for cervical cancer. Risk analysis revealed geographical heterogeneity, highlighting Leoncio Prado as a high-risk province for all three types of cancer evaluated. The rate ratio between high- and low-risk provinces was 35.99 for cervical cancer and 5.10 for gastric cancer. Conclusions: The cancer mortality in Huanuco exhibits significant geographical inequalities linked to social determinants and sanitary access. These findings provide useful evidence for prioritizing interventions and strengthening territorial sanitary management.