579 Cambios recientes en la mortalidad por cáncer de próstata en Chile: estudio de tendencias en el período 1955-2001 Alejandra Vives V, Gonzalo Valdivia C, Guillermo M arshall R a . Recent changes in prostate cancer mortality in Chile. Trends analysis from 1955 to 2001 Background : By the year 2000, prostate cancer became the sec- ond leading cause of cancer death in Chilean men of all ages and is the leading cause of can- cer deaths in men of eighty years of age or older. Aim: To analyze the trends in mortality rates from prostate cancer in Chile in a fifty years series, estimating the rate of increase of such rates and their changes in time. Material and methods : A trend analysis for age standardized mortality rates was performed, using join point regression analysis, which allows estimation of the annual percent change of rates and to find significant changes in such trend. Results: Age standardized mortality rates in Chile reached their peak value in 1996, becoming apparently stable from then on. Crude rates have had a steady increase during the whole period. The trends analysis identified three different periods in the growth of the age standardized rates: a first one of slow increase in rates between 1955 and 1981 (0.9% annual increase), a second one of more aggressive growth starting in 1981 (2.6% annual increase), and a third period starting in 1996, in which rates slowly decline at an annual rate of 1%. Conclusions : The ten- dency of prostate cancer seen in Chile resembles that of industrialized countries, with an in- crease in its age standardized death rates that suffers a downturn by the end of the past decade. Besides early detection techniques, a substantial part of the reduction in mortality from prostate cancer could be explained by therapeutic improvements (Rev Méd Chile 2004; 132: 579-87). ( Key Words : Mortality; Prostate specific antigen; Prostatic neoplasms) Recibido el 17 de noviembre, 2003. Aceptado en versión corregida el 12 marzo, 2004. Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile. a Doctor en Bioestadística. Correspondencia a : Alejandra Vives V. Departamento Salud Pública. Marcoleta 434, 1º Piso, Santiago Centro. Fono: 354-3038. Fax: 633-1840. E-mail: alvives@med.puc.cl Rev Méd Chile 2004; 132: 579-587 A RTÍCULO DE I NVESTIGACIÓN E l cáncer de próstata es de importancia para la salud pública en Chile y el resto del mundo, siendo en muchos países industrializados uno de los diagnósticos de cáncer más frecuentes en hombres 1 . Su incidencia aumentó en forma soste- nida en los años ochenta y noventa, a tal punto que se duplicó en Estados Unidos de Norteaméri- ca (EEUU), Canadá, Francia y Singapur entre 1973 y 1992 2 . En Chile, en el año 2000 llegó a ser la segunda causa de muerte por cáncer en hombres, superan- do al de tráquea, bronquios y pulmones 3 . En los mayores de 80 años, grupo donde este cáncer concentra la mayor parte de sus muertes, el cáncer