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Introducción y objetivo: Medir el impacto en la gestión del tratamiento del cáncer renal a partir de la implementación de acciones, incluyendo el comité de tumores renales, en el Hospital de Oncología del Centro Médico Nacional (CMN) Siglo XXI. Material y métodos: Estudio observacional retrospectivo sobre una muestra de pacientes con cáncer renal en la Unidad Médica de Alta Especialidad (UMAE), Hospital de Oncología del CMN Siglo XXI. Se seleccionaron indicadores de gestión para medir tiempo, eficiencia y nivel de cumplimiento de procesos clave en el flujo de un paciente con cáncer renal. Resultados: Se creó una base de datos con información de 741 pacientes con variables de distintas áreas terapéuticas. Tras 5 meses, se estimó un cumplimiento promedio de 37% en los indicadores evaluados. Tras 2 años, un cumplimiento del 47%. Conclusiones: La implementación de las acciones resultó en mejoras en la gestión y atención de pacientes con cáncer renal en la UMAE, Hospital de Oncología del CMN Siglo XXI, particularmente en el tiempo promedio entre referencia e inicio del tratamiento.

Objective. To analyze the coverage of lung cancer in Mexico and offer recommendations in this regard. Materials and methods. By means of the conformation of a multidisci­plinary group, we analyze the burden of the disease relative to the lung cancer and the access to the medical treatment offered by the different public health subsystems in Mexico. Results. Important inequalities in lung cancer care are documented among the different public health subsystems. Our data suggest differential access and coverage to both traditional treatments and existing therapeutic innovations and differences in the capacity of health service providers to guarantee the right to health protection without distinction. Conclusions. Recommendations are made on the need to improve actions for tobacco control, early diagnosis for lung cancer and inclusion of innovative therapies and homologa­tion among different public health service providers through financing via tobacco taxes.

Objective. To analyze cancer mortality in affiliates of the Mexican Social Security Institute (Instituto Mexicano del Seguro Social -IMSS) and time trends in the risk of death due to cancer from 1989 to 2013. Materials and methods. A descriptive analysis of cancer mortality trends in beneficiaries of the IMSS was performed. Age and sex adjusted mortality rates were obtained using direct standardization with the WHO population. Changes in the risk of death due to cancer over time were evaluated using Poisson regression. Results. The absolute number of deaths due to cancer doubled from 1989 to 2013 due to increasing age of the affiliate population. The risk of death among affiliates decreased for the majority of cancers except for colon and rectal cancer. Conclusion. The risk of dying from cancer among IMSS affiliates showed a marked decrease, which may be due to an increase in detection and opportune treatment. DOI: http://dx.doi.org/10.21149/spm.v58i2.7784

Chronic noncommunicable diseases (NCDs), including can- cer, have become the leading cause of human morbidity and mortality. In Mexico, cancer is the third leading cause of death, with a high incidence among the economically active popula- tion, a high proportion of advanced stages at diagnosis and limited care coverage for patients. However, no public policy aimed at managing this important public health problem has been developed and implemented to date. This manuscript describes the first interinstitutional proposal of a National Program for Cancer Control, considering the known risk factors, early detection, treatment, palliative care and patient rehabilitation. This manuscript also outlines a series of thoughts on the difficulties and needs that the Mexican health system faces in achieving the main objectives of the program: to decrease the incidence of cancer, to increase survival and to improve the quality of life for this group of patients. DOI: http://dx.doi.org/10.21149/spm.v58i2.7804