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Item type:Ítem, Access status: Acceso Abierto , Factors associated with parental acceptance of the HPV vaccine in girls from metropolitan Lima, Peru(BioMed Central Ltd, 2025) Juárez Leon, Valeria; Calderón Solano, Delahnie; Poterico, Julio A.; Ybaseta Medina, Jorge; Azañedo, Diego; Torres Román, J. SmithBackground In 2022, cervical cancer was the second most common neoplasia among women in Peru, with 4809 cases and 2545 deaths reported. Infection with human papillomavirus (HPV) is a key factor in the development of this disease. Vaccination is the primary strategy for HPV prevention. Although HPV vaccination coverage has improved, evaluating acceptance profiles is crucial for effectively monitoring public immunization policies. We aimed to determine the associated factors with parental acceptance of the HPV vaccine in girls from Peru. Methods An observational, analytical, and cross-sectional study was conducted with a sample of 204 parents of girls and adolescents aged 9 to 19 years in Metropolitan Lima. The dependent variable was acceptance of the HPV vaccine, while the independent variables included demographic data, level of knowledge about HPV, and socioeconomic and cultural factors. Results A total of 204 parents participated in the study. Overall, 61.3% expressed willingness to vaccinate their daughters against HPV. Factors significantly associated with vaccine acceptance in the bivariate analysis included being a mother, being married, residing in the South-Central region, having a high monthly income, possessing private or public health insurance, and having a higher level of education. In both bivariate and multivariable analyses, having a daughter previously vaccinated against HPV was significantly associated with HPV vaccine acceptance, and remained the only independent predictor in the adjusted model (aPR=1.25, 95% CI: 1.03–1.53, p=0.023). Knowledge level about HPV was not significantly associated with vaccine acceptance in the adjusted model. Conclusion Prior experience with HPV vaccination was the strongest predictor of parental acceptance. Increasing awareness and addressing misconceptions through educational campaigns may enhance vaccine uptakeItem type:Ítem, Access status: Acceso Abierto , Evolution of mortality rates due to gastrointestinal bleeding in Peru and its geographic areas, 2003–2022(BioMed Central Ltd, 2025) Ortiz Alfaro, Miguel Andrés; Vizcarra Díaz, José Carlos; Rudas Sulca, Bryan; Alegre Cordero, Ivan; Damjanovic Burga, Yenko; Poterico, Julio A.; Ybaseta Medina, Jorge; Tasayco Marquez, Luis M.; Torres Roman, J. SmithBackground Gastrointestinal bleeding (GIB) is a common cause of emergency medical admissions and represents a significant public health issue due to its high morbidity and mortality. In Peru, information on mortality rates from GIB disaggregated by region and sex is limited. Therefore, this study aimed to analyze GIB mortality in the country between 2003 and 2022 using official data from the Peruvian Ministry of Health (MINSA). Methods An observational, ecological, and descriptive time-series study was conducted using MINSA mortality records for gastrointestinal bleeding from 2003 to 2022. Mortality rates were analyzed by sex and geographical region. Trends were assessed using Poisson regression models in Joinpoint software, identifying significant changes over time. Results Comparing the first (2003–2007) and last (2018–2022) five-year periods, a shift in the geographic burden was observed in coastal departments such as Ica and La Libertad to highland regions like Huancavelica, Puno, and Huánuco, which reported the highest mortality rates in the most recent period for both sexes. Between 2003 and 2022, GIB mortality rates declined significantly among men in Peru, with an annual percent change (APC) of −2.2%. In contrast, no significant national trend was observed among women. Regional analysis showed a significant decline in the coastal region for both sexes, while no significant trends were detected in the highland or jungle regions. At the departmental level, three departments (Ica, La Libertad, and Piura) showed significant decreases among men, whereas two departments (Arequipa and La Libertad) showed reductions among women. Notably, Madre de Dios experienced a significant increase in GIB mortality among men. Conclusion Comparing the first (2003–2007) and last (2018–2022) five-year periods, a shift in the geographic burden was observed in coastal departments such as Ica and La Libertad to highland regions like Huancavelica, Puno, and Huánuco, which reported the highest mortality rates in the most recent period for both sexes. Keywords Gastrointestinal bleeding, Mortality, PeruItem type:Ítem, Access status: Acceso Abierto , Trends in breast cancer mortality in Peru and its geographical areas from 2013 to 2022 and prediction until 2027(BioMed Central Ltd, 2025) Terrel Poccomo, Melanie Kiara; Santillán Romero, Grecia; Quispe Vicuña, Carlos; Ybaseta Medina, Jorge; Torres Roman, J. SmithBackground: In 2022, breast cancer was one of the most commonly diagnosed neoplasms and the leading cause of cancer death among women worldwide. In Peru, reports on mortality due to this neoplasm are scarce, especially after implementing strategies to reduce its impact. This study aimed to estimate mortality rates for breast cancer in Peru and its geographic regions from 2013 to 2022 and to project its evolution to 2027. Methods: An observational ecological study of multiple time series was conducted. Data were obtained from the Ministry of Health’s death database via SINADEF. Mortality rates per 100,000 women were calculated using the direct method and Segi’s world standard population. Mortality trends were analyzed using the Annual Percent Change (APC) calculated with Joinpoint regression software. Predictions for 2027 were also made using the Nordpred package in R Studio. Results: In 2013, the departments with the highest breast cancer mortality rates in Peru were Ica, Callao, Lambayeque and La Libertad. In 2022, Ancash and Tumbes were added, with Tumbes having the highest rates. For women under 50, Lambayeque and Madre de Dios led in 2013, while for women over 50, Tumbes had the highest mortality rate in 2022. Peru reported a significant increase of 3.97% on an annual basis for the entire period. According to regions, Rainforest region (APC = + 8.37) and the Rainforest region (APC = + 11.55) showed significant increases in mortality rates, while no significant changes were observed in the Coastal region. Moreover, an increase in breast cancer mortality in Peru is projected for the year 2027. Conclusion: Breast cancer mortality in Peru has shown a constant increase, with significant regional disparities. The highest rates were recorded in the coastal region, although the Andean and jungle regions experienced the most pronounced increases. These disparities may be attributed to data underreporting during the COVID-19 pandemic and unequal access to diagnostic and treatment services. The findings highlight the urgent need for focused public health interventions to reduce these regional gaps and improve breast cancer management outcomes. © The Author(s) 2025.Item type:Ítem, Access status: Acceso Abierto , Liver Cancer Mortality Rates in Peru: Trend Analysis from 2003 to 2017(Asian Pacific Organization for Cancer Prevention, 2025) Torres Roman, J. Smith; Cruz Ku, Gabriel De la; Alvarez, Christian S.; Ybaseta Medina, Jorge; Ruiz, Eloy F.; Martinez Herrera, José Fabian; Bazalar Palacios, Janina; Rio Muñiz, Lita Del; Poterico, Julio A.; McGlynn, Katherine A.Background: Liver cancer is one of the leading causes of cancer-related death in Peru, and some reports have indicated an increase in mortality rates among the largest cities. To our knowledge, no study has been carried out at a national level or by geographic area in recent years. Thus, our objective was to examine overall, regional and sexspecific liver cancer mortality rates in Peru between 2003-2017. Methods: We retrieved data on liver cancer deaths between 2003 and 2017 from the mortality database of the Peruvian Ministry of Health. Age-standardized mortality rates (ASMR) were estimated per 100,000 person-years using the world standard SEGI population. We analyzed mortality trends using Joinpoint regression Program Version 4.7.0. To examine the spatial distribution of the mortality rates, we used GeoDa software. Results: Between 2003 and 2017, 31,473 deaths from liver cancer were reported in Peru. Overall, liver cancer mortality rates have decreased significantly among Peruvian women since 2005 (−3.1% annually) with decreases in the coastal and highland regions ranging from 2.8% to 3.5%. In Arequipa, Cusco, La Libertad, Lima, and Moquegua, rates decreased bewteen 2003 and 2017. Among men in Ancash a significant increase (+12.5 annually) was observed from 2003-2011, followed by a sharpdecline (−10.5 annually) between 2011 and 2017. In contrast, rates in Cajamarca, Junin, and Ucayali decreased between 2003 and 2017. Conclusions: Although decreases in liver cancer mortality rates were observed in some regions of Peru, these trends were not statistically significant. In addition, some provinces experienced increases in rates. Effective interventions, such as expanding access to healthcare and controlling the various risk factors for liver cancer, remains a key challenge for the country.Item type:Ítem, Access status: Acceso Abierto , La desigualdad sociogeográfica en la prevalencia de anemia en niños(Sociedad Iberoamericana de Informacion Cientifica, 2024) Pari Olarte, Josefa Berta; Zagaceta Guevara, Zaira; Chacaltana Ramos, Luz Josefina; Quispe Ilanzo, Melisa Pamela; Almeida Donaire, Roberto Santiago; Oyola García, Alfredo; Solano García, Cecilia Guiliana; Almeida Galindo, José SantiagoBackground: Anemia in children is a major public health problem in the world and Perú, especially in those under three years old. Aim: The study was designed to identify the social determinants that explain the socio-geographic inequality in the distribution of anemia prevalence in six-to-35-month Peruvian children. Methods: An observational, ecological, and analytic study was carried out in 26 subnational governments of Peru. Correlation tests, simple and multiple linear regression, and calculating inequality gaps and gradients were applied. Results: The proportion of pregnant women without iron supplementation was the only explanatory variable for the prevalence of anemia in children under 36 months. The absolute gradient of inequality reflected a pattern of equity (ICI = 0.02). Excess of anemia prevalence in six-to-35-month children was equivalent to 11.53% along the gradient determined by the proportion of pregnant women without iron supplementation. Territories in the quintile with the highest proportion of pregnant women without iron supplementation had the highest gap in absolute and relative terms (18.49% and 1.46%; respectively). Conclusions: The proportion of pregnant women without iron supplementation would explain the socio-geographic inequality gap in the prevalence of anemia in 6-to-35-month Peruvian children. In other words, territories with the lowest achievement of this indicator would be exposed to a higher prevalence of anemia, so universal interventions must be focused on them.