International Journal of Environmental Research and Public Health, 2021
Background: Hurricanes are the immediate ways that people experience climate impacts in the Carib... more Background: Hurricanes are the immediate ways that people experience climate impacts in the Caribbean. These events affect socio-ecological systems and lead to major disruptions in the healthcare system, having effects on health outcomes. In September 2017, Puerto Rico (PR) and the United States Virgin Islands (USVI) experienced one of the most catastrophic hurricane seasons in recent history (Hurricane Irma was a Category 5 and Hurricane María was a Category 4 when they hit PR). Objective: This study examines environmental stressors experienced by women with gynecologic (GYN) cancers from PR and USVI who received oncologic cancer care in PR, in the aftermath of the hurricanes. Methods: A descriptive qualitative study design was used to obtain rich information for understanding the context, barriers, knowledge, perspectives, risks, vulnerabilities, and attitudes associated to these hurricanes. We performed focus groups among GYN cancer patients (n = 24) and key-informant interviews ...
Due to advances in the care of people living with HIV/AIDS (PLWHA), life expectancy significantly... more Due to advances in the care of people living with HIV/AIDS (PLWHA), life expectancy significantly increased, putting this group vulnerable to age-related comorbidities, such as cancer. The objective of this study was to describe the knowledge of cancer screening (cervical, breast, anal, colon, prostate) and other cancer prevention strategies (HPV vaccination, HPV testing) among HIV care professionals in Puerto Rico (PR). Cross-sectional study using a sample of 104 HIV healthcare professionals in PR. Descriptive analyses were used to characterize the study sample. Logistic regression analysis was used to determine the relation of sociodemographic and work-related factors with cancer screening knowledge. On average, the healthcare professionals interviewed had been working for more than 10 years with the HIV/AIDS population (11.5±7.6 years). Multivariate analysis showed that physicians had a higher likelihood of having extensive knowledge of cervical (OR=3.96; 95% CI=1.23, 12.77) and ...
The aim of this manuscript is to describe the prevalence, genotypic distribution of penile HPV in... more The aim of this manuscript is to describe the prevalence, genotypic distribution of penile HPV infection and the behavioral risk factors associated with penile HPV infection (any HPV type, high-oncogenic-risk [HR] types, low-oncogenic-risk [LR] types, and of multiple HPV types) in a group of sexually active males who went to an STI clinic in San Juan, Puerto Rico. After providing informed consent, the participants, underwent a detailed behavioral interview and a clinical examination. Frequency distributions and descriptive statistics were used to characterize the study samples. Prevalence estimates and 95% confidence intervals (CI) were calculated for any type of HPV, HR types, LR types, or multiple types. Logistic regression analyses was performed to determine factors associated with each of the HPV types. Two hundred and six participants were enrolled in this study. The mean age of the participants was 37.8±13.1 years. Close to 80% of the sample were infected with at least one HPV...
Cancer Epidemiology, Biomarkers & Prevention, 2014
Objective: Statistics about cancer survivorship are inexistent for the Puerto Rican population. W... more Objective: Statistics about cancer survivorship are inexistent for the Puerto Rican population. With this study we intend to address the first objective of the Puerto Rico Cancer Control Plan 2008-2012 of increasing the knowledge and awareness of survivorship among the Puerto Rican community. Thus, this study aimed to estimate the number of cancer survivors living with a history of a primary malignant tumor in Puerto Rico (PR) as of January 1, 2011, through a secondary data analysis of the Puerto Rico Central Cancer Registry and assess cancer survivorship prevalence of the five most incident cancers in Puerto Rico (breast, prostate, colon and rectum, lung and bronchus, and thyroid). Methods: The study population consisted of people in Puerto Rico living with a cancer diagnosis as of January 1, 2011, as documented in the Puerto Rico Central Cancer Registry. We calculated the limited-duration prevalence, which represents the proportion of people alive on a certain day that had a diagn...
The metabolic syndrome is associated with a high risk of diabetes and cardiovascular disease, and... more The metabolic syndrome is associated with a high risk of diabetes and cardiovascular disease, and Hispanics in the United States have higher rates than do other ethnic groups. We assessed the prevalence of the metabolic syndrome and its individual components in Puerto Rican adults. We conducted a cross-sectional study that used a probability cluster design to select a sample of households of the San Juan metropolitan area from 2005 through 2007. A total of 859 persons aged 21-79 years completed a face-to-face interview, blood pressure and waist circumference measurements, and blood sampling. Our primary outcome measure was metabolic syndrome as defined by the updated NCEP-ATP criteria. Prevalence of the metabolic syndrome was 43.3%; 45.3% for men and 42.2% for women (P>.05). Prevalence significantly rose with age, from 12.8% among participants aged 21-29 years to 58.2% for participants aged 70-79 years (P<.001). Corresponding increases in the prevalence of the metabolic syndro...
Cancer Epidemiology, Biomarkers & Prevention, 2011
Background: HPV is associated to cancer of the cervix, anus, vulva, vagina, penis, oral cavity an... more Background: HPV is associated to cancer of the cervix, anus, vulva, vagina, penis, oral cavity and oro-pharynx. Studies in Puerto Rico (PR) and in the United States (US) have documented that HPV infection and HPV-related cancers are higher in persons living with HIV/AIDS (PLHA) than in the general population. After 30 years of the HIV/AIDS epidemic, cancer research in the HIV/AIDS population is highly warranted. However, in PR, a minority population with a disproportionate burden of HIV/AIDS as compared to the US, data on the burden of HPV-related cancers among HIV/AIDS patients is still limited. Primary aim: This study estimated the hazard ratio of death among PLHA in PR, by sex, age at AIDS diagnosis and cancer status. Methods: A total of 29,535 (96%) of all the AIDS cases reported to the PR AIDS Surveillance system between 1985 and 2005, aged ≥15 years, were eligible for analysis. The PR AIDS Surveillance and PR Central Cancer Registry databases were linked using Link Plus v.2.0 ...
Journal of Clinical and Translational Science, 2019
OBJECTIVES/SPECIFIC AIMS: The objective of this study was to evaluate the impact of the research ... more OBJECTIVES/SPECIFIC AIMS: The objective of this study was to evaluate the impact of the research and the scientific collaborations as shown in research publication supported by the PRCTRC. METHODS/STUDY POPULATION: Manuscripts published from 2010 to 2017 were retrieved from the Science Citation Index database. Our search criteria included manuscripts: 1) with the PRCTRC grant number and 2) with a PMCID number. Scientometric indicators including h-index (HI), average citation (AC), collaboration coefficient (CC), collaboration index (CI) and degree of collaboration (DC) were calculated using the Web of Science Platform and Stata software for statistical inquiry. Joinpoint was used to calculate the annual percent change (APC). RESULTS/ANTICIPATED RESULTS: A total of 316 publications were identified from 2010-2017, with an average of 39.5 publications per year, and a total of 2,383 citing articles without self-citations. During this period a significant growth (APC = ¬15.3%, p < 0.0...
MMWR. Morbidity and mortality weekly report, Jan 17, 2015
Cancer is a leading cause of morbidity and death in Puerto Rico. To set a baseline for identifyin... more Cancer is a leading cause of morbidity and death in Puerto Rico. To set a baseline for identifying new trends and patterns of cancer incidence, Puerto Rico Central Cancer Registry staff and CDC analyzed data from Puerto Rico included in U.S. Cancer Statistics (USCS) for 2007-2011, the most recent data available. This is the first report of invasive cancer incidence rates for 2007-2011 among Puerto Rican residents by sex, age, cancer site, and municipality. Cancer incidence rates in Puerto Rico were compared with those in the U.S. population for 2011. A total of 68,312 invasive cancers were diagnosed and reported in Puerto Rico during 2007-2011. The average annual incidence rate was 330 cases per 100,000 persons. The cancer sites with the highest cancer incidence rates included prostate (152), female breast (84), and colon and rectum (43). Cancer incidence rates varied by municipality, particularly for prostate, lung and bronchus, and colon and rectum cancers. In 2011, cancer inciden...
Puerto Rico has one of the highest incidence rates of HIV in the U.S. Concurrent with increases i... more Puerto Rico has one of the highest incidence rates of HIV in the U.S. Concurrent with increases in sexually transmitted infections (STI), an increasing share of the new infections in PR are associated with sexual transmission. Much of the available research on sexual risk in PR derives from STI/HIV surveillance data. There is limited social and epidemiological research on sexual risk in PR, particularly in hidden and often hard-to-reach populations at high risk. Despite the absence of substantial resources that most epidemiological studies require, a research collaboration was initiated in 2007 between researchers in the School of Public Health at the University of Puerto Rico and the Centro Latinoamericano de Enfermedades de Transmisión Sexual (CLETS), one of the largest publicly funded centers for STI/HIV screening and treatment in the San Juan metropolitan area. Structured as a case study in the development of community-based research collaborations, this paper describes the earl...
The incidence of anal cancer is increasing, particularly among HIV and men who have sex with men ... more The incidence of anal cancer is increasing, particularly among HIV and men who have sex with men (MSM) groups. The vast majority of cases are associated with human papillomavirus (HPV), the most common sexually transmitted infection. Epidemiological studies have also documented low survival, which might be linked to lack of appropriate screening, access, and utilization of pertinent health care services. Our objective was to assess the relative survival (1 and 3 years) of anal cancer in Puerto Rico for men and women during the period from 2000-2007. All histological types of cancer of anus, anal canal, and anorectum (ICD-O-3 codes C210-C218), except for sarcomas, were included. Relative survival was estimated with the use of life tables from the population of Puerto Rico. In addition, the excess survival was compared by age at diagnosis, histology, and stage (defined as local, regional, or distant), using the Poisson regression model. The overall 3-year relative survival in Puerto Rico was the same (53 %) for men and women. Our findings establish baseline survival data for anal cancer in Hispanics from Puerto Rico. Since now, the national guidelines for anal cancer screening and treatment are on their way to be determined; baseline information about survival will allow monitoring the efficacy that standardized screening programs may eventually have in increasing anal cancer survival in this population.
The study's objective was to examine the relationship between cesarean section delivery and t... more The study's objective was to examine the relationship between cesarean section delivery and the initiation of breastfeeding in a representative sample of 1695 Puerto Rican women aged 15 to 49 years, who delivered their last healthy singleton child in Puerto Rico between 1990 and 1996. Secondary analysis of data collected in the population-based cross-sectional study Puerto Rico Reproductive Health Survey was performed. Bivariate and multivariate logistic regression analyses were used to examine the crude and covariate adjusted association between type of childbirth and initiation of breastfeeding. Overall, 36% of all births were performed by cesarean section, while initiation of breastfeeding was achieved by 61.5% of the women. Cesarean section was negatively related to breastfeeding initiation in multivariable logistic regression models (odds ratio = .64; 95% CI = 0.51-0.81) after controlling for confounding variables. Intervention programs that aim to promote breastfeeding and...
Cancer is a leading cause of morbidity and death in Puerto Rico. To set a baseline for identifyin... more Cancer is a leading cause of morbidity and death in Puerto Rico. To set a baseline for identifying new trends and patterns of cancer incidence, Puerto Rico Central Cancer Registry staff and CDC analyzed data from Puerto Rico included in U.S. Cancer Statistics (USCS) for 2007-2011, the most recent data available. This is the first report of invasive cancer incidence rates for 2007-2011 among Puerto Rican residents by sex, age, cancer site, and municipality. Cancer incidence rates in Puerto Rico were compared with those in the U.S. population for 2011. A total of 68,312 invasive cancers were diagnosed and reported in Puerto Rico during 2007-2011. The average annual incidence rate was 330 cases per 100,000 persons. The cancer sites with the highest cancer incidence rates included prostate (152), female breast (84), and colon and rectum (43). Cancer incidence rates varied by municipality, particularly for prostate, lung and bronchus, and colon and rectum cancers. In 2011, cancer inciden...
The incidence of anal cancer is increasing, particularly among HIV and men who have sex with men ... more The incidence of anal cancer is increasing, particularly among HIV and men who have sex with men (MSM) groups. The vast majority of cases are associated with human papillomavirus (HPV), the most common sexually transmitted infection. Epidemiological studies have also documented low survival, which might be linked to lack of appropriate screening, access, and utilization of pertinent health care services. Our objective was to assess the relative survival (1 and 3 years) of anal cancer in Puerto Rico for men and women during the period from 2000-2007. All histological types of cancer of anus, anal canal, and anorectum (ICD-O-3 codes C210-C218), except for sarcomas, were included. Relative survival was estimated with the use of life tables from the population of Puerto Rico. In addition, the excess survival was compared by age at diagnosis, histology, and stage (defined as local, regional, or distant), using the Poisson regression model. The overall 3-year relative survival in Puerto Rico was the same (53 %) for men and women. Our findings establish baseline survival data for anal cancer in Hispanics from Puerto Rico. Since now, the national guidelines for anal cancer screening and treatment are on their way to be determined; baseline information about survival will allow monitoring the efficacy that standardized screening programs may eventually have in increasing anal cancer survival in this population.
Puerto Rico has one of the highest incidence rates of HIV in the U.S. Concurrent with increases i... more Puerto Rico has one of the highest incidence rates of HIV in the U.S. Concurrent with increases in sexually transmitted infections (STI), an increasing share of the new infections in PR are associated with sexual transmission. Much of the available research on sexual risk in PR derives from STI/HIV surveillance data. There is limited social and epidemiological research on sexual risk in PR, particularly in hidden and often hard-to-reach populations at high risk. Despite the absence of substantial resources that most epidemiological studies require, a research collaboration was initiated in 2007 between researchers in the School of Public Health at the University of Puerto Rico and the Centro Latinoamericano de Enfermedades de Transmisión Sexual (CLETS), one of the largest publicly funded centers for STI/HIV screening and treatment in the San Juan metropolitan area. Structured as a case study in the development of community-based research collaborations, this paper describes the earl...
Puerto Rico has one of the highest incidence rates of HIV in the U.S. Concurrent with increases i... more Puerto Rico has one of the highest incidence rates of HIV in the U.S. Concurrent with increases in sexually transmitted infections (STI), an increasing share of the new infections in PR are associated with sexual transmission. Much of the available research on sexual risk in PR derives from STI/HIV surveillance data. There is limited social and epidemiological research on sexual risk in PR, particularly in hidden and often hard-to-reach populations at high risk. Despite the absence of substantial resources that most epidemiological studies require, a research collaboration was initiated in 2007 between researchers in the School of Public Health at the University of Puerto Rico and the Centro Latinoamericano de Enfermedades de Transmisión Sexual (CLETS), one of the largest publicly funded centers for STI/HIV screening and treatment in the San Juan metropolitan area. Structured as a case study in the development of community-based research collaborations, this paper describes the earl...
International Journal of Environmental Research and Public Health, 2021
Background: Hurricanes are the immediate ways that people experience climate impacts in the Carib... more Background: Hurricanes are the immediate ways that people experience climate impacts in the Caribbean. These events affect socio-ecological systems and lead to major disruptions in the healthcare system, having effects on health outcomes. In September 2017, Puerto Rico (PR) and the United States Virgin Islands (USVI) experienced one of the most catastrophic hurricane seasons in recent history (Hurricane Irma was a Category 5 and Hurricane María was a Category 4 when they hit PR). Objective: This study examines environmental stressors experienced by women with gynecologic (GYN) cancers from PR and USVI who received oncologic cancer care in PR, in the aftermath of the hurricanes. Methods: A descriptive qualitative study design was used to obtain rich information for understanding the context, barriers, knowledge, perspectives, risks, vulnerabilities, and attitudes associated to these hurricanes. We performed focus groups among GYN cancer patients (n = 24) and key-informant interviews ...
Due to advances in the care of people living with HIV/AIDS (PLWHA), life expectancy significantly... more Due to advances in the care of people living with HIV/AIDS (PLWHA), life expectancy significantly increased, putting this group vulnerable to age-related comorbidities, such as cancer. The objective of this study was to describe the knowledge of cancer screening (cervical, breast, anal, colon, prostate) and other cancer prevention strategies (HPV vaccination, HPV testing) among HIV care professionals in Puerto Rico (PR). Cross-sectional study using a sample of 104 HIV healthcare professionals in PR. Descriptive analyses were used to characterize the study sample. Logistic regression analysis was used to determine the relation of sociodemographic and work-related factors with cancer screening knowledge. On average, the healthcare professionals interviewed had been working for more than 10 years with the HIV/AIDS population (11.5±7.6 years). Multivariate analysis showed that physicians had a higher likelihood of having extensive knowledge of cervical (OR=3.96; 95% CI=1.23, 12.77) and ...
The aim of this manuscript is to describe the prevalence, genotypic distribution of penile HPV in... more The aim of this manuscript is to describe the prevalence, genotypic distribution of penile HPV infection and the behavioral risk factors associated with penile HPV infection (any HPV type, high-oncogenic-risk [HR] types, low-oncogenic-risk [LR] types, and of multiple HPV types) in a group of sexually active males who went to an STI clinic in San Juan, Puerto Rico. After providing informed consent, the participants, underwent a detailed behavioral interview and a clinical examination. Frequency distributions and descriptive statistics were used to characterize the study samples. Prevalence estimates and 95% confidence intervals (CI) were calculated for any type of HPV, HR types, LR types, or multiple types. Logistic regression analyses was performed to determine factors associated with each of the HPV types. Two hundred and six participants were enrolled in this study. The mean age of the participants was 37.8±13.1 years. Close to 80% of the sample were infected with at least one HPV...
Cancer Epidemiology, Biomarkers & Prevention, 2014
Objective: Statistics about cancer survivorship are inexistent for the Puerto Rican population. W... more Objective: Statistics about cancer survivorship are inexistent for the Puerto Rican population. With this study we intend to address the first objective of the Puerto Rico Cancer Control Plan 2008-2012 of increasing the knowledge and awareness of survivorship among the Puerto Rican community. Thus, this study aimed to estimate the number of cancer survivors living with a history of a primary malignant tumor in Puerto Rico (PR) as of January 1, 2011, through a secondary data analysis of the Puerto Rico Central Cancer Registry and assess cancer survivorship prevalence of the five most incident cancers in Puerto Rico (breast, prostate, colon and rectum, lung and bronchus, and thyroid). Methods: The study population consisted of people in Puerto Rico living with a cancer diagnosis as of January 1, 2011, as documented in the Puerto Rico Central Cancer Registry. We calculated the limited-duration prevalence, which represents the proportion of people alive on a certain day that had a diagn...
The metabolic syndrome is associated with a high risk of diabetes and cardiovascular disease, and... more The metabolic syndrome is associated with a high risk of diabetes and cardiovascular disease, and Hispanics in the United States have higher rates than do other ethnic groups. We assessed the prevalence of the metabolic syndrome and its individual components in Puerto Rican adults. We conducted a cross-sectional study that used a probability cluster design to select a sample of households of the San Juan metropolitan area from 2005 through 2007. A total of 859 persons aged 21-79 years completed a face-to-face interview, blood pressure and waist circumference measurements, and blood sampling. Our primary outcome measure was metabolic syndrome as defined by the updated NCEP-ATP criteria. Prevalence of the metabolic syndrome was 43.3%; 45.3% for men and 42.2% for women (P>.05). Prevalence significantly rose with age, from 12.8% among participants aged 21-29 years to 58.2% for participants aged 70-79 years (P<.001). Corresponding increases in the prevalence of the metabolic syndro...
Cancer Epidemiology, Biomarkers & Prevention, 2011
Background: HPV is associated to cancer of the cervix, anus, vulva, vagina, penis, oral cavity an... more Background: HPV is associated to cancer of the cervix, anus, vulva, vagina, penis, oral cavity and oro-pharynx. Studies in Puerto Rico (PR) and in the United States (US) have documented that HPV infection and HPV-related cancers are higher in persons living with HIV/AIDS (PLHA) than in the general population. After 30 years of the HIV/AIDS epidemic, cancer research in the HIV/AIDS population is highly warranted. However, in PR, a minority population with a disproportionate burden of HIV/AIDS as compared to the US, data on the burden of HPV-related cancers among HIV/AIDS patients is still limited. Primary aim: This study estimated the hazard ratio of death among PLHA in PR, by sex, age at AIDS diagnosis and cancer status. Methods: A total of 29,535 (96%) of all the AIDS cases reported to the PR AIDS Surveillance system between 1985 and 2005, aged ≥15 years, were eligible for analysis. The PR AIDS Surveillance and PR Central Cancer Registry databases were linked using Link Plus v.2.0 ...
Journal of Clinical and Translational Science, 2019
OBJECTIVES/SPECIFIC AIMS: The objective of this study was to evaluate the impact of the research ... more OBJECTIVES/SPECIFIC AIMS: The objective of this study was to evaluate the impact of the research and the scientific collaborations as shown in research publication supported by the PRCTRC. METHODS/STUDY POPULATION: Manuscripts published from 2010 to 2017 were retrieved from the Science Citation Index database. Our search criteria included manuscripts: 1) with the PRCTRC grant number and 2) with a PMCID number. Scientometric indicators including h-index (HI), average citation (AC), collaboration coefficient (CC), collaboration index (CI) and degree of collaboration (DC) were calculated using the Web of Science Platform and Stata software for statistical inquiry. Joinpoint was used to calculate the annual percent change (APC). RESULTS/ANTICIPATED RESULTS: A total of 316 publications were identified from 2010-2017, with an average of 39.5 publications per year, and a total of 2,383 citing articles without self-citations. During this period a significant growth (APC = ¬15.3%, p < 0.0...
MMWR. Morbidity and mortality weekly report, Jan 17, 2015
Cancer is a leading cause of morbidity and death in Puerto Rico. To set a baseline for identifyin... more Cancer is a leading cause of morbidity and death in Puerto Rico. To set a baseline for identifying new trends and patterns of cancer incidence, Puerto Rico Central Cancer Registry staff and CDC analyzed data from Puerto Rico included in U.S. Cancer Statistics (USCS) for 2007-2011, the most recent data available. This is the first report of invasive cancer incidence rates for 2007-2011 among Puerto Rican residents by sex, age, cancer site, and municipality. Cancer incidence rates in Puerto Rico were compared with those in the U.S. population for 2011. A total of 68,312 invasive cancers were diagnosed and reported in Puerto Rico during 2007-2011. The average annual incidence rate was 330 cases per 100,000 persons. The cancer sites with the highest cancer incidence rates included prostate (152), female breast (84), and colon and rectum (43). Cancer incidence rates varied by municipality, particularly for prostate, lung and bronchus, and colon and rectum cancers. In 2011, cancer inciden...
Puerto Rico has one of the highest incidence rates of HIV in the U.S. Concurrent with increases i... more Puerto Rico has one of the highest incidence rates of HIV in the U.S. Concurrent with increases in sexually transmitted infections (STI), an increasing share of the new infections in PR are associated with sexual transmission. Much of the available research on sexual risk in PR derives from STI/HIV surveillance data. There is limited social and epidemiological research on sexual risk in PR, particularly in hidden and often hard-to-reach populations at high risk. Despite the absence of substantial resources that most epidemiological studies require, a research collaboration was initiated in 2007 between researchers in the School of Public Health at the University of Puerto Rico and the Centro Latinoamericano de Enfermedades de Transmisión Sexual (CLETS), one of the largest publicly funded centers for STI/HIV screening and treatment in the San Juan metropolitan area. Structured as a case study in the development of community-based research collaborations, this paper describes the earl...
The incidence of anal cancer is increasing, particularly among HIV and men who have sex with men ... more The incidence of anal cancer is increasing, particularly among HIV and men who have sex with men (MSM) groups. The vast majority of cases are associated with human papillomavirus (HPV), the most common sexually transmitted infection. Epidemiological studies have also documented low survival, which might be linked to lack of appropriate screening, access, and utilization of pertinent health care services. Our objective was to assess the relative survival (1 and 3 years) of anal cancer in Puerto Rico for men and women during the period from 2000-2007. All histological types of cancer of anus, anal canal, and anorectum (ICD-O-3 codes C210-C218), except for sarcomas, were included. Relative survival was estimated with the use of life tables from the population of Puerto Rico. In addition, the excess survival was compared by age at diagnosis, histology, and stage (defined as local, regional, or distant), using the Poisson regression model. The overall 3-year relative survival in Puerto Rico was the same (53 %) for men and women. Our findings establish baseline survival data for anal cancer in Hispanics from Puerto Rico. Since now, the national guidelines for anal cancer screening and treatment are on their way to be determined; baseline information about survival will allow monitoring the efficacy that standardized screening programs may eventually have in increasing anal cancer survival in this population.
The study's objective was to examine the relationship between cesarean section delivery and t... more The study's objective was to examine the relationship between cesarean section delivery and the initiation of breastfeeding in a representative sample of 1695 Puerto Rican women aged 15 to 49 years, who delivered their last healthy singleton child in Puerto Rico between 1990 and 1996. Secondary analysis of data collected in the population-based cross-sectional study Puerto Rico Reproductive Health Survey was performed. Bivariate and multivariate logistic regression analyses were used to examine the crude and covariate adjusted association between type of childbirth and initiation of breastfeeding. Overall, 36% of all births were performed by cesarean section, while initiation of breastfeeding was achieved by 61.5% of the women. Cesarean section was negatively related to breastfeeding initiation in multivariable logistic regression models (odds ratio = .64; 95% CI = 0.51-0.81) after controlling for confounding variables. Intervention programs that aim to promote breastfeeding and...
Cancer is a leading cause of morbidity and death in Puerto Rico. To set a baseline for identifyin... more Cancer is a leading cause of morbidity and death in Puerto Rico. To set a baseline for identifying new trends and patterns of cancer incidence, Puerto Rico Central Cancer Registry staff and CDC analyzed data from Puerto Rico included in U.S. Cancer Statistics (USCS) for 2007-2011, the most recent data available. This is the first report of invasive cancer incidence rates for 2007-2011 among Puerto Rican residents by sex, age, cancer site, and municipality. Cancer incidence rates in Puerto Rico were compared with those in the U.S. population for 2011. A total of 68,312 invasive cancers were diagnosed and reported in Puerto Rico during 2007-2011. The average annual incidence rate was 330 cases per 100,000 persons. The cancer sites with the highest cancer incidence rates included prostate (152), female breast (84), and colon and rectum (43). Cancer incidence rates varied by municipality, particularly for prostate, lung and bronchus, and colon and rectum cancers. In 2011, cancer inciden...
The incidence of anal cancer is increasing, particularly among HIV and men who have sex with men ... more The incidence of anal cancer is increasing, particularly among HIV and men who have sex with men (MSM) groups. The vast majority of cases are associated with human papillomavirus (HPV), the most common sexually transmitted infection. Epidemiological studies have also documented low survival, which might be linked to lack of appropriate screening, access, and utilization of pertinent health care services. Our objective was to assess the relative survival (1 and 3 years) of anal cancer in Puerto Rico for men and women during the period from 2000-2007. All histological types of cancer of anus, anal canal, and anorectum (ICD-O-3 codes C210-C218), except for sarcomas, were included. Relative survival was estimated with the use of life tables from the population of Puerto Rico. In addition, the excess survival was compared by age at diagnosis, histology, and stage (defined as local, regional, or distant), using the Poisson regression model. The overall 3-year relative survival in Puerto Rico was the same (53 %) for men and women. Our findings establish baseline survival data for anal cancer in Hispanics from Puerto Rico. Since now, the national guidelines for anal cancer screening and treatment are on their way to be determined; baseline information about survival will allow monitoring the efficacy that standardized screening programs may eventually have in increasing anal cancer survival in this population.
Puerto Rico has one of the highest incidence rates of HIV in the U.S. Concurrent with increases i... more Puerto Rico has one of the highest incidence rates of HIV in the U.S. Concurrent with increases in sexually transmitted infections (STI), an increasing share of the new infections in PR are associated with sexual transmission. Much of the available research on sexual risk in PR derives from STI/HIV surveillance data. There is limited social and epidemiological research on sexual risk in PR, particularly in hidden and often hard-to-reach populations at high risk. Despite the absence of substantial resources that most epidemiological studies require, a research collaboration was initiated in 2007 between researchers in the School of Public Health at the University of Puerto Rico and the Centro Latinoamericano de Enfermedades de Transmisión Sexual (CLETS), one of the largest publicly funded centers for STI/HIV screening and treatment in the San Juan metropolitan area. Structured as a case study in the development of community-based research collaborations, this paper describes the earl...
Puerto Rico has one of the highest incidence rates of HIV in the U.S. Concurrent with increases i... more Puerto Rico has one of the highest incidence rates of HIV in the U.S. Concurrent with increases in sexually transmitted infections (STI), an increasing share of the new infections in PR are associated with sexual transmission. Much of the available research on sexual risk in PR derives from STI/HIV surveillance data. There is limited social and epidemiological research on sexual risk in PR, particularly in hidden and often hard-to-reach populations at high risk. Despite the absence of substantial resources that most epidemiological studies require, a research collaboration was initiated in 2007 between researchers in the School of Public Health at the University of Puerto Rico and the Centro Latinoamericano de Enfermedades de Transmisión Sexual (CLETS), one of the largest publicly funded centers for STI/HIV screening and treatment in the San Juan metropolitan area. Structured as a case study in the development of community-based research collaborations, this paper describes the earl...
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Papers by Naydi Perez Rios