Browsing by Author "Puschel Illanes, Klaus"

Now showing 1 - 20 of 34
  • Thumbnail Image
    Item
    Academic excellence in Latin America : social accountability of medical schools
    (2020) Puschel Illanes, Klaus; Riquelme Pérez, Arnoldo; Sapag Muñoz de la Peña, Jaime; Moore Clive, Philippa María; Díaz Piga, Luis Antonio; Fuentes López, Eduardo; Jiménez de la Jara, Jorge; Burdick, W.; Norcini, J.; Campos, H.; Valdez, J. E.; Llosa, M. P.; Lamus-Lemus, F.; Yulitta, H.; Grez, M.
  • Thumbnail Image
    Item
    Acceso a colecistectomía en un programa de tamizaje ecográfico de colelitiasis en centros de medicina familiar
    (2016) Bay, C.; Ocares, M.; Toledo, F.; Nicolás, Barticevic; Mora, I.; Villouta, F.; Cruz Olivos, Francisco; Puschel Illanes, Klaus; Miquel P., Juan Francisco
  • Thumbnail Image
    Item
    Access disparities and underutilization of germline genetic testing in Chilean breast cancer patients
    (2023) Acevedo Claros, Francisco Nicolás; Walbaum García, Benjamín Vicente; Camus Appuhn, Mauricio Gonzalo; Manzor Véliz, Manuel; Muñiz Muñoz, María Sabrina; Medina Araya, Lidia; Petric Guajardo, Militza Paulina; Reyes, Paula; Domínguez, Francisco; Puschel Illanes, Klaus; Merino Lara, Tomás Rodrigo; Bravo, M. Loreto; Pinto, Mauricio P.; Ibáñez, Carolina; Hughes, Kevin; Sánchez Rojel, César Giovanni
    Purpose Latin American reports on genetic cancer risk assessments are scarce. In Chile, current breast cancer (BC) guidelines do not define strategies for germline genetic testing. Our study sought to quantify the disparities in access to genetic testing in Chilean BC patients, according to international standards and their clinical characteristics to explore improvement strategies.Methods Retrospective analysis of invasive BC databases including patients treated in a Public Hospital (PH) and in an Academic Private Center (AC) in Santiago, Chile between 2012 and 2021.Results Of 5438 BC patients, 3955 had enough data for National Comprehensive Cancer Network (NCCN) categorization. From these, 1911 (48.3%) fulfilled NCCN criteria for germline testing, of whom, 300 were tested for germline mutations and 268 with multigene panels. A total of 65 pathogenic variants were found in this subset. As expected, BRCA1/2 mutations were the most frequent (17.7%). Access to genetic testing was higher in AC versus PH (19.6% vs. 10.3%, p = 0.0001). Other variables associated with germline genetic testing were BC diagnosis after 2018, being 45 years old or younger at diagnosis, BC family history (FH), FH of ovarian cancer, non-metastatic disease, and triple-negative subtype.Conclusion In our cohort, 15% of BC patients who met NCCN criteria for germline testing were effectively tested. This percentage was even lower at the PH. Current recommendations encourage universal genetic testing for BC patients; however, our findings suggest that Chile is far from reaching such a goal and national guidelines in this regard are urgently needed. To our knowledge, this is the first study of its kind in Chile and Latin America.
  • Thumbnail Image
    Item
    Breast Cancer Screening in Latin America: The Challenge to Move from Opportunistic to Organized-Systematic Screening
    (2023) Puschel Illanes, Klaus; Paz, S.; Rioseco Castillo, Andrea; Fowler, M.; Vescovic, Z.; Fuentes, I.; Sánchez, C.; Acevedo Claros, Francisco Nicolas
    Background: Breast cancer is the leading cause of death from cancer among women in Latin America. Most Latin American countries started national mammogram screening programs a decade ago. The implementation level and effects of screening programs in Latin America have not been evaluated. Aim: To evaluate the association between screening programs implementation and breast cancer mortality in selected North American and European countries compared to a group of Latin American countries with national screening programs. Methods: The study applied an ecological design with secondary data from official national and international sources. Join point regression analysis was conducted to describe the trends in mortality rates in a group of five Latin American countries (Brazil, Chile, Colombia, Costa Rica and Mexico) with five Non-Latin American countries (Canada, Spain, Sweden, United Kingdom and the United States of America). The association between screening and mortality rates was explored using correlation and linear regression. National cancer plans were assessed to describe screening strategies among selected countries. Results: A significant reduction in standardized breast cancer mortality rates was observed in all Non-Latin American countries with an Average Annual Percent Change (AAPC) of -2.00 (p<.05, 95%CI [-3.33, -0.70]) for the period 2010-2020. In contrast, Latin American countries reported a significant increase in the AAPC of +1.38 (p<.05, 95%CI [0.86,1.76]) in breast cancer mortality rates for the period 2010-2020. For Latin American countries, with screening rates below 50%, there was no correlation between screening and mortality rates for the period 1985-2020 (r = -0.17, p = .78). For non-Latin American countries, with screening rates over 70%, the linear regression model explained significantly 55% of the variance in mortality rates (R2aj =.55, F (5,14) = 5.69, p = .005), with a negative and significant effect of mammogram screening on mortality rates (β = -0.14, p = .01). The National Plans analysis revealed an opportunistic screening model for Latin American countries and an organized-systematic model in Non-Latin American countries. Conclusion: There is an association between the level of implementation of screening programs and mortality rates from breast cancer. Latin American countries should transform their opportunistic strategy into an organized-systematic model.
  • Thumbnail Image
    Item
    Caregiver's depressive symptoms and asthma control in children from an underserved community
    (2017) Rioseco Castillo, Andrea; Serrano Honeyman, Carolina; Celedón, Juan C.; Padilla Pérez, Oslando; Puschel Illanes, Klaus; Castro Rodríguez, José Antonio
  • Thumbnail Image
    Item
    Clinical characteristics, risk factors, and outcomes in Chilean triple negative breast cancer patients: a real-world study
    (2023) Acevedo Claros, Francisco Nicolás; Walbaum, Benjamin; Medina, Lidia; Merino Lara, Tomás Rodrigo; Camus Appuhn, Mauricio Gonzalo; Puschel Illanes, Klaus; Ramírez Parada, Karol Lilia; Manzor, Manuel; Veglia, Paulina; Martinez, Raul; Guerra, Constanza; Navarro, Marisel; Bauerle, Catherine; Domínguez Covarrubias, Francisco José; Sánchez Rojel, César Giovanni
    Background Latin American (LA) studies on triple-negative breast cancer (TNBC) and their characteristics are scarce. This forces physicians to make clinical decisions based on data obtained from studies that include non-Hispanic patients. Our study sought to obtain local epidemiological data, including risk factors and clinical outcomes from a Chilean BC registry. Methods This was a retrospective population-cohort study that included patients treated at a community hospital (mid-low income) or an academic private center (high income), in the 2010-2021 period. Univariate and multivariate analyses were performed to identify prognostic factors associated with survival. Results 647 out of 5,806 BC patients (11.1%) were TNBC. These patients were younger (p = 0.0001) and displayed lower rates of screening-detected cases (p = 0.0001) compared to non-TNBC counterparts. Among TNBC patients, lower income (i. e., receiving treatment at a community hospital) was associated with poorer overall survival (HR: 1.53; p = 0.0001) and poorer BC specific survival (HR: 1.29; p = 0.004). Other risk factors showed no significant differences between TNBC and non-TNBC. As expected, 5-year OS was significantly shorter on TNBC versus non-TNBC patients (p = 0.00001). In our multivariate analyses TNBC subtype (HR: 2.30), locally advanced stage (HR: 7.04 for stage III), lower income (HR: 1.64), or non-screening detected BC (HR: 1.32) were associated with poorer OS. Conclusion To the best of our knowledge, this is the largest LA cohort of TNBC patients. Interestingly, the proportion of TNBC among Chileans was smaller compared to similar studies within LA. As expected, TNBC patients had poorer survival and higher risk for early recurrence versus non-TNBC. Other relevant findings include a higher proportion of premenopausal patients among TNBC. Also, mid/low-income patients that received medical attention at a community hospital displayed lower survival versus private health center counterparts.
  • Thumbnail Image
    Item
    Common variants in ABCG8 and TRAF3 genes confer risk for gallstone disease and gallbladder cancer in admixed Latinos with Mapuche Native American ancestry
    (2018) Bustos, Bernabé I.; Pérez Palma, Eduardo; Buch, Stephan; Azócar, Lorena; Riveras, Eleodoro; Ugarte, Giorgia D.; Toliat, Mohammad; Nürnberg, Peter; Lieb, Wolfgang; Franke, Andre; Hinz, Sebastian; Burmeister, Greta; von Schönfels, Witigo; Schafmayer, Clemens; Völzke, Henry; Völker, Uwe; Homuth, Georg; Lerch, Markus M.; Santos Martín, José Luis; Puschel Illanes, Klaus; Bambs S., Claudia; Gutiérrez Ilabaca, Rodrigo Antonio; Hampe, Jochen; de Ferrari, Giancarlo V.; Miquel, Juan Francisco
    Background Latin Americans and Chilean Amerindians have the highest prevalence of cholesterol gallstone disease (GSD) and gallbladder cancer (GBC) in the world. A handful of loci have been associated with GSD in populations of predominantly European ancestry, however they only explain a small portion of the population-attributable risk of the disease.Methods We performed a genome-wide association study (GWAS) for GSD in 1,095 admixed Latinos with Mapuche Native American Ancestry, followed by a replication analysis of 10 candidate single nucleotide polymorphisms (SNPs) with suggestive genome-wide significance (P<1×10−5) in 1,643 individuals. Disease status was assessed by cholecystectomy or abdominal ultrasonography. Logistic regression analyses were adjusted for age, sex, BMI, Type 2 Diabetes and Amerindian ancestry. Associated variants were further examined in two large GSD European populations and in a Chilean gallbladder cancer (GBC) cohort. We determined the expression levels of a novel GSD-candidate gene in normal and GSD-tissue samples.Results We consistently replicated the ABCG8 gene (rs11887534; P=3.24×10−8, OR=1.74) associated with GSD in admixed Latinos and identified a novel candidate signal within the TRAF3 gene on chromosome 14 (rs12882491; P=1.11×10−7, OR=1.40). ABCG8 and TRAF3 variants also conferred risk to GBC. Gene expression analyses indicated that TRAF3 levels were significantly decreased in the gallbladder (P=0.015) and the duodenal mucosa (P=0.001) of affected GSD individuals compared to healthy controls.Conclusions We confirmed ABCG8 and identified TRAF3 both associated with GSD and GBC in admixed Latinos. Decreased TRAF3 expression levels could enhance gallbladder inflammation as is observed in GSD and GSD-associated GBC.
  • Thumbnail Image
    Item
    Copy number variants in lipid metabolism genes are associated with gallstones disease in men
    (2020) Perez-Palma, E.; Bustos, B. I.; Lal, D.; Buch, S.; Azócar, L.; Toliat, M. R.; Lieb, W.; Franke, A.; Hinz, S.; Burmeister, G.; von Shonfels, W.; Schafmayer, C.; Ahnert, P.; Volzke, H.; Volker, U.; Homuth, G.; Lerch, M. M.; Puschel Illanes, Klaus; Gutiérrez Ilabaca, Rodrigo Antonio; Hampe, J.; Nurnberg, P.; Miquel P., Juan Francisco; De Ferrari, GV
  • Thumbnail Image
    Item
    Desarrollo de habilidades transversales en estudiantes de pregrado de terapia ocupacional, kinesiología y fonoaudiología a través del Aprendizaje Servicio: un scoping review
    (2024) Estrada Palavecino, Leonardo Andrés; Puschel Illanes, Klaus; Pontificia Universidad Católica de Chile. Facultad de Medicina
    La Educación Médica Basada en Evidencia orienta las elecciones metodológicas asegurando efectividad en los procesos formativos. Existe evidencia del desarrollo de habilidades transversales en estudiantes de pregrado de terapia ocupacional, kinesiología y fonoaudiología a través del Aprendizaje Servicio, pero no está debidamente sistematizada, por lo que no se conoce con claridad cuáles son las habilidades transversales mayormente desarrolladas a través de este enfoque metodológico. Se vuelve necesario explorar cuál es el nivel de desarrollo de habilidades transversales a través del Aprendizaje Servicio en estudiantes de pregrado de estas carreras, justificando su elección metodológica. Método: Se realiza un Scoping Review de la literatura relacionada en 4 bases de datos (PubMED, ERIC, Liliacs y Web of Science), aplicando la escala SANRA de evaluación de análisis narrativos y el protocolo CASP para el análisis temático. Resultados: de 248 artículos encontrados en 4 bases de datos, 23 artículos cumplieron con criterios de inclusión; más del 50% de los seleccionados presentó criterios de alta calidad. Se identificaron seis habilidades de alto desarrollo en la estrategia de Aprendizaje y Servicio: trabajo en equipo, identificación del rol profesional, habilidades interculturales, autoeficacia, pensamiento crítico y competencias globales. Conclusiones: La metodología de Aprendizaje Servicio, aplicada bajo ciertas condiciones, facilita el desarrollo de habilidades transversales en estudiantes de pregrado de terapia ocupacional, kinesiología y fonoaudiología, además de otras competencias necesarias para el desempeño profesional. Se proyecta la necesidad de desarrollar protocolos de implementación de la metodología para asegurar su efectividad.
  • Thumbnail Image
    Item
    Detección precoz del cáncer cervicouterino en Chile : tiempo para el cambio
    (2014) Leniz Martelli, Javiera; Van De Wyngard, V.; Lagos Lucero, Sonia Marcela; Barriga Cosmelli, María Isabel; Puschel Illanes, Klaus; Ferreccio Readi, Catterina
  • Thumbnail Image
    Item
    Development of mobile technologies for the prevention of cervical cancer in Santiago, Chile study protocol : a randomized controlled trial
    (2017) Martínez Gutiérrez, Javiera; Soto Subiabre, Mauricio Andrés; Capurro, Daniel; Puschel Illanes, Klaus; Momany, McKenzie C.; Ciampi, Francis; Thompson, Beti
    Abstract Background In Chile, more than 500 women die every year from cervical cancer, and a majority of Chilean women are not up-to-date with their Papanicolau (Pap) test. Mobile health has great potential in many health areas, particularly in health promotion and prevention. There are no randomized controlled trials in Latin America assessing its use in cervical cancer screening. The ‘Development of Mobile Technologies for the Prevention of Cervical Cancer in Santiago, Chile’ study aims to determine the efficacy of a text-message intervention on Pap test adherence among Chilean women in the metropolitan region of Santiago. Methods/design This study is a parallel randomized-controlled trial of 400 Chilean women aged 25–64 who are non-adherent with current recommendations for Pap test screening. Participants will be randomly assigned to (1) a control arm (usual care) or (2) an intervention arm, where text and voice messages containing information and encouragement to undergo screening will be sent to the women. The primary endpoint is completion of a Pap test within 6 months of baseline assessment, as determined by medical record review at community-based clinics. Medical record reviewers will be blinded to randomization arms. The secondary endpoint is an evaluation of the implementation and usability of the text message intervention as a strategy to improve screening adherence. Discussion This intervention using mobile technology intends to raise cervical cancer screening adherence and compliance among a Chilean population of low and middle-low socioeconomic status. If successful, this strategy may reduce the incidence of cervical cancer. Trial registration Clinicaltrials.gov NCT02376023 Registered 2/17/2015. First participant enrolled Feb 22nd 2016.Abstract Background In Chile, more than 500 women die every year from cervical cancer, and a majority of Chilean women are not up-to-date with their Papanicolau (Pap) test. Mobile health has great potential in many health areas, particularly in health promotion and prevention. There are no randomized controlled trials in Latin America assessing its use in cervical cancer screening. The ‘Development of Mobile Technologies for the Prevention of Cervical Cancer in Santiago, Chile’ study aims to determine the efficacy of a text-message intervention on Pap test adherence among Chilean women in the metropolitan region of Santiago. Methods/design This study is a parallel randomized-controlled trial of 400 Chilean women aged 25–64 who are non-adherent with current recommendations for Pap test screening. Participants will be randomly assigned to (1) a control arm (usual care) or (2) an intervention arm, where text and voice messages containing information and encouragement to undergo screening will be sent to the women. The primary endpoint is completion of a Pap test within 6 months of baseline assessment, as determined by medical record review at community-based clinics. Medical record reviewers will be blinded to randomization arms. The secondary endpoint is an evaluation of the implementation and usability of the text message intervention as a strategy to improve screening adherence. Discussion This intervention using mobile technology intends to raise cervical cancer screening adherence and compliance among a Chilean population of low and middle-low socioeconomic status. If successful, this strategy may reduce the incidence of cervical cancer. Trial registration Clinicaltrials.gov NCT02376023 Registered 2/17/2015. First participant enrolled Feb 22nd 2016.Abstract Background In Chile, more than 500 women die every year from cervical cancer, and a majority of Chilean women are not up-to-date with their Papanicolau (Pap) test. Mobile health has great potential in many health areas, particularly in health promotion and prevention. There are no randomized controlled trials in Latin America assessing its use in cervical cancer screening. The ‘Development of Mobile Technologies for the Prevention of Cervical Cancer in Santiago, Chile’ study aims to determine the efficacy of a text-message intervention on Pap test adherence among Chilean women in the metropolitan region of Santiago. Methods/design This study is a parallel randomized-controlled trial of 400 Chilean women aged 25–64 who are non-adherent with current recommendations for Pap test screening. Participants will be randomly assigned to (1) a control arm (usual care) or (2) an intervention arm, where text and voice messages containing information and encouragement to undergo screening will be sent to the women. The primary endpoint is completion of a Pap test within 6 months of baseline assessment, as determined by medical record review at community-based clinics. Medical record reviewers will be blinded to randomization arms. The secondary endpoint is an evaluation of the implementation and usability of the text message intervention as a strategy to improve screening adherence. Discussion This intervention using mobile technology intends to raise cervical cancer screening adherence and compliance among a Chilean population of low and middle-low socioeconomic status. If successful, this strategy may reduce the incidence of cervical cancer. Trial registration Clinicaltrials.gov NCT02376023 Registered 2/17/2015. First participant enrolled Feb 22nd 2016.
  • Thumbnail Image
    Item
    Early detection of cervical cancer in Chile: time for change
    (SOC MEDICA SANTIAGO, 2014) Leniz Martelli, Javiera; Van De Wyngard, Vanessa; Lagos, Marcela; Isabel Barriga, Maria; Puschel Illanes, Klaus; Ferreccio Readi, Catterina
    Mortality rates for cervical cancer (CC) in Chile are higher than those of developed countries and it has an unequal socioeconomic distribution. The recognition of human papilloma virus (HPV) as the causal agent of cervical cancer in the early 80's changed the prevention paradigms. Current goals are to prevent HPV infection by vaccination before the onset of sexual activity and to detect HPV infection in women older than 30 years. This article reviews CC prevention and early detection methods, discusses relevant evidence to support a change in Chile and presents an innovation proposal. A strategy of primary screening based on HPV detection followed by triage of HPV-positive women by colposcopy in primary care or by cytological or molecular reflex testing is proposed. Due to the existence in Chile of a well-organized nationwide CC prevention program, the replacement of a low-sensitivity screening test such as the Papanicolau test with a highly sensitive one such as HPV detection, could quickly improve the effectiveness of the program. The program also has a network of personnel qualified to conduct naked-eye inspections of the cervix, who could easily be trained to perform triage colposcopy. The incorporation of new prevention strategies could reduce the deaths of Chilean women and correct inequities.
  • Thumbnail Image
    Item
    Examining barriers for mammography screening compliance within a private hospital and an underserved primary care clinic in Santiago, Chile
    (2013) Wood, Mary F.; Vial Alliende, Maria Catalina; Martínez Gutiérrez, Javiera; Mason, Mary J.; Puschel Illanes, Klaus
  • No Thumbnail Available
    Item
    Factores de riesgo de alteraciones citológicas del cuello uterino en mujeres Chilenas: Un estudio de casos y controles
    (2010) Solís, M. T.; Aguayo González, Francisco Renan; Vargas, M.; Olcay, F.; Puschel Illanes, Klaus; Corvalán Rodríguez, Alejandro; Ferreccio Readi, Catterina
  • Thumbnail Image
    Item
    Genetic and functional identification of the likely causative variant for cholesterol gallstone disease at the ABCG5/8 lithogenic locus
    (2013) Von Kampen, Oliver; Buch, Stephan; Nothnagel, Michael; Azócar, Lorena; Molina, Héctor; Brosch, Mario; Erhart, Wiebke; Von Schöenfels, Witigo; Egberts, Jan; Seeger, Marcus; Miquel P., Juan Francisco; Puschel Illanes, Klaus
  • Thumbnail Image
    Item
    Hacia un nuevo modelo de atención primaria en salud. Evaluación del proyecto de salud familiar Ancora UC
    (2013) Puschel Illanes, Klaus; Tellez, Alvaro; Montero Labbé, Joaquín; Brunner, Astrid; Peñaloza Hidalgo, Blanca Elvira; Rojas Villar, María Paulina; Poblete A., Fernando; Pantoja Calderón, Tomás
  • Thumbnail Image
    Item
    High-risk HPV infection after five years in a population-based cohort of Chilean women
    (2011) Ferreccio Readi, Catterina; Van De Wyngard, Vanessa; Domínguez, M. A.; Puschel Illanes, Klaus; Corvalán R., Alejandro; Olcay, Fabiola; Franceschi, Silvia; Snijders, Peter J.; Ferreccio Readi, Catterina; Van De Wyngard, Vanessa; Domínguez, M. A.; Puschel Illanes, Klaus; Corvalán R., Alejandro; Olcay, Fabiola; Franceschi, Silvia; Snijders, Peter J.
    Abstract Background The need to review cervical cancer prevention strategies has been triggered by the availability of new prevention tools linked to human papillomavirus (HPV): vaccines and screening tests. To consider these innovations, information on HPV type distribution and natural history is necessary. This is a five-year follow-up study of gynecological high-risk (HR) HPV infection among a Chilean population-based cohort of women. Findings A population-based random sample of 969 women from Santiago, Chile aged 17 years or older was enrolled in 2001 and revisited in 2006. At both visits they answered a survey on demographics and sexual history and provided a cervical sample for HPV DNA detection (GP5+/6+ primer-mediated PCR and Reverse line blot genotyping). Follow-up was completed by 576 (59.4%) women; 45 (4.6%) refused participation; most losses to follow-up were women who were unreachable, no longer eligible or had missing samples. HR-HPV prevalence increased by 43%. Incidence was highest in women < 20 years of age (19.4%) and lowest in women > 70 (0%); it was three times higher among women HR-HPV positive versus HPV negative at baseline (25.5% and 8.3%; OR 3.8, 95% CI 1.8-8.0). Type-specific persistence was 35.3%; it increased with age, from 0% in women < 30 years of age to 100% in women > 70. An enrollment Pap result ASCUS or worse was the only risk factor for being HR-HPV positive at both visits. Conclusions HR-HPV prevalence increased in the study population. All HR-HPV infections in women < 30 years old cleared, supporting the current recommendation of HR-HPV screening for women > 30 years.
  • Thumbnail Image
    Item
    HPV vaginal self-sampling among women non-adherent to Papanicolaou screening in Chile
    (2013) Léniz Martelli, Javiera; Barriga Cosmelli, María Isabel; Lagos Lucero, Marcela; Ibáñez Cáceres, Carolina; Puschel Illanes, Klaus; Catterina Ferreccio
  • No Thumbnail Available
    Item
    Implementation of cancer prevention practices in primary care: results of a cohort study in Chile 2018–2022
    (2024) Puschel Illanes, Klaus; Rioseco A.; Soto M.; Paz S.; Martinez J.; Soto G.; Faundez M.; Arenas E.; Vescovi Z.; Fuentes I.; Thompson B.; Emery J.
    Objectives: The burden of cancer is increasing rapidly in Latin America. Primary care has an essential role in cancer prevention, but implementation levels of prevention practices are not well known. This study evaluated implementation levels and associated factors of cancer preventive practices in primary care over time. Study design: The study incorporated a retrospective multicentre cohort study. Methods: A population of 59,949 patients registered at three primary care clinics was followed from January 2018 to December 2022 in Santiago, Chile. We studied human papillomavirus (HPV) and hepatitis B virus (HBV) immunisation, brief counselling for smoking cessation and alcohol consumption, and cervical and breast cancer screening practices. Standardised electronic medical records were utilised as the source of information. Social, clinical, and organisational factors associated with prevention practices were studied. Results: The cohort attrition level was 17.1%. Most of the population was of a low socioeconomic status, and 70% visited a primary health centre yearly. Implementation rates of immunisation practices were 90.84% for HPV and 80.94% for HBV in 2022. In contrast, brief counselling for smoking and alcohol consumption was below 20% during the study period. Cervical cancer screening decreased by 25.58% between 2018 and 2022, whereas breast cancer screening reached only 41.71% of the target population. Opportunistic medical visits were strongly associated with brief counselling and breast cancer screening. Conclusion: Implementation practices for cancer prevention in a Chilean primary care cohort are high for immunisation and very low for brief counselling and screening practices. A comprehensive non-medical-based model is needed to improve cancer prevention in primary care.
  • Thumbnail Image
    Item
    "In our own words": defining medical professionalism from a latin american perspective
    (2017) Puschel Illanes, Klaus; Repetto Lisboa, Paula Beatriz; Bernales, Margarita; Barros Beck, Jorge Alejandro; Snell, Linda