Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 May 15;121(10):1563-9.
doi: 10.1002/cncr.29228. Epub 2015 Jan 8.

The colorectal cancer mortality-to-incidence ratio as an indicator of global cancer screening and care

Vasu Sunkara  1 , James R Hébert
Affiliations

The colorectal cancer mortality-to-incidence ratio as an indicator of global cancer screening and care

Vasu Sunkara et al. Cancer. .

Abstract

Background: Disparities in cancer screening, incidence, treatment, and survival are worsening globally. The mortality-to-incidence ratio (MIR) has been used previously to evaluate such disparities.

Methods: The MIR for colorectal cancer is calculated for all Organisation for Economic Cooperation and Development (OECD) countries using the 2012 GLOBOCAN incidence and mortality statistics. Health system rankings were obtained from the World Health Organization. Two linear regression models were fit with the MIR as the dependent variable and health system ranking as the independent variable; one included all countries and one model had the "divergents" removed.

Results: The regression model for all countries explained 24% of the total variance in the MIR. Nine countries were found to have regression-calculated MIRs that differed from the actual MIR by >20%. Countries with lower-than-expected MIRs were found to have strong national health systems characterized by formal colorectal cancer screening programs. Conversely, countries with higher-than-expected MIRs lack screening programs. When these divergent points were removed from the data set, the recalculated regression model explained 60% of the total variance in the MIR.

Conclusions: The MIR proved useful for identifying disparities in cancer screening and treatment internationally. It has potential as an indicator of the long-term success of cancer surveillance programs and may be extended to other cancer types for these purposes.

Keywords: clinical medicine; colorectal cancer; mass screening; public health.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES

Dr. Hebert is the owner of Connecting Health Innovations LLC, which exists to commercialize his inventions (developed as an employee of the University of South Carolina). Currently, Connecting Health Innovations LLC has a grant from the National Institute of Diabetes and Digestive and Kidney Diseases for work related to commercializing the dietary inflammatory index for use in clinical practice. That work has absolutely nothing to do with the current study.

Figures

Figure 1
Figure 1
Full data plot of the mortality-to-incidence ratio (MIR) versus health system ranking is shown. U.K. indicates United Kingdom.
Figure 2
Figure 2
Edited data plot of the mortality-to-incidence ratio (MIR) versus health system ranking is shown. U.K. indicates United Kingdom.
See this image and copyright information in PMC

Comment in

References

    1. International Agency for Research on Cancer. Latest World Cancer Statistics. Geneva, Switzerland: World Health Organization; 2013.
    1. World Bank. World Development Indicators 2012. Washington, DC: World Bank; 2012.
    1. Tapay N, Colombo F. OECD Health Working Papers No 15. Paris, France: OECD Publishing; 2004. Private Health Insurance in OECD Countries: The Benefits and Costs for Individuals and Health Systems; pp. 265–319.
    1. Devaux M. Income-related inequalities and inequities in health care services utilisation in 18 selected OECD countries. Eur J Health Econ published online ahead of print December 14, 2013. - PubMed
    1. Machii R, Saito H. Time trends in cervical cancer screening rates in the OECD countries. Jpn J Clin Oncol. 2011;41:731–732. - PubMed

Publication types

LinkOut - more resources