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An examination of colorectal cancer burden by socioeconomic status: evidence from GLOBOCAN 2018

. 2019 Sep 11;11(1):95-117. doi: 10.1007/s13167-019-00185-y. eCollection 2020 Mar. An examination of colorectal cancer burden by socioeconomic status: evidence from GLOBOCAN 2018

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An examination of colorectal cancer burden by socioeconomic status: evidence from GLOBOCAN 2018

Rajesh Sharma. EPMA J. 2019.

. 2019 Sep 11;11(1):95-117. doi: 10.1007/s13167-019-00185-y. eCollection 2020 Mar. Affiliation

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Abstract

Aim and background: Colon and rectum (colorectal) cancer cause substantial mortality and morbidity worldwide. The management and control of a complex disease such as cancer cannot rely on the old strategy of "one disease one medicine" and must make a transition into new-age practices involving predictive, preventive, and personalized medicine (PPPM) at its core. Adoption of PPPM approach to cancer management at the policy level requires quantification of cancer burden at the country level. For this purpose, we examine the burden of colorectal cancer in 185 countries in 2018. Based on results, we discuss the opportunities presented by PPPM and challenges to be encountered while adopting PPPM for the treatment and prevention of colorectal cancer.

Data and methods: Age- and sex-wise estimates of colorectal cancer were procured from the GLOBOCAN 2018. The country- and region-wise burden of colorectal cancer in 185 countries was examined using all-age and age-standardized incidence and mortality estimates. Human development index (HDI) was employed as the indicator of socioeconomic status of a country. Mortality-to-incidence ratio (MIR) was employed as the proxy of 5-year survival rate.

Results: Globally, colorectal cancer claimed an estimated 880,792 lives (males 484,224; females 396,568) with 1.85 million new cases (males 1.03 million; females 823,303) were estimated to be diagnosed in 2018. Globally, the age-standardized incidence rate (ASIR) was 19.7/100,000, whereas age-standardized mortality rate (ASMR) recorded to be 16.3/100,000 in 2018. Age-standardized rates were the highest in developed countries led by Hungary with ASIR of 51.2/100,000 followed by South Korea with ASIR of 44.5/100,000. ASMR followed the patterns of ASIR with the highest ASMR recorded by Hungary (21.5 per 100,000) and Slovakia (20.4 per 100,000). Globally, MIR stood at 0.48, and among the countries recording more than 1000 cases, Nepal registered the highest MIR of 0.83 and the lowest was recorded by South Korea (0.27). The age-standardized rates exhibited nonlinear association with HDI, whereas MIR was negatively associated with HDI.

Conclusion: Colorectal cancer causes a substantial burden worldwide and exhibit a positive association with the socioeconomic status. With the aid of improving screening modalities, preventable nature of the disease (due to dietary and lifestyle risk factors) and improving treatment procedures, the burden of CRC can largely be curtailed. The high burden of CRC in developing countries, therefore, calls for effective prevention strategies, cost-effective screening, and early-stage detection, cost-effective predictive, and personalized treatment regime.

Keywords: Colorectal Cancer; GLOBOCAN; Incidence; Mortality; Precision medicine; Predictive preventive personalized medicine.

© European Association for Predictive, Preventive and Personalised Medicine (EPMA) 2019.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

Fig. 1

Geographical distribution of colorectal cancer…

Fig. 1

Geographical distribution of colorectal cancer burden in both sexes in 2017. a ASIR.…

Fig. 1

Geographical distribution of colorectal cancer burden in both sexes in 2017. a ASIR. b ASMR. ASIR age-standardized incidence rate per 100,000 person-years, ASMR age-standardized mortality rate per 100,000 person-years. Data source: GLOBOCAN 2018 (IARC)

Fig. 2

Age-group and gender-wise burden of…

Fig. 2

Age-group and gender-wise burden of colon and rectum cancer in 2018. a Incidence.…

Fig. 2

Age-group and gender-wise burden of colon and rectum cancer in 2018. a Incidence. b Deaths. Data source: GLOBOCAN 2018 (IARC)

Fig. 3

Nonlinear relationship between human development…

Fig. 3

Nonlinear relationship between human development and age-standardized rates. a ASIR vs HDI. b…

Fig. 3

Nonlinear relationship between human development and age-standardized rates. a ASIR vs HDI. b ASMR vs HDI. c MIR vs HDI. ASMR age-standardized mortality rate per 100,000 person-years, both sexes, ASIR age-standardized incidence rate per 100,000 person-years, both sexes, MIR mortality-to-incidence ratio, HDI human development index. Data source: MIR was calculated directly as the ratio of all-age death numbers and no. of all-age incident cases, both of which were procured from GLOBOCAN 2018 (IARC) and HDI estimates were obtained from UNDP

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