Work

Examining the relationship between incidence and mortality for commonly diagnosed cancers in the USA: an observational study using population-based SEER database

Year: 2025

Type: article

Abstract: OBJECTIVE: Incidence and mortality are fundamental epidemiologic measures of cancer burden, yet few studies have examined individual cancers to determine how these measures correlate across place. We assessed the relationship between incidence and mortality for commonly diagnosed cancers in the USA. DESIGN: Population-based observational study of US counties. SETTING AND PARTICIPANTS: The Surveillance, Epidemiology and End Results (SEER) database was used to obtain incidence (2000-2016) and mortality (2002-2018) data for the 12 most commonly diagnosed non-haematologic cancers. OUTCOME MEASURES: County-level correlation between cancer incidence and mortality. Cancers were grouped into terciles based on the population-weighted correlation coefficient (r). We also examined the 10 year risk of death, both from the diagnosed cancer and other causes. RESULTS: County-level incidence and mortality were strongly correlated in some cancers, yet uncorrelated in others. Cancers in the high-correlation tercile (r range: 0.96 to 0.78) included lung, stomach, liver and pancreas. For patients with these cancers, the risk of death from the diagnosed cancer was >4-times the risk of death from other causes. The moderate-correlation tercile (r: 0.75 to 0.58) included cancers of the colon, bladder, kidney and uterus. There was little or no relationship between incidence and mortality for cancers in the low-correlation tercile (r: 0.33 to -0.10): melanoma, prostate, breast and thyroid. The risk of death from the diagnosed cancer for these patients was either lower or no different than their risk of death from other causes. CONCLUSIONS: For some cancers in the USA, the fundamental epidemiologic measure of disease frequency-incidence-now has little relationship with cancer death (mortality). Low correlations are most likely explained by differences in diagnostic practice leading to variable amounts of cancer overdiagnosis between different US counties.

Source: BMJ Open

DOI: 10.1136/bmjopen-2024-084955

Authors: Adewole S Adamson, Vishal R Patel, H Gilbert Welch

Institutions: The University of Texas at Austin, Brigham and Women's Hospital

Language: English

Topic: Global Cancer Incidence and Screening

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,839