Cancer Incidence For 27 Sites In 2012 According To The Human Development Index

Miranda FIDLER, International Agency for Research on Cancer, France
SOERJOMATARAM I. 1 , FIDLER M. 1 , BRAY F. 1

1 Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, 69372 CEDEX 08, France

Background
Social and economic factors are strongly associated with cancer incidence; however, these factors influence cancer patterns through different pathways (negative or positive relationships).  We aimed to assess cancer incidence for 27 sites according to varying levels of human development.
 
Methods
Age-standardized incidence rates (ASRs) using GLOBOCAN 2012 were calculated for 27 cancer sites by four levels (low, medium, high, very high) of the Human Development Index (HDI) 2012.  The HDI is a composite index of life expectancy, educational attainment, and gross national income.
 
Findings
As regions developed, decreases in the ASRs of infection-related (Kaposi sarcoma, stomach, liver, cervical) cancers were offset by increases in the ASRs of cancers related to industrialization.  Infection-related cancers accounted for 35% of the total ASR for the cancers assessed in low HDI regions, whereas the corresponding percentage was 6% in very high HDI regions.  Conversely, the proportion of the ASR attributable to breast, prostate, colorectum, and lung cancers rose from 40% in low HDI regions to 61% in very high HDI regions.  When specific cancers were assessed, a stepwise negative relationship was observed for cervical cancers, where the ASR declined from 25 to 8 per 100,000 in low and very high HDI regions, respectively.  Stepwise positive associations were found for lip/oral cavity, gallbladder, pancreas, melanoma, corpus uteri, ovary, kidney, testis, thyroid, brain/nervous system, leukemia, non-Hodgkin lymphoma, multiple myeloma, colorectum, lung, breast, and prostate cancers; most notable increases were for cancers of the lung (10-fold), prostate (6-fold), and colorectum (5-fold).
 
Interpretation
Our results suggest that societal and economical transitions are associated with a decline in infection-related cancers and an increase in cancers associated with industrialization; future cancer burdens for these cancers in countries transitioning from low and medium human development to higher levels can be decreased through effective primary prevention strategies and early detection.