Understanding Differences in Cancer Survival between Populations: A New Approach and Application to Breast Cancer Survival Differentials between Danish Regions

Bergeron-Boucher, Marie-Pier; Oeppen, Jim; Holm, Niels V.; Nielsen, Hanne Melgaard; Lindahl-Jacobsen, Rune; Wensink, Maarten Jan

doi:10.3390/ijerph16173093

Cited by 9 publications

(4 citation statements)

References 40 publications

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“…This study has several limitations. Our decomposition analyses employed aggregate population and mortality data, and estimation of confidence intervals for the decomposition analysis using individual level data was not possible [ 19 ]. Another limitation is that because this analysis used the classification of causes of death from Statistics Korea, it was not possible to re-classify ill-defined causes (R00-R99).…”

Section: Discussionmentioning

confidence: 99%

Stagnation of life expectancy in Korea in 2018: A cause-specific decomposition analysis

et al. 2020

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According to the most recent annual report released by Korea Statistics, the life expectancy at birth (for both sexes) in 2018 was 82.7 years, an increase of 0.0 years over 2017, reflecting the first stagnation in life expectancy since 1960. In this study, a time-series analysis was conducted of trends in life expectancy from 2003 to 2018, and causes of death were analyzed using the Kannisto-Thatcher method and the Arriaga decomposition method. The time trend analysis of yearly life expectancy changes indicated that, in Korea, there was a tendency for the yearly increase in life expectancy between 2003 and 2018 to decrease by 0.0211 years per calendar year. The contribution of cardiovascular diseases, the most important contributor to the life expectancy increase in Korea, gradually decreased over this period. The contribution of cardiovascular diseases to the life expectancy increase was 0.506 years in 2003–2006, but this contribution decreased to 0.218 years in 2015–2018. The positive contributions of ill-defined causes and external causes to life expectancy increase detected in previous periods were not evident in 2015–2018. Diseases of the respiratory system made the largest negative contribution both between 2015 and 2018 and between 2017–2018. The life expectancy stagnation in 2018 could be understood as the combined effect of (a) decreasing momentum in the increase of life expectancy and (b) a chance event in 2018 involving life expectancy. Currently, it is difficult to judge whether the stagnation of life expectancy in 2018 is temporary, and further analyses of life expectancy and contributing causes of death in the future are needed.

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Section: Discussionmentioning

confidence: 99%

Stagnation of life expectancy in Korea in 2018: A cause-specific decomposition analysis

et al. 2020

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“…Decomposition approaches like the one used in this paper are commonly used to explain the role of age structure on changing incidence rates [7]. They have also been applied to differences in cancer fatality rates across regions with varying age structures [8]. We are not aware of any application to CFRs of infectious diseases in general and the COVID-19 pandemic in particular.…”

Section: Plos Onementioning

confidence: 99%

Monitoring trends and differences in COVID-19 case-fatality rates using decomposition methods: Contributions of age structure and age-specific fatality

et al. 2020

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The population-level case-fatality rate (CFR) associated with COVID-19 varies substantially, both across countries at any given time and within countries over time. We analyze the contribution of two key determinants of the variation in the observed CFR: the age-structure of diagnosed infection cases and age-specific case-fatality rates. We use data on diagnosed COVID-19 cases and death counts attributable to COVID-19 by age for China, Germany, Italy, South Korea, Spain, the United States, and New York City. We calculate the CFR for each population at the latest data point and also for Italy, Germany, Spain, and New York City over time. We use demographic decomposition to break the difference between CFRs into unique contributions arising from the age-structure of confirmed cases and the age-specific case-fatality. In late June 2020, CFRs varied from 2.2% in South Korea to 14.0% in Italy. The age-structure of detected cases often explains more than two-thirds of crosscountry variation in the CFR. In Italy, the CFR increased from 4.2% to 14.0% between March 9 and June 30, 2020, and more than 90% of the change was due to increasing agespecific case-fatality rates. The importance of the age-structure of confirmed cases likely reflects several factors, including different testing regimes and differences in transmission trajectories; while increasing age-specific case-fatality rates in Italy could indicate other factors, such as the worsening health outcomes of those infected with COVID-19. Our findings lend support to recommendations for data to be disaggregated by age, and potentially other variables, to facilitate a better understanding of population-level differences in CFRs. They also show the need for well-designed seroprevalence studies to ascertain the extent to which differences in testing regimes drive differences in the age-structure of detected cases.

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“…Underprivileged populations in conflict regions are faced with multiple challenges that delay diagnosis, hinder care, and make screening almost impossible. Treatable diseases become incurable with late diagnoses causing advanced stages, lower-quality care, and incomplete treatments, all of which are detrimental to patient outcomes [29][30][31].…”

Section: Challenges Facing Cancer Care In Conflict-affected Regionsmentioning

confidence: 99%

Cancer Care During War and Conflict

Sayed

Abdul‐Sater

Mukherji

2022

Cancer in the Arab World

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The Arab World has sadly witnessed protracted conflict affecting several of its regions in recent years. Conflict-affected populations have been significantly impacted by chronic deficiencies in medical care including unprecedented numbers of refugees and migrants requiring ongoing support in neighbouring countries. Humanitarian response to crisis has historically focused on the supply of nutrition, water, and emergent trauma relief, followed by control and prevention of infections. Prevention and management of non-communicable diseases, specifically cancer, have been relatively neglected; however, with regional conflicts lasting for many years, cancer care has become an increasingly urgent issue to be addressed. The humanitarian community has stressed the need for situational assessment regarding disease prevalence and available resources, with identification of specific regional challenges. Lack of infrastructure, important diagnostic and treatment modalities, clinical experts and regulatory bodies are the main obstacles to cancer care at all stages from screening and prevention to therapeutics and palliation. The initial step to improving cancer care provision should be implementing needs-based priority assessment and policies within the context of governing bodies that control and monitor performance. Collaboration and coordination among national and international organizations and stakeholders are essential to improve data collection on which to base resource allocation and address growing disparities in cancer outcomes.

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Understanding Differences in Cancer Survival between Populations: A New Approach and Application to Breast Cancer Survival Differentials between Danish Regions

Cited by 9 publications

References 40 publications

Stagnation of life expectancy in Korea in 2018: A cause-specific decomposition analysis

Stagnation of life expectancy in Korea in 2018: A cause-specific decomposition analysis

Monitoring trends and differences in COVID-19 case-fatality rates using decomposition methods: Contributions of age structure and age-specific fatality

Cancer Care During War and Conflict

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