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Both incidence rates and mortality rates vary substantially between countries. Why?

Differences between countries in incidence rates, could be:

Actual differences due to underlying differences in susceptibility to a cancer or to differences in prevalence of risk factors

Artefactual differences due to differences in:

  • Detection
  • Screening
  • Reporting

Difference between countries in mortality rates could be caused by:

  • Underlying variations in actual incidence rates
  • Differences in treatment (access to curative treatment may differ across countries)
  • Differences in reporting

Discussion question (see figures)

What are possible reasons for the differences between incidence and mortality rates all cancers combined in

  • women?
  • men?
http://meddev.uio.no/elaring/lcms13/ernaeringslaere/nutr-cancer-epidemiology/illustrations/incidence_2008both_all.jpg

http://meddev.uio.no/elaring/lcms13/ernaeringslaere/nutr-cancer-epidemiology/illustrations/mortality_2008both_all.jpg

Different patterns between incidence and mortality maps, could be:

Actual differences due to better treatment or access to treatment in some countries

Artefactual differences due to:

  • Over reported incidence
  • Under reported incidence
  • Mortality incorrectly reported?