Examining the relationship between incidence and mortality for commonly diagnosed cancers in the USA: an observational study using population-based SEER database
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.D...
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/2/e084955.full |
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| author | H Gilbert Welch Adewole S Adamson Vishal R Patel |
| author_facet | H Gilbert Welch Adewole S Adamson Vishal R Patel |
| author_sort | H Gilbert Welch |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-28a8a3597a9f4aadbbfb95766b2d2b26 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-28a8a3597a9f4aadbbfb95766b2d2b262025-02-08T08:30:09ZengBMJ Publishing GroupBMJ Open2044-60552025-02-0115210.1136/bmjopen-2024-084955Examining the relationship between incidence and mortality for commonly diagnosed cancers in the USA: an observational study using population-based SEER databaseH Gilbert Welch0Adewole S Adamson1Vishal R Patel22 Department of Surgery, Brigham and Women`s Hospital, Boston, Massachusetts, USA1 Department of Internal Medicine, The University of Texas at Austin Dell Medical School, Austin, Texas, USA2 Department of Surgery, Brigham and Women`s Hospital, Boston, Massachusetts, USAObjective 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.https://bmjopen.bmj.com/content/15/2/e084955.full |
| spellingShingle | H Gilbert Welch Adewole S Adamson Vishal R Patel Examining the relationship between incidence and mortality for commonly diagnosed cancers in the USA: an observational study using population-based SEER database BMJ Open |
| title | Examining the relationship between incidence and mortality for commonly diagnosed cancers in the USA: an observational study using population-based SEER database |
| title_full | Examining the relationship between incidence and mortality for commonly diagnosed cancers in the USA: an observational study using population-based SEER database |
| title_fullStr | Examining the relationship between incidence and mortality for commonly diagnosed cancers in the USA: an observational study using population-based SEER database |
| title_full_unstemmed | Examining the relationship between incidence and mortality for commonly diagnosed cancers in the USA: an observational study using population-based SEER database |
| title_short | Examining the relationship between incidence and mortality for commonly diagnosed cancers in the USA: an observational study using population-based SEER database |
| title_sort | examining the relationship between incidence and mortality for commonly diagnosed cancers in the usa an observational study using population based seer database |
| url | https://bmjopen.bmj.com/content/15/2/e084955.full |
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