Impact of universal health care on trends of incidence and mortality of cancers with screening recommendations in North America. A GLOBOCAN 2020 study.
Bibliographic record
Abstract
e18513 Background: Cancers with screening recommendations in general population include breast, colorectal, cervical and prostate cancers. Our study is aimed at comparing the current and future trends in incidence and mortality amongst two biggest countries in North America (United States of America and Canada) with and without universal health care. Methods: Incidence and mortality data, their trends were obtained from the GLOBOCAN 2020 database. Crude rate and age standardized rate (ASR) data on incidence and mortality was obtained to minimize population-based distribution errors. Age groups were divided as 20-40, 40-49, 50-65 and above 65. Current incidence, mortality and future trends were obtained for both USA and Canada and compared. Results: Breast cancer incidence is higher in USA in all age groups. Mortality in the age groups of 20-39 and 50-64 is comparable in Canada and USA with ASR of 9.6 (Canada), 9.5 (USA) 197.2 (Canada), 195 (USA) respectively. Future trends predict higher increase in incidence and mortality in Canada in age groups of 40-49 (I: Canada +22.5% USA +19.2%. M: Canada +22.8% USA +19.3%) above 65 (I: Canada +52.3% USA +40.8%. M: Canada +70.9%. USA +57.3%). In age group above 65 the mortality is significantly higher in USA compared to Canada (p=0.001). The incidence of colorectal cancer is higher in USA compared to Canada. The ASR mortality of above 65 age group is significantly higher in Canada (p=0.0009) (M: Canada: 835.6 USA: 713.9). Mortality trends for the 2040 year are higher in the age groups of 50-64 and above 65 in Canada (50-64 M: Canada: +25.9% USA: +21.2%) (above 65: M: Canada +70.9% USA: +57.3%). Prostate cancer has higher incidence in 50-64 age group. The mortality is higher in 40-49 age group. The predicted incidence for 2040 is also higher in Canada in above 65 age group (Canada +48.3%, USA: 39.9%). Similarly, mortality is higher in Canada for the above 65 age group (Canada: +112.7%, USA: +90.2%). Both USA and Canada have higher mortality for prostate cancer in age group 40-49 than 50-64. Cervical cancer incidence and mortality ASR are higher in USA for age groups of 20-39 and 40-49. For ages 50-64, while the incidence is higher in the USA, mortality is higher in Canada. For ages above 65 the mortality is significantly higher in Canada (p=0.0022) compared to USA. The predicted percentage change in 2040, incidence and mortality of age group 40-49 is higher compared to 50-64. Conclusions: Though both health care systems have screening recommendations for breast, CRC, prostate and cervical cancers, mortality appears to be higher compared to the world population suggesting need for improvement in screening access/awareness. Younger adults (20-39) and middle age adults (40-49) appear to be more vulnerable population and need for improvement in identifying high risk population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.002 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".