Evidence map›Paper›PMID 25572676›Full record

ArticleCancer2015

The colorectal cancer mortality-to-incidence ratio as an indicator of global cancer screening and care.

Vasu Sunkara, James R Hébert

Abstract read
In one paragraph

Article in Cancer, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers.

0numbers the graph read from it
0cells of the map it votes in
79citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

79 citing papers in PubMed.

  1. Article
  2. Evaluating the efficacy ofFrontiers in oncology · 2026
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  7. Current Status of the National Cancer Screening Program in Korea: History, Achievements, and Future Directions.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2025
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19 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

Vasu SunkaraDepartment of Economics, Harvard University, Cambridge, Massachusetts; Saint Vincent Hospital, Erie, Pennsylvania.
James R Hébert

Funding

Training ProgramU54CA153461 · NCI · UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA · PI HEBERT, JAMES R · 2010 to 2015
$4.8M
NCI NIH HHS 1U54 CA153461-01NCI NIH HHS U54 CA153461
6 · The paper itself

Abstract

backgroundDisparities in cancer screening, incidence, treatment, and survival are worsening globally. The mortality-to-incidence ratio (MIR) has been used previously to evaluate such disparities.

methodsThe MIR for colorectal cancer is calculated for all Organisation for Economic Cooperation and Development (OECD) countries using the 2012 GLOBOCAN incidence and mortality statistics. Health system rankings were obtained from the World Health Organization. Two linear regression models were fit with the MIR as the dependent variable and health system ranking as the independent variable; one included all countries and one model had the "divergents" removed.

resultsThe regression model for all countries explained 24% of the total variance in the MIR. Nine countries were found to have regression-calculated MIRs that differed from the actual MIR by >20%. Countries with lower-than-expected MIRs were found to have strong national health systems characterized by formal colorectal cancer screening programs. Conversely, countries with higher-than-expected MIRs lack screening programs. When these divergent points were removed from the data set, the recalculated regression model explained 60% of the total variance in the MIR.

conclusionsThe MIR proved useful for identifying disparities in cancer screening and treatment internationally. It has potential as an indicator of the long-term success of cancer surveillance programs and may be extended to other cancer types for these purposes.

Indexed as

Early Detection of CancerGlobal HealthAdultAgedCanadaColorectal NeoplasmsDelivery of Health CareEuropeFemaleHealthcare DisparitiesHumansIncidenceMaleMiddle AgedMortalityUnited Statesclinical medicinecolorectal cancermass screeningpublic health

Identifiers

PMID25572676
PMCPMC4424055

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.