Predicting the Future Burden of Cancer on Society

Evaluating the burden of cancer on society is of great interest to health officials and planning authorities. It is of particular importance to be able to correctly estimate the burden of cancer in the coming years in order that appropriate provisions can be put in place. The vast majority of developed, and also developing, countries have a cancer registry set-up and have at least 20 years of complete data. In the leading developed countries, the cancer registry data is complete and reliable for the past 50 years. Using this data it is possible to estimate key quantities that can be used to assess the burden of cancer. Prevalence gives a good proxy for the burden of cancer on society; it gives an estimate of the number of people who are alive having had a previous cancer diagnosis. Prevalence can be estimated by combining models for incidence and patient survival. To accurately model the prevalence, it is important to develop the best methods for modelling the incidence and patient survival from population-based cancer registries. Therefore, as part of this thesis, novel methods have been developed for projecting cancer incidence into the future using an approach that treats the data continuously. Also, methods for projecting cancer patient survival have been assessed and improved as part of the work by effectively estimating the quantities in continuous time. These projected estimates have been combined to give future estimates of cancer prevalence. Making predictions is obviously fraught with danger and, therefore, it should be made clear that these projections are liable to be uncertain and based on strong assumptions. However, if the assumptions of these models are fully understood, they may well provide a useful tool for health and financial planning in terms of assessing the disease burden due to the differing forms of cancer.