Estimating the world cancer burden: GLOBOCAN 2000

Describing the distribution of disease between different populations and over time has been a highly successful way of devising hypotheses about causation and for quantifying the potential for preventive activities.' Statistical data are also essential components of disease surveillance programs. These play a critical role in the development and implementation of health policy, through identification of health problems, decisions on priorities for preventive and curative programs and evaluation of outcomes of programs of prevention, early detection/screening and treatment in relation to resource inputs. Over the last 12 years, a series of estimates of the global burden of cancer have been published in the International Journal of Cancer.(2-6) The methods have evolved and been refined, but basically they rely upon the best available data on cancer incidence and/or mortality at country level to build up the global picture. The results are more or less accurate for different countries, depending on the extent and accuracy of locally available data. This "databased" approach is rather different from the modeling method used in other estimates.(7-10) Essentially, these use sets of regression models, which predict cause-specific mortality rates of different populations from the corresponding all-cause mortality." The constants of the regression equations derive from datasets with different overall mortality rates (often including historic data from western countries). Cancer deaths are then subdivided into the different cancer types, according to the best available information on relative frequencies. GLOBOCAN 2000 updates the previously published data-based global estimates of incidence, mortality and prevalence to the year 2000.(12)