Developing Concerns: Colorectal Cancer Trends and Human Development Index in South-East Asia

Document Type : Research/Original Article


1 Laboratory, Sunway Medical Centre, 47500, Selangor Darul Ehsan, Malaysia

2 Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, 47500, Selangor Darul Ehsan, Malaysia

3 Research Centre for Applied Physics and Radiation Technologies, School of Engineering and Technology, Sunway University, 47500, Selangor Darul Ehsan, Malaysia

4 Department of Biotechnology, Institute of Biological Sciences, Faculty of Science, University Malaya, 50603, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia

5 Department of Surgery, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, 43400 Selangor Darul Ehsan, Malaysia

6 Department of Gastroenterology, Sunway Medical Centre, 47500, Selangor Darul Ehsan, Malaysia

7 Jeffrey Sachs Centre On Sustainable Development, Sunway University, 47500, Selangor Darul Ehsan, Malaysia

8 Department of Actuarial Science and Risk, School of Mathematical Sciences, Sunway University, 47500, Selangor Darul Ehsan, Malaysia


Background: From 2008 to 2020, colorectal cancer (CRC) incidence and mortality increased by approximately 50% and 47%, respectively, in South-East Asia (SEA). The human development index (HDI) influences various lifestyle choices (including physical activity), which may contribute to the prevalence of CRC in this region, distinct from factors related to medical or hereditary history. This study aims to evaluate and demonstrate the impacts and association of HDI with age-standardized rates (ASR) of CRC incidence and mortality in SEA.
Methods: Utilizing data from the Global Cancer Observatory (GLOBOCAN) 2020, this study analyzed ASR for CRC incidence and mortality in each SEA country. Concurrently, the HDI for 2021 in these nations was gathered from the Human Development Reports. Using Spearman correlation analysis, we investigated the link between CRC ASR (incidence and mortality) and HDI indicators, including life expectancy at birth, mean years of schooling, and Gross National Income per Capita (2017 Purchasing power parity [PPP$]). The statistical significance threshold was set at P<0.05.
Results: The statistical analysis revealed noteworthy positive correlations between HDI and its components (life expectancy at birth, mean years of schooling, and Gross National Income per Capita) with the ASR for incidence. Specifically, Spearman’s rho values were 0.834, 0.755, 0.827, and 0.882, respectively. Similarly, significant correlations were observed between HDI and its constituents with ASR for mortality, with corresponding values of 0.720, 0.755, 0.718, and 0.782 at a 5% significance level.
Conclusion: Countries with a high HDI exhibit a dual impact influence by fostering economic growth while potentially posing challenges to public health. Despite very high HDI nations demonstrating successful CRC screening programs that lower both incidence and mortality rates, various SEA countries face impediments in implementing such screenings. 


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