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

Document Type : Research/Original Article

Authors

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

Abstract

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. 

Keywords


  1. Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, et al. Global Cancer Observatory: Cancer Today Lyon, France: International Agency for Research on Cancer; 2020 [Available from: https://gco.iarc.fr/today.
  2. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer Res. 2010;127(12):2893-917.
  3. United Nations Development Programme. Human Development Report: Global Human Development Indicators 2021 [Available from: http://hdr.undp.org/en/countries.
  4. United Nations Department of Economic and Social Affairs. World urbanization prospects: The 2018 revision 2018 [Available from: https://population.un.org/wup/Download/Files/WUP2018_Classification_of_countries.pdf.
  5. Bray F, Jemal A, Grey N, Ferlay J, Forman D. Global cancer transitions according to the Human Development Index (2008–2030): a population-based study. Lancet Oncol. 2012;13(8):790-801.
  6. Fidler MM, Soerjomataram I, Bray F. A global view on cancer incidence and national levels of the human development index. Int J Cancer. 2016;139(11):2436-46.
  7. Rezaeian S, Khazaei S, Khazaei S, Mansori K, Moghaddam AS, Ayubi E. Human Development Inequality index and cancer pattern: a global distributive study. Asian Pac J Cancer Prev 2016;17(sup3):201-4.
  8. Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66(4):683-91.
  9. Torre LA, Siegel RL, Ward EM, Jemal A. Global cancer incidence and mortality rates and trends—an update. Cancer Epidemiol Biomarkers Prev. 2016;25(1):16-27.
  10. Loke YL, Chew MT, Ngeow YF, Lim WWD, Peh SC. Colon carcinogenesis: The interplay between diet and gut microbiota. Front Cell Infect Microbiol. 2020;10:603086.
  11. Elistia E, Syahzuni BA. The correlation of the human development index (HDI) towards economic growth (GDP per capita) in 10 ASEAN member countries. J Humanit Soc Sci. 2018;2(2):40-6.
  12. Chen H, Liu Y, Li Z, Xue D. Urbanization, economic development and health: evidence from China’s labor-force dynamic survey. Int J Equity Health. 2017;16:1-8.
  13. Rafiemanesh H, Mohammadian-Hafshejani A, Ghoncheh M, Sepehri Z, Shamlou R, Salehiniya H, et al. Incidence and mortality of colorectal cancer and relationships with the human development index across the world. Asian Pac J Cancer Prev. 2016;17(5):2465-73.
  14. Kimman M, Norman R, Jan S, Kingston D, Woodward M. The burden of cancer in member countries of the Association of Southeast Asian Nations (ASEAN). Asian Pac J Cancer Prev. 2012;13(2):411-20.
  15. Razali NM, Wah YB. Power comparisons of Shapiro-Wilk, Kolmogorov-Smirnov, lilliefors, and Anderson-darling tests. JOSMA. 2011;2(1):21-33.
  16. De Winter JC, Gosling SD, Potter J. Comparing the Pearson and Spearman correlation coefficients across distributions and sample sizes: A tutorial using simulations and empirical data. Psychological methods. 2016;21(3):273.
  17. Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1· 9 million participants. Lancet Glob Health. 2018;6(10):e1077-e86.
  18. World Health Organization. Global recommendations on physical activity for health Geneva: WHO; 2010 [Available from: https://apps.who.int/iris/rest/bitstreams/52834/retrieve.
  19. Atkinson K, Lowe S, Moore S. Human development, occupational structure and physical inactivity among 47 low and middle-income countries. Prev Med Rep. 2016;3:40-5.
  20. Win AM, Yen LW, Tan KH, Lim RBT, Chia KS, Mueller-Riemenschneider F. Patterns of physical activity and sedentary behavior in a representative sample of a multi-ethnic South-East Asian population: a cross-sectional study. BMC Public Health. 2015;15(1):1-11.
  21. Pengpid S, Peltzer K. Overweight or obesity and related lifestyle and psychosocial factors among adolescents in Brunei Darussalam. Int J Adolesc Med Health. 2018;32(6):20180019.
  22. Khoo S, Poh BK, Suhaimi SA, Chong KH, Ramirez Varela A. Physical activity promotion in Malaysia: Challenges and opportunities. Front Public Health. 2020;8:536239.
  23. Napasirth P, Napasirth V. Current situation and future prospects for beef production in Lao People’s Democratic Republic—a review. Asian-Australas J Anim Sci. 2018;31(7):961.
  24. Farmery AK, Kajlich L, Voyer M, Bogard JR, Duarte A. Integrating fisheries, food, and nutrition–Insights from people and policies in Timor-Leste. Food Policy. 2020;91:101826.
  25. Food and Agriculture Organization of the United Nations. FAO in Myanmar: Myanmar at a glance Bangkok, Thailand2021 [Available from: http://www.fao.org/myanmar/fao-in-myanmar/myanmar/en/.
  26. Aziz A, Awang Pawi AA. Redefining Malay Food in the Post Malaysia’s New Economic Policy (NEP)/Abd. Razak Aziz and Awang Azaman Awang Pawi. JTHCA. 2016;8(2):1-9.
  27. Naidoo N, van Dam RM, Ng S, Tan CS, Chen S, Lim JY, et al. Determinants of eating at local and western fast-food venues in an urban Asian population: a mixed methods approach. Int J Behav Nutr Phys Act. 2017;14:1-12.
  28. Papier K, Jordan S, D’Este C, Banwell C, Yiengprugsawan V, Seubsman S-a, et al. Social demography of transitional dietary patterns in Thailand: prospective evidence from the Thai Cohort Study. Nutrients. 2017;9(11):1173.
  29. Colozza D, Avendano M. Urbanisation, dietary change and traditional food practices in Indonesia: A longitudinal analysis. Soc Sci Med. 2019;233:103-12.
  30. Umberger WJ, Rupa JA, Zeng D. Understanding food westernization and other contemporary drivers of adult, adolescent, and child nutrition quality in urban Vietnam. Public Health Nutr. 2020;23(14):2571-83.
  31. In S, Lambre C, Camel V, Onldelhkim M. Regional and seasonal variations of food consumption in Cambodia. Malays J Nutr. 2015;21(2).
  32. Mahrt K, Mather D, Herforth A, Headey DD. Household dietary patterns and the cost of a nutritious diet in Myanmar: Intl Food Policy Res Inst; 2019.
  33. Teo MC, Soo KC. Cancer trends and incidences in Singapore. Jpn J Clin Oncol. 2013;43(3):219-24.
  34. Chan PWW, Ngu JH, Poh Z, Soetikno R. Colorectal cancer screening. Singapore Med J. 2017;58(1):24.
  35. Tan WS, Tang CL, Koo WH. Opportunistic screening for colorectal neoplasia in Singapore using a faecal immunochemical occult blood test. Singapore Med J. 2013;54(4):220-3.
  36. Lim TZ, Lau J, Wong GJ, Tan K-K. Colorectal cancer in patients with single versus double positive fecal immunochemical test results: a retrospective cohort study from a public tertiary hospital. PloS one. 2021;16(6):e0250460.
  37. Singapore Cancer Society. Annual Reports Singapore Singapore Cancer Society; [Available from: https://www.singaporecancersociety.org.sg/about/publications/48-annual-reports.html.
  38. Hilmi I, Hartono JL, Goh K. Negative perception in those at highest risk--potential challenges in colorectal cancer screening in an urban Asian population. Asian Pac J Cancer Prev. 2010;11(3):815-22.
  39. Sudoyo AW, Lesmana CRA, Krisnuhoni E, Pakasi LS, Cahyadinata L, Lesmana LA. Detection rate of colorectal adenoma or cancer in unselected colonoscopy patients: Indonesian experience in a private hospital. Asian Pac J Cancer Prev. 2014;15(22):9801-4.
  40. Latt NN, Cho SM, Htun NMM, Saw YM, Myint MNHA, Aoki F, et al. Healthcare in Myanmar. Nagoya J Med Sci. 2016;78(2):123.
  41. Price JA, Soares AI, Asante AD, Martins JS, Williams K, Wiseman VL. “I go I die, I stay I die, better to stay and die in my house”: understanding the barriers to accessing health care in Timor-Leste. BMC Health Serv Res. 2016;16(1):1-15.
  42. Qian Y, Yan F, Wang W, Clancy S, Akkhavong K, Vonglokham M, et al. Challenges for strengthening the health workforce in the Lao People’s Democratic Republic: perspectives from key stakeholders. Hum Resour Health. 2016;14(1):72-.
  43. Cousins S. Health in Timor-Leste: 20 years of change. Lancet. 2019;394(10216):2217-8.
  44. Saw YM, Than TM, Thaung Y, Aung S, Wen-Shuan Shiao L, Win EM, et al. Myanmar’s human resources for health: current situation and its challenges. Heliyon. 2019;5(3):e01390.