Modelling and forecasting lung cancer incidence and mortality in Saudi Arabia

Alzahrani, SM

Abstract

The aim of this research is to forecast the rates of lung cancer incidence and mortality in
the Kingdom of Saudi Arabia using data on lung cancer diagnosis between 1994 and 2009.
Lung cancer data, including incidence and mortality, were obtained from Saudi Cancer
Registry at the Ministry of Health. The Central Department of Statistics & Information at
the Ministry of Planning also provided data on person characteristics, such as age, gender
and ethnicity. These data serve as a basis for modelling the effect of gender, ethnicity, and
age at diagnosis, and region on incidence and mortality. For comparison of incidence and
mortality rates between region and over time, standardised rates are used in this thesis,
based on a hypothetical standard population, in our case the world standard population.
We use several modelling approaches. The first part of the analysis uses two approaches.
The first approach concentrates on Box–Jenkins methodology, and the second approach
uses dynamic regression modelling including both finite and infinite lag models to forecast
lung cancer incident cases. The second part focuses on age-period-cohort modelling
including both incidence and mortality rates of lung cancer, and using two methodological
approaches, namely spline functions and Bayesian dynamic models, for the incidence and
mortality respectively. Lung cancer is rarely diagnosed in people under 30 years of age in
Saudi Arabia, but incidence rises sharply thereafter peaking in the 65-69 years age group.
Males have a 79% greater incidence rate of lung cancer than females across the entire
dataset when adjusting for the other effects. The average age standardised incidence rate in
2009 was 3.8 per 100,000 population whereas the average age standardised mortality rate
was 1.9 per 100,000 population in the same year. The highest number of cases of lung
cancer were reported in the Western region at 187 and in Riyadh at 144 cases and the
majority of cases were diagnosed in winter (December - March). The forecast incidence
rate of lung cancer is expected to decrease in men but to increase in women over the next
ten years. This is perhaps due to the increase in the proportion of female smokers. The
male age standardised rate of lung cancer incidence is forecast to fall from 4.6 in 2010 to
2.4 per 100,000 by 2020, whereas the female age standardised rate is forecast to increase
from 2.0 in 2010 to 2.2 per 100,000 by 2020. On the other hand, the overall mortality rate
of lung cancer (with 95% credible interval shown) is forecast to increase to 2020 from 1.8
(1.61, 1.94) in 2010 to 3.04 (0.13, 5.94) per 100,000 population. Age has a strong
association with lung cancer mortality, suggesting age-related causes such as accumulative
exposures to smoking over time may be the main reason for increasing lung cancer
mortality in Saudi Arabia. This is the first study to forecast lung cancer incidence and
mortality in Saudi Arabia. It will help the Saudi Arabian Ministry of Health to understand
the rate of future lung cancer incidence and mortality and the overall effects of the
population classes, and to plan healthcare provision accordingly. The data are limited
because the Saudi Cancer Registry has only been in existence since 1992. Therefore, we
can expect the precision of forecasts to improve as further data are collected.

Citation

Alzahrani, S. Modelling and forecasting lung cancer incidence and mortality in Saudi Arabia. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: Mar 20, 2017
• Publicly Available Date: Mar 20, 2017
• Additional Information: Funders : Al-Baha University