Objectives	To be able to identify major resources for assessing the global cancer burden To describe and differentiate cancer incidence, mortality, and survival
Key Concepts	Define a cancer incidence rate as the number of persons diagnosed with a registrable malignancy in a given country or region (state, province, etc) in a given calendar year, typically expressed per 100,000 population per year (see also Cancer Registries) Define a cancer mortality rate as the number of persons certified as having died with cancer as the underlying cause of death (a specific cancer, or all cancers combined) in a given country/region, again per 100,000 population per year (see also Cancer Registries) Distinguish between crude and age-adjusted incidence and mortality rates and understand when each metric should be used Demonstrate an understanding of the role of high-quality national or state-wide population-based cancer registries for producing reliable national and global statistics on cancer incidence, survival and mortality Demonstrate an understanding that cancer survival is a probability (not a rate) in the range 0-1, usually expressed as a percentage in the range 0%-100% for convenience (see also Cancer Registries) Recognise that survival estimates are only meaningful if the period when the patients were diagnosed and the duration of survival is stated (eg, the estimated 5-year survival of patients diagnosed during 2015-2019 was 75%; see also Cancer Registries) Demonstrate an understanding of why the mortality-to-incidence ratio (M/I ratio) is not a case-fatality ratio, and why its complement (1-M/I) is not a valid proxy for survival Demonstrate an understanding of the importance of age-standardisation for comparing incidence, mortality, and survival estimates over time, or between countries or population sub-groups Define and understand the interpretation of cumulative risk estimates Define the annual percentage change in incidence and mortality rates, and understand its interpretation for cancer trends Define age effects as variations in biologic and social changes in individuals over time, including physiologic changes, external exposure and social experiences accumulated over the lifespan Define period effects as the result of exposures that affect all age groups equally at a particular point in calendar time. These could include local, regional or global changes in environment, economics or social behaviours that are age-independent, as well as changes in how cancer data are coded, defined and collected that change at a fixed point or period in time Define cohort effects as the result of a unique exposure or experience to a group of subjects (eg, a birth cohort) as they move through time (eg, early life exposure to radiation effects of the atomic bomb in Japan)
Skills	Demonstrate the ability to: Use GLOBOCAN publications for estimates of cancer incidence and mortality worldwide Use CONCORD publications for estimates of cancer survival worldwide Perform calculation of age-adjusted incidence and mortality rates Use crude incidence and mortality rates as estimates of disease burden for resource allocation and planning Use age-adjusted incidence and mortality rates to compare cancer burden between populations Use trends and inequalities in population-based survival estimates to evaluate the overall effectiveness of health systems Use the average annual percentage change to evaluate impact of population or policy changes on the cancer burden over time Evaluate age-specific cancer rates and trends with an understanding of age-period-cohort effects to identify the root causes of change in cancer burden over time