Magali Barbieri , Institut National d'Études Démographiques (INED)
Omer Gersten, University of California, Berkeley
This paper engages Omran’s classic “epidemiologic transition”, incorporating what we now know about cancers (1971). Key to the epidemiologic transition theory is the idea that when nations develop, they move from a regime of high and fluctuating mortality to a regime of low mortality. This process is accompanied by a transition from an epidemiologic profile dominated by infectious diseases to one that is dominated by what Omran called "degenerative diseases and man-made diseases". In our study, we demonstrate that the opposition between the two types of diseases might be artificial due to the infectious root of many cancers. We demonstrate that a “cancer transition” is under way in a number of highly-developed countries. The "cancer transition" mirrors the epidemiologic transition with its four different stages: in the first phase, cancers with infectious roots (e.g. stomach cancer) dominate and mortality from these cancers is high; then mortality from such cancers starts declining while mortality from non-infectious cancers increases (e.g. those resulting from smoking); next, the most lethal cancers of non-infectious origin also start declining (e.g. breast, colo-rectum, brunch and lung). We speculate that a fourth stage of the cancer transition could be foreseen, similar to the fourth stage of the health transition as proposed by Olshansky and Ault (1986), that is when the age pattern of mortality from cancer shifts to higher and higher ages. Thus, there is a “mini” epidemiologic transition that is still playing out within the broad cancer grouping, rendering the health transition theory still very relevant today.
Presented in Session 19. Causes of Death and Morbidity