Journal of cancer policy · 2026
Are national cancer indicators decision-grade for remote regions? A stress-test using Corsica (France).
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Melidis Christos, Tsiouprou Maria
Аннотация
BACKGROUND: Publicly available cancer indicators are increasingly used to guide regional health-care planning and investment. Their robustness for decision-making in remote or insular regions remains insufficiently examined.
METHODS: We analysed publicly available incidence, mortality, standardised incidence ratios, standardised mortality ratios, mortality-to-incidence ratios (MIR), premature mortality and temporal trends using Corsica as a stress test and comparing with other French regions using national datasets. Indicators were compared using confidence intervals, temporal aggregation and rank-stability analyses. No causal inference was attempted.
RESULTS: Across multiple indicators, Corsica's relative position varied substantially depending on indicator choice, time window and statistical representation. Several indicators showed wide confidence-interval overlap with most French regions and marked rank instability, despite large apparent position changes. MIR and trend-based indicators were particularly sensitive to temporal aggregation and data structure.
DISCUSSION: Our findings suggest that commonly used national cancer indicators are frequently insufficiently robust to support decision-grade regional planning in remote settings. Apparent "good" or "poor" performance in such contexts can reflect statistical instability rather than meaningful differences.
CONCLUSION: For remote regions, cancer indicators should be interpreted with particular caution. Routinely published cancer indicators are insufficiently robust to support decision-grade regional health-care planning in small or insular populations.
METHODS: We analysed publicly available incidence, mortality, standardised incidence ratios, standardised mortality ratios, mortality-to-incidence ratios (MIR), premature mortality and temporal trends using Corsica as a stress test and comparing with other French regions using national datasets. Indicators were compared using confidence intervals, temporal aggregation and rank-stability analyses. No causal inference was attempted.
RESULTS: Across multiple indicators, Corsica's relative position varied substantially depending on indicator choice, time window and statistical representation. Several indicators showed wide confidence-interval overlap with most French regions and marked rank instability, despite large apparent position changes. MIR and trend-based indicators were particularly sensitive to temporal aggregation and data structure.
DISCUSSION: Our findings suggest that commonly used national cancer indicators are frequently insufficiently robust to support decision-grade regional planning in remote settings. Apparent "good" or "poor" performance in such contexts can reflect statistical instability rather than meaningful differences.
CONCLUSION: For remote regions, cancer indicators should be interpreted with particular caution. Routinely published cancer indicators are insufficiently robust to support decision-grade regional health-care planning in small or insular populations.