Wang Chi-Chih, Tsai Ming-Chang, Peng Cheng-Ming, Lee Hsiang-Lin, Chen Hsuan-Yi, Yang Tzu-Wei, Sung Wen-Wei, Lin Chun-Che
aDepartment of Internal Medicine, Division of Gastroenterology and Hepatology Departments of bSurgery cUrology dMedical Education, Chung Shan Medical University Hospital eDepartment and Institute of Biological Science and Technology, School of Medicine fInstitute of Medicine, Chung Shan Medical University, Taichung gDepartment and Institute of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
Eur J Gastroenterol Hepatol. 2017 Dec;29(12):1397-1401. doi: 10.1097/MEG.0000000000000969.
Health expenditure is a marker associated with an advanced healthcare system, which contributes toward the good prognosis of patients. Mortality-to-incidence ratios (MIRs) are one of the predictors that reflect the prognosis of cancer patients. There remains some uncertainty on the correlation of MIRs of liver cancer with the health expenditure of countries.
We therefore analyzed the correlation of MIRs from the GLOBOCAN 2012 database with the WHO rankings and the total expenditures on health/gross domestic product from WHO by linear regression analyses. A total of 29 countries were selected in this study according to the data quality and the incidence number.
The results showed high rates of incidence/mortality and MIRs in less developed regions (0.92 vs. 0.96 for more vs. less developed regions). Among the continents, Asia has the highest incidence/mortality in case number, crude rate, and age-standardized rate. In terms of the MIR, Northern America has the lowest MIR and Latin America and the Caribbean have the highest MIRs (0.82 and 1.04, respectively). Finally, favorable MIRs are associated significantly with good WHO ranking and high expenditures on gross domestic product (P=0.048 and 0.025, respectively).
The MIR variation for liver cancer is thus found to be associated with the health expenditure and WHO ranking.
卫生支出是与先进医疗体系相关的一个指标，有助于患者的良好预后。死亡率与发病率之比（MIR）是反映癌症患者预后的预测指标之一。肝癌的MIR与各国卫生支出之间的相关性仍存在一些不确定性。
因此，我们通过线性回归分析，分析了来自GLOBOCAN 2012数据库的MIR与世界卫生组织排名以及世界卫生组织公布的各国卫生总支出/国内生产总值之间的相关性。根据数据质量和发病率，本研究共选取了29个国家。
结果显示，欠发达地区的发病率/死亡率和MIR较高（较发达地区与欠发达地区分别为0.92对0.96）。在各大洲中，亚洲的发病数、粗率和年龄标准化率的发病率/死亡率最高。就MIR而言，北美洲的MIR最低，拉丁美洲和加勒比地区的MIR最高（分别为0.82和1.04）。最后，良好的MIR与世界卫生组织的良好排名以及较高的国内生产总值支出显著相关（P值分别为0.048和0.025）。
因此发现，肝癌的MIR变化与卫生支出和世界卫生组织排名有关。
