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全球头颈部癌症负担:经济后果、健康状况以及手术的作用。

Global Burden of Head and Neck Cancer: Economic Consequences, Health, and the Role of Surgery.

机构信息

Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.

Tufts University School of Medicine, Boston, Massachusetts, USA.

出版信息

Otolaryngol Head Neck Surg. 2020 Mar;162(3):296-303. doi: 10.1177/0194599819897265. Epub 2020 Jan 7.

DOI:10.1177/0194599819897265
PMID:31906785
Abstract

OBJECTIVE

We aimed to describe the mortality burden and macroeconomic effects of head and neck cancer as well as delineate the role of surgical workforce in improving head and neck cancer outcomes.

STUDY DESIGN

Statistical and economic analysis.

SETTING

Research group.

SUBJECTS AND METHODS

We conducted a statistical analysis on data from the World Development Indicators and the 2016 Global Burden of Disease study to describe the relationship between surgical workforce and global head and neck cancer mortality-to-incidence ratios. A value of lost output model was used to project the global macroeconomic effects of head and neck cancer.

RESULTS

Significant differences in mortality-to-incidence ratios existed between Global Burden of Disease study superregions. An increase of surgical, anesthetic, and obstetric provider density by 10% significantly correlated with a reduction of 0.76% in mortality-to-incidence ratio ( < .0001; adjusted = 0.84). There will be a projected global cumulative loss of $535 billion US dollars (USD) in economic output due to head and neck cancer between 2018 and 2030. Southeast Asia, East Asia, and Oceania will suffer the greatest gross domestic product (GDP) losses at $180 billion USD, and South Asia will lose $133 billion USD.

CONCLUSION

The mortality burden of head and neck cancer is increasing and disproportionately affects those in low- and middle-income countries and regions with limited surgical workforces. This imbalance results in large and growing economic losses in countries that already face significant resource constraints. Urgent investment in the surgical workforce is necessary to ensure access to timely surgical services and reverse these negative trends.

摘要

目的

本研究旨在描述头颈部癌症的死亡负担和宏观经济影响,并阐明外科劳动力在改善头颈部癌症结局方面的作用。

研究设计

统计和经济分析。

研究地点

研究组。

研究对象与方法

我们对来自世界发展指标和 2016 年全球疾病负担研究的数据进行了统计分析,以描述外科劳动力与全球头颈部癌症死亡率与发病率比值之间的关系。采用产出损失模型来预测头颈部癌症的全球宏观经济影响。

结果

全球疾病负担研究超地区之间的死亡率与发病率比值存在显著差异。外科医生、麻醉师和产科医生的密度每增加 10%,与死亡率与发病率比值降低 0.76%显著相关(<0.0001;调整后=0.84)。由于头颈部癌症,2018 年至 2030 年期间,预计全球将累计损失 5350 亿美元的经济产出。东南亚、东亚和大洋洲将遭受最大的国内生产总值(GDP)损失,达 1800 亿美元,南亚将损失 1330 亿美元。

结论

头颈部癌症的死亡负担正在增加,且不成比例地影响到那些外科劳动力有限的中低收入国家和地区。这种不平衡导致了已经面临重大资源限制的国家出现了巨大且不断增长的经济损失。迫切需要对外科劳动力进行投资,以确保获得及时的外科服务,并扭转这些负面趋势。

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