Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
PLoS One. 2022 Apr 21;17(4):e0263403. doi: 10.1371/journal.pone.0263403. eCollection 2022.
Colorectal cancer (CRC) is among the five most incident and lethal cancers in world and its burden varies between countries and sexes. We aimed to present a comprehensive measure called the quality of care index (QCI) to evaluate the inequity and healthcare quality of care regarding CRC by sex and location.
Data on the burden of CRC were extracted from the Global Burden of Disease study 2019. It was transformed to four ratios, including mortality-to-incidence, disability-adjusted life years (DALYs)-to-prevalence, prevalence-to-incidence, and years of life lost (YLLs)-to-years lived with disability (YLDs). Principal component analysis was implemented on the four ratios and the most influential component was considered as QCI with a score ranging from zero to 100, for which higher scores represented better quality of care. Gender Disparity Ratio (GDR) was calculated by dividing QCI for females by males.
The global incidence and death numbers of CRC were 2,166,168 (95% uncertainty interval: 1,996,298-2,342,842) and 1,085,797 (1,002,795-1,149,679) in 2019, respectively. Globally, QCI and GDR values were 77.6 and 1.0 respectively in 2019. There was a positive association between the level of quality of care and socio-demographic index (SDI) quintiles. Region of the Americas and African Region had the highest and lowest QCI values, respectively (84.4 vs. 23.6). The QCI values started decreasing beyond the age of 75 in 2019 worldwide.
There is heterogeneity in QCI between SDI quintiles. More attention should be paid to people aged more than 75 years old because of the lower quality of care in this group.
结直肠癌（CRC）是全球发病率和致死率最高的五种癌症之一，其负担在国家和性别之间存在差异。我们旨在提出一种综合衡量标准，即护理质量指数（QCI），以评估 CRC 按性别和地区的不公平性和医疗保健质量。
CRC 负担数据来自 2019 年全球疾病负担研究。它被转化为四个比值，包括死亡率与发病率、残疾调整生命年（DALYs）与患病率、患病率与发病率以及生命损失年（YLLs）与残疾生存年（YLDs）。对这四个比值进行主成分分析，最具影响力的比值被认为是 QCI，其得分范围为 0 至 100，得分越高表示护理质量越好。性别差异比（GDR）通过将女性的 QCI 除以男性的 QCI 计算得出。
2019 年全球 CRC 的发病率和死亡率分别为 2,166,168（95%不确定区间：1,996,298-2,342,842）和 1,085,797（1,002,795-1,149,679）。2019 年全球 QCI 和 GDR 值分别为 77.6 和 1.0。护理质量水平与社会人口指数（SDI）五分位数呈正相关。美洲地区和非洲地区的 QCI 值最高和最低（84.4 比 23.6）。2019 年全球 QCI 值在 75 岁以上开始下降。
SDI 五分位数之间的 QCI 值存在异质性。由于该组人群的护理质量较低，应更加关注 75 岁以上的人群。
