Su Chang-Cheng, Chen Brian-Shiian, Chen Hsin-Hung, Sung Wen-Wei, Wang Chi-Chih, Tsai Ming-Chang
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
Healthcare (Basel). 2023 Jan 4;11(2):159. doi: 10.3390/healthcare11020159.
Primary liver cancer is one of the leading causes of death globally. Liver cancer has a unique geographical distribution, as its etiologies include chronic viral infections and aging. We hypothesize that the human development index (HDI), current health expenditure (CHE) per capita, and CHE-to-gross domestic product ratio (CHE/GDP) influence the incidence, mortality, and mortality-to-incidence ratios (MIRs) of liver cancer worldwide. Data were obtained from the Global Cancer Observatory (GLOBOCAN) database and the World Health Organization. MIRs and the changes in MIR over time (δMIR) were used to evaluate the correlation of expenditures on healthcare and the HDI disparities via Spearman's rank correlation coefficient. The crude incidence and mortality were significantly associated with HDI, CHE per capita, and CHE/GDP. Specifically, there were significant associations between δMIR and HDI, as well as between δMIR and CHE per capita. However, there were no significant associations between δMIR and CHE/GDP. Evidently, a favorable liver cancer δMIR was not associated with CHE/GDP, although it had a significant association with HDI and CHE per capita. These results are worthy of the attention of public health systems in correlation to improved outcomes in liver cancer.
原发性肝癌是全球主要死因之一。肝癌具有独特的地理分布，因为其病因包括慢性病毒感染和老龄化。我们假设人类发展指数（HDI）、人均当前卫生支出（CHE）以及卫生支出与国内生产总值的比率（CHE/GDP）会影响全球肝癌的发病率、死亡率以及死亡率与发病率之比（MIR）。数据来自全球癌症观测站（GLOBOCAN）数据库和世界卫生组织。通过斯皮尔曼等级相关系数，使用MIR以及MIR随时间的变化（δMIR）来评估医疗保健支出与HDI差异之间的相关性。粗发病率和死亡率与HDI、人均CHE以及CHE/GDP显著相关。具体而言，δMIR与HDI之间以及δMIR与人均CHE之间存在显著关联。然而，δMIR与CHE/GDP之间没有显著关联。显然，尽管肝癌的δMIR与HDI和人均CHE存在显著关联，但它与CHE/GDP无关。这些结果值得公共卫生系统关注，以改善肝癌治疗效果。
