Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum - Univeristy of Bologna, Bologna, Italy; Morgagni-Pierantoni Hospital, Ausl Romagna, Forlì, Italy.
Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
Pancreatology. 2023 Nov;23(7):829-835. doi: 10.1016/j.pan.2023.09.001. Epub 2023 Sep 6.
To highlight correlations existing between incidence and mortality of pancreatic cancer, and health care indicators in 36 European countries.
The Global Burden of Disease (GBD) and Eurostat databases were queried between 2004 and 2019. Incidence and mortality were age-standardized. From Eurostat, indicators regarding expenditure, hospital beds, medical technology, health personnel, physicians by medical specialty and unmet needs for medical examination were extracted. Correlations between GBD and Eurostat data were analysed through mediation analysis applying clustering for countries.
Incidence increased by +0.6% per year (p = 0.001) and mortality by +0.3% (p = 0.001), being increasing for most of the European countries considered. Incidence and mortality were strongly positively correlated (p = 0.001). Higher current health expenditure, expenditure in inpatient curative care, the number of available beds, the number of computed tomography scan, magnetic resonance units, practising medical doctors were all related to higher incidence (p < 0.05), whereas the unmet need for medical examinations was related to lower incidence. When the mediator' effect of incidence was handled, these indicators, together with expenditure on outpatient curative cares, the number of pet scanners and of radiation therapy equipment, were related to lower mortality (p < 0.05).
Health care environment correlates with reported incidence and mortality of pancreatic cancer. This highlights both that ameliorated socio-economic societies suffer from higher incidence but lower mortality, as well as the epidemiological bias originating from countries' diagnostic ability.
强调在 36 个欧洲国家中，胰腺癌的发病率和死亡率与卫生保健指标之间存在的相关性。
使用全球疾病负担（GBD）和欧盟统计局数据库，检索 2004 年至 2019 年的数据。对发病率和死亡率进行年龄标准化。从欧盟统计局提取有关支出、医院床位、医疗技术、卫生人员、按医学专业划分的医生和未满足的医学检查需求的指标。通过对国家进行聚类分析，对 GBD 和欧盟统计局数据之间的相关性进行中介分析。
发病率每年增长 0.6%（p=0.001），死亡率每年增长 0.3%（p=0.001），大多数被考虑的欧洲国家都呈上升趋势。发病率和死亡率呈强正相关（p=0.001）。较高的当前卫生支出、住院治疗支出、可用床位数量、计算机断层扫描数量、磁共振单位数量、执业医生数量均与较高的发病率相关（p<0.05），而未满足的医学检查需求与较低的发病率相关。当处理发病率的中介效应时，这些指标，加上门诊治疗支出、宠物扫描和放射治疗设备的数量，与较低的死亡率相关（p<0.05）。
卫生保健环境与胰腺癌的报告发病率和死亡率相关。这既表明了社会经济条件改善的社会发病率较高但死亡率较低，也反映了源自各国诊断能力的流行病学偏差。
