MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada.
Department of Oncology, Queen's University, Kingston, Ontario, Canada.
Cancer Med. 2023 Nov;12(22):20745-20758. doi: 10.1002/cam4.6642. Epub 2023 Oct 30.
Cancer is the second leading cause of death worldwide. Alongside other interventions, access to certain medicines may decrease cancer-associated mortality. Listing medicines on national essential medicines lists may improve health outcomes. We examine the association between cancer mortality amenable to care and the listing of cancer medicines on national essential medicines lists (NEMLs) of 124 countries.
In this cross-sectional study, we determined the number of medicines used to treat eight cancers on NEMLs and used multiple linear regression to analyze the association between cancer health outcome scores and the number of medicines on NEMLs while controlling for GDP. A sensitivity analysis was also conducted using selected medicines.
The number of cancer medicines on NEMLs was not associated with cancer health outcome scores when GDP was controlled for non-melanoma skin (p = 0.224), uterine (p = 0.221), breast (p = 0.145), Hodgkin's lymphoma (p = 0.697), colon (p = 0.299), leukemia (p = 0.103), cervical (p = 0.834), and testicular cancers (p = 0.178).
There was a weak association between listing medicines for eight cancers in NEMLs and amenable mortality. Further studies are required to explore association between cancer health outcomes and other factors such as actual availability of medicines listed, access to surgeries, accurate diagnosis, radiotherapy, and early detection.
癌症是全球第二大致死原因。除其他干预措施外,获得某些药物可能会降低与癌症相关的死亡率。将药物列入国家基本药物清单可能会改善健康结果。我们研究了 124 个国家的国家基本药物清单(NEML)中癌症药物的列名与癌症可治疗死亡率之间的关系。
在这项横断面研究中,我们确定了 NEML 中用于治疗八种癌症的药物数量,并使用多元线性回归分析了癌症健康结果评分与 NEML 中药物数量之间的关联,同时控制了 GDP。还进行了敏感性分析,使用了选定的药物。
在控制 GDP 后,NEML 中癌症药物的数量与非黑色素瘤皮肤癌(p=0.224)、子宫癌(p=0.221)、乳腺癌(p=0.145)、霍奇金淋巴瘤(p=0.697)、结肠癌(p=0.299)、白血病(p=0.103)、宫颈癌(p=0.834)和睾丸癌(p=0.178)的癌症健康结果评分无关。
将八种癌症的药物列入 NEML 与可治疗死亡率之间存在弱关联。需要进一步研究以探索癌症健康结果与其他因素之间的关联,例如列入的药物的实际可用性、手术机会、准确诊断、放疗和早期发现。