Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Jalal-AL-Ahmad St., Chmaran HWY., Tehran, Tehran, Iran 1411713119, Iran.
Global Cooperation and Social Cohesion, The Global Health Economy, Kiel Institute for the World Economy, Hindenburgufer 66 24105 Kiel Germany, Kiel 24148, Germany.
Int J Qual Health Care. 2024 Jan 22;36(1). doi: 10.1093/intqhc/mzad113.
Kidney cancer (KC) is a prevalent cancer worldwide. The incidence and mortality rates of KC have risen in recent decades. The quality of care provided to KC patients is a concern for public health. Considering the importance of KC, in this study, we aim to assess the burden of the disease, gender and age disparities globally, regionally, and nationally to evaluate the quality and inequities of KC care. The 2019 Global Burden of Disease study provides data on the burden of the KC. The secondary indices, including mortality-to-incidence ratio, disability-adjusted life years -to-prevalence ratio, prevalence-to-incidence ratio, and years of life lost-to-years lived with disability ratio, were utilized. These four newly merged indices were converted to the quality-of-care index (QCI) as a summary measure using principal component analysis. QCI ranged between 0 and 100, and higher amounts of QCI indicate higher quality of care. Gender disparity ratio was calculated by dividing QCI for females by males to show gender inequity. The global age-standardized incidence and mortality rates of KC increased by 29.1% (95% uncertainty interval 18.7-40.7) and 11.6% (4.6-20.0) between 1990 and 2019, respectively. Globally, the QCI score for KC increased by 14.6% during 30 years, from 71.3 to 81.6. From 1990 to 2019, the QCI score has increased in all socio-demographic index (SDI) quintiles. By 2019, the highest QCI score was in regions with a high SDI (93.0), and the lowest was in low SDI quintiles (38.2). Based on the World Health Organization regions, the QCI score was highest in the region of America, with Canada having the highest score (99.6) and the lowest in the African Region, where the Central African Republic scored the lowest (17.2). In 1990, the gender disparity ratio was 0.98, and in 2019, it was 0.97 showing an almost similar QCI score for females and males. Although the quality of care for KC has improved from 1990 to 2019, there is a significant gap between nations and different socioeconomic levels. This study provides clinicians and health authorities with a global perspective on the quality of care for KC and identifies the existing disparities.
全球范围内，肾癌（KC）是一种常见的癌症。近几十年来，KC 的发病率和死亡率呈上升趋势。为 KC 患者提供的护理质量是公共卫生关注的问题。鉴于 KC 的重要性，在这项研究中，我们旨在评估全球、区域和国家的疾病负担、性别和年龄差异，以评估 KC 护理的质量和不平等。2019 年全球疾病负担研究提供了 KC 负担的数据。次要指标包括死亡率与发病率比、残疾调整生命年与流行率比、流行率与发病率比以及生命年损失与残疾年比，利用这些指标通过主成分分析将四个新合并的指标转换为护理质量指数（QCI）作为综合衡量标准。QCI 范围在 0 到 100 之间，QCI 越高表示护理质量越高。性别差异比通过将女性的 QCI 除以男性的 QCI 来计算，以显示性别不平等。1990 年至 2019 年，全球年龄标准化的 KC 发病率和死亡率分别上升了 29.1%（95%不确定区间 18.7-40.7）和 11.6%（4.6-20.0）。全球范围内，30 年来 KC 的 QCI 评分从 71.3 上升到 81.6，增长了 14.6%。1990 年至 2019 年，所有社会人口指数（SDI）五分位数的 QCI 评分都有所增加。到 2019 年，SDI 较高的地区 QCI 评分最高（93.0），SDI 较低的地区评分最低（38.2）。根据世界卫生组织区域，美洲地区的 QCI 评分最高，加拿大的评分最高（99.6），非洲地区的评分最低，其中中非共和国的评分最低（17.2）。1990 年，性别差异比为 0.98，2019 年为 0.97，表明女性和男性的 QCI 评分几乎相同。尽管 1990 年至 2019 年期间 KC 的护理质量有所提高，但各国之间以及不同社会经济水平之间仍存在显著差距。本研究为临床医生和卫生当局提供了全球视角，了解 KC 护理的质量，并确定了现有的差距。
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