Al-Asadi Jasim N, Salman Jasim M
College of Medicine, University of Basrah Email:
Qatar Med J. 2024 Jan 15;2023(4):38. doi: 10.5339/qmj.2023.38. eCollection 2023.
Cancer continues to be a significant worldwide health concern with substantial mortality. The cancer mortality-to-incidence ratio (MIR), a proxy measure of observed five-year survival, can serve as a valuable indicator of cancer management outcomes and healthcare disparities among countries. This study aims to determine the MIR trend for all cancers combined among Iraqi citizens during 2012-2020 for health expenditure percentages out of the gross domestic product (e/GDP (%)) and population growth rate.
The study used the Iraqi Cancer Registry annual reports for cancer data and World Bank data for health expenditure and population growth. Simple linear regression analysis examined the relationship between health expenditure, growth rate, and MIR, while joinpoint regression analysis examined the trend over time. The Ethics Committee of the College of Medicine at the University of Basrah approved the study.
An increasing trend in crude incidence rates for all cancer types combined was seen with a decrease in mortality rates from 2012 to 2020 in both sexes. A non-statistically significant reduction in MIR was found with an average annual percent change (AAPC) of -3.1% (P = 0.100). The decrease in MIR was higher among females than males, with a statistically significant difference (P = 0.003). High health expenditure presented as e/GDP (%) was associated with a favorable cancer survival rate, but this was not statistically significant (R = 0.263, P = 0.158). In contrast, a low growth rate was significantly associated with cancer patients' survival (R = 0.505, P = 0.032).
As indicated by the MIR and the MIR complement (1-MIR), the proxy five-year survival rate is improving in Iraq with time. Although not statistically significant, high health expenditure favorably affected overall cancer survival. A low growth rate, on the other hand, significantly improves cancer patients' survival.
癌症仍然是一个重大的全球健康问题，死亡率很高。癌症死亡率与发病率之比（MIR）是观察到的五年生存率的替代指标，可作为癌症管理结果和各国医疗保健差距的重要指标。本研究旨在确定2012年至2020年期间伊拉克公民所有癌症合并的MIR趋势，以了解国内生产总值中卫生支出的百分比（e/GDP（%））和人口增长率。
该研究使用伊拉克癌症登记处的年度报告获取癌症数据，并使用世界银行的数据获取卫生支出和人口增长数据。简单线性回归分析检查了卫生支出、增长率和MIR之间的关系，而连接点回归分析检查了随时间的趋势。巴士拉大学医学院伦理委员会批准了该研究。
2012年至2020年期间，所有癌症类型合并的粗发病率呈上升趋势，男女死亡率均有所下降。发现MIR有非统计学意义的降低，平均年度百分比变化（AAPC）为-3.1%（P = 0.100）。女性的MIR下降幅度高于男性，差异有统计学意义（P = 0.003）。以e/GDP（%）表示的高卫生支出与良好的癌症生存率相关，但无统计学意义（R = 0.263，P = 0.158）。相比之下，低增长率与癌症患者的生存率显著相关（R = 0.505，P = 0.032）。
正如MIR和MIR补充指标（1-MIR）所示，伊拉克的替代五年生存率随时间推移正在提高。尽管无统计学意义，但高卫生支出对总体癌症生存率有积极影响。另一方面，低增长率显著提高了癌症患者的生存率。
