Department of Family Medicine, Chi Mei Foundation Hospital, Tainan, Taiwan.
Division of Urogynecology, Department of Obstetrics and Gynecology, Chi Mei Foundation Hospital, Tainan, Taiwan.
Taiwan J Obstet Gynecol. 2024 Jul;63(4):527-531. doi: 10.1016/j.tjog.2023.11.012.
Breast cancer is the most frequently diagnosed cancer among women worldwide. Mortality-to-incidence ratio (MIR) is a marker that reflects the efficacy and availability of screening interventions and treatment outcomes. MIR can be used to influence public health strategy. The association between the MIRs for breast cancer among countries with different economic statuses and health expenditure is important yet has been investigated. This study was aimed to elucidate the association between the breast cancer MIRs and the human development and health expenditure among different countries.
Cancer incidence and mortality rates were obtained from the GLOBOCAN database. The MIRs were calculated by dividing the crude rate of mortality to the incidence. Associations among the MIR and variants of human development index (HDI) and current health expenditure (CHE) in 50 countries were estimated via linear regression.
Breast cancer had a higher incidence rate, but lower mortality rate, in developed countries (high HDI, CHE per capita, CHE/GDP), as compared with developing countries. Favorable MIRs were associated with a high HDI and high health expenditure countries (presented by high CHE per capita, and CHE/GDP) (both p < 0.001) CONCLUSION: The MIR for breast cancer is reversely correlated with the development and healthcare disparities among different countries. This implies that allocating more resources to healthcare systems for breast cancer screening and treatment can improve disease outcomes. Our report may be helpful for public health policy making.
乳腺癌是全球女性中最常见的癌症。死亡率与发病率之比(MIR)是反映筛查干预和治疗结果效果和可及性的指标。MIR 可用于影响公共卫生策略。不同经济状况和卫生支出国家之间的乳腺癌 MIR 之间的关系很重要,但尚未得到研究。本研究旨在阐明不同国家乳腺癌 MIR 与人类发展和卫生支出之间的关系。
从 GLOBOCAN 数据库中获取癌症发病率和死亡率数据。通过将死亡率除以发病率来计算 MIR。通过线性回归估计 50 个国家的 MIR 与人类发展指数(HDI)和当前卫生支出(CHE)变异之间的关系。
与发展中国家(高 HDI、人均 CHE、CHE/GDP)相比,发达国家(高 HDI、高 CHE 人均、CHE/GDP)乳腺癌发病率较高,但死亡率较低。有利的 MIR 与高 HDI 和高卫生支出国家相关(表现为高 CHE 人均和 CHE/GDP)(均 p<0.001)。
乳腺癌的 MIR 与不同国家之间的发展和医疗保健差距呈负相关。这意味着为乳腺癌筛查和治疗的卫生系统分配更多资源可以改善疾病结局。我们的报告可能有助于制定公共卫生政策。