Ul Haq Moizza Zia, Heredia Camila, Buadu Adelaide, Rizvi Amal, Workentin Aine, Persaud Nav
MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria St, Toronto, ON, M5B 1T8, Canada.
Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
BMC Cancer. 2024 Dec 18;24(1):1526. doi: 10.1186/s12885-024-13247-w.
Cancer is a major cause of mortality worldwide, and differences in cancer mortality rates between countries are, in part, due to differences in access to cancer care, including medicines. National essential medicines lists (NEMLs) play a role in prioritization of healthcare expenditure and access to medicines. We examined the association between amenable cancer mortality and listing medicines used in the management of eight cancers (non-melanoma skin, uterine, breast, Hodgkin lymphoma, colon, leukemia, cervical, and testicular) in national essential medicines lists of 158 countries and summarized changes to the inclusion of cancer treatments in NEMLs.
We conducted a cross-sectional examination of NEMLs for 158 countries, which were obtained in May 2023. We identified medicines used to treat each of the eight cancers and determined the number of medicines listed by NEMLs for each cancer. We conducted multiple linear regressions to examine the association between the number of medicines listed on the NEMLs and cancer mortality.
We found associations between cancer medicine listing and outcomes for six of the eight examined cancers (non-melanoma skin cancer (p = 0.001), uterine cancer (p = 0.006), breast cancer (p = 0.001), Hodgkin lymphoma (p = 0.021), colon cancer (p = 0.006), and leukemia (p = 0.002)), when adjusting for healthcare expenditure and population size.
There was an association between listing cancer medicines on NEMLs and cancer mortality. Further research is required to explore how cancer mortality may be impacted by other cancer interventions, as well as policies to improve equitable access to cancer care.
癌症是全球主要的死亡原因，各国癌症死亡率的差异部分归因于获得癌症治疗（包括药物）的机会不同。国家基本药物清单（NEMLs）在医疗保健支出的优先排序和药物获取方面发挥着作用。我们研究了158个国家的国家基本药物清单中用于治疗八种癌症（非黑色素瘤皮肤癌、子宫癌、乳腺癌、霍奇金淋巴瘤、结肠癌、白血病、宫颈癌和睾丸癌）的可避免癌症死亡率与所列药物之间的关联，并总结了国家基本药物清单中癌症治疗药物纳入情况的变化。
我们对2023年5月获取的158个国家的国家基本药物清单进行了横断面研究。我们确定了用于治疗这八种癌症的药物，并确定了国家基本药物清单为每种癌症列出的药物数量。我们进行了多元线性回归分析，以研究国家基本药物清单上列出的药物数量与癌症死亡率之间的关联。
在调整医疗保健支出和人口规模后，我们发现八种研究癌症中的六种（非黑色素瘤皮肤癌（p = 0.001）、子宫癌（p = 0.006）、乳腺癌（p = 0.001）、霍奇金淋巴瘤（p = 0.021）、结肠癌（p = 0.006）和白血病（p = 0.002））的癌症药物列入情况与治疗结果之间存在关联。
国家基本药物清单上列出癌症药物与癌症死亡率之间存在关联。需要进一步研究，以探讨其他癌症干预措施以及改善公平获得癌症治疗的政策如何可能影响癌症死亡率。
