Unfavorable Mortality-To-Incidence Ratio of Lung Cancer Is Associated with Health Care Disparity

Abstract

The mortality-to-incidence ratio (MIR) is associated with the clinical outcome of cancer treatment. For several cancers, countries with relatively good health care systems have favorable MIRs. However, the association between lung cancer MIR and health care expenditures or rankings has not been evaluated. We used linear regression to analyze the correlation between lung cancer MIRs and the total expenditures on health/gross domestic product (e/GDP) and the World Health Organization (WHO) rankings. We included 57 countries, for which data of adequate quality were available, and we found high rates of incidence and mortality but low MIRs in more developed regions. Among the continents, North America had the highest rates of incidence and mortality, whereas the highest MIRs were in Africa, Asia, Latin America, and the Caribbean. Globally, favorable MIRs correlated with high e/GDP and good WHO ranking (regression coefficient, −0.014 and 0.001; p = 0.004, and p = 0.014, respectively). In conclusion, the MIR for lung cancer in different countries varies with the expenditure on health care and health system rankings.

Correlations between Mortality-to-Incidence Ratios and Health Care Disparities in Testicular Cancer

“…This can be reflected by differences in MIRs. Globally, the MIR of lung cancer is 0.87 [21], while it is 0.19 for testicular cancer. Despite that, our study found a significant correlation between the MIR for testicular cancer and a country's WHO ranking, echoing the findings of previous papers on colon cancer and lung cancer [18,21].…”

“…Globally, the MIR of lung cancer is 0.87 [21], while it is 0.19 for testicular cancer. Despite that, our study found a significant correlation between the MIR for testicular cancer and a country's WHO ranking, echoing the findings of previous papers on colon cancer and lung cancer [18,21]. The association between the total expenditures on health/GDP and the crude rates of (A) incidence and (B) mortality, and the ASR (age-standardized rate) of (C) incidence and (D) mortality.…”

“…The statistical analysis methods that were used have been described previously [16,[19][20][21]. We evaluated the association between the MIRs and the variables with the Spearman's rank correlation coefficient (CC) using SPSS statistical software version 15.0 (SPSS, Inc., Chicago, IL, USA).…”

A global, regional, and national survey on burden and Quality of Care Index (QCI) of hematologic malignancies; global burden of disease systematic analysis 1990–2017

“…QCI scores were calculated and scaled into 0 to 100 range, with higher scores representing better quality of care. Moreover, similar indices like mortality to incidence ratio were utilized to assess the quality of care in different cancers [ 15 , 16 ].…”

The challenges of implementing low-dose computed tomography for lung cancer screening in low- and middle-income countries

“…More specifically, lung cancer incidence in China has increased 465% over the past 30 years, ranking the highest among all cancer types since the beginning of this century, and accounting for more than one-third of global lung cancer mortality 37 . Gross domestic product (GDP) correlates negatively with case fatality, being estimated at 90% versus 74.8% in LMICs and HICs, respectively 38 . This phenomenon is multifactorial and likely associated with challenges in access to diagnostic tools leading to delayed detection, as well as barriers to adequate treatment 39 .…”