Abstract
This study aimed to quantify associations of the human development inequality (HDI) index with incidence, mortality, and mortality to incidence ratios for eight common cancers among different countries. In this ecological study, data about incidence and mortality rates of cancers was obtained from the Global Cancer Project for 169 countries. HDI indices for the same countries was obtained from the United Nations Development Program (UNDP) database. The concentration index was defined as the covariance between cumulative percentage of cancer indicators (incidence, mortality and mortality to incidence ratio) and the cumulative percentage of economic indicators (country economic rank). Results indicated that incidences of cancers of liver, cervix and esophagus were mainly concentrated in countries with a low HDI index while cancers of lung, breast, colorectum, prostate and stomach were concentrated mainly in countries with a high HDI index. The same pattern was observed for mortality from cancer except for prostate cancer that was more concentrated in countries with a low HDI index. Higher MIRs for all cancers were more concentrated in countries with a low HDI index. It was concluded that patterns of cancer occurrence correlate with care disparities at the country level.
Highlights
Cancer is one of the leading causes of death among women population worldwide (Jemal et al, 2011)
This study indicates that cancers incidence of liver, cervical and esophagus has become more concentrated in low human development inequality (HDI) countries and in contrast, cancers incidence of lung, breast, colorectal, prostate, and stomach are more concentrated in developed countries by HDI
This pattern was consistent for mortality expect for prostate cancer, it is more concentrated in low HDI countries
Summary
Cancer is one of the leading causes of death among women population worldwide (Jemal et al, 2011). MIR as proxy of survival can be a more sensitive measure to availability cancer care including screening, diagnosis and treatment previous studies found that developed countries e.g. strong national health system had lower than expected MIR (Hébert et al, 2009; Sunkara and Hébert, 2015). Several studies showed that the incidence and mortality disparities between countries can be attributed to some factors such as differences in life expectancy, education level, income level, and access to healthcare (Coughlin et al, 2007; Akinyemiju, 2012; Myers et al, 2015). Using the concentration index to clarify the HDI on cancer measure, the aim was assess the HDI inequalities in cancers measures including incidence, mortality and MIR four eight common cancers with worldwide aggregated data
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