Improvement in the Mortality-to-Incidence Ratios for Gastric Cancer in Developed Countries With High Health Expenditures.

Tzu-Wei Yang,Ming-Chang Tsai,Chi-Chih Wang,Wei-Cheng Hung,Wen-Wei Sung,Yu-Hsiang Liu

doi:10.3389/fpubh.2021.713895

Abstract

The mortality-to-incidence ratio (MIR) is widely used to evaluate the efficacy of cancer management outcomes for individual countries. However, the association among health care expenditure, human development index (HDI), and changes in MIR over time (δMIR) remains unknown. We aimed to elucidate the significance between these indicators and gastric cancer outcomes in different countries. Among the regions, Asia had the highest number of new gastric cancer cases, gastric cancer-related deaths, age-standardized ratio of incidence, and mortality. Chile had the highest age-standardized ratio (ASR) for gastric cancer incidence and the highest ASR for mortality. Moreover, MIR was highest in Africa (0.91) and lowest in North America (0.43). Of note, MIR was negatively associated with HDI, current health expenditure (CHE) per capita, and CHE/GDP % and δMIR was positively associated with CHE/GDP % in countries with very high HDI. However, δMIR showed no significant associations with these indicators in the countries analyzed. In conclusion, increased HDI, CHE per capita, and CHE/GDP are associated with improved gastric cancer outcomes. In addition, the δMIR could be an indicator that can be used to evaluate the improvement in cancer management outcomes over time.

Highlights

Along with increasing life expectancy, cancer has become the leading cause of death in humans, and the incidence of cancer and cancer-related deaths is growing rapidly [1]
By comparing the δMIRs of the investigated countries, we found that the mortality-to-incidence ratio (MIR) in most countries decreased in 2018
This study aimed to analyze the association among the levels of economic development, health expenditure, gastric cancer outcomes globally in 2018, and the improvement of gastric cancer management over time

Summary

Introduction

Along with increasing life expectancy, cancer has become the leading cause of death in humans, and the incidence of cancer and cancer-related deaths is growing rapidly [1]. Gastric cancer is one of the most common cancers worldwide; gastric cancer has the fifth highest incidence among all cancers, and the third leading cause of cancer-related deaths in 2018 [2]. The epidemiology of gastric cancer varies in different regions. Gastric cancer incidence and mortality rates are highest in Eastern Asia, while the rates in North America are lower than those in other regions [2, 3]. Efforts were made to improve the incidence rate of gastric cancer, such as HP infection eradication, food preservation, and lifestyle modifications [3, 6]. The mortality rates vary in different regions [7,8,9]. A good indicator to evaluate the improvement of gastric cancer management and outcome is needed

Objectives

Methods

Results

Conclusion