The Outcome of Breast Cancer Is Associated with National Human Development Index and Health System Attainment.

Kaimin Hu,Juan Ye,Tao Pan,Wei Tian,Suzhan Zhang,Lixia Lou,Nancy Lan Guo

doi:10.1371/journal.pone.0158951

Kaimin Hu, Juan Ye + Show 5 more

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https://doi.org/10.1371/journal.pone.0158951

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Journal: PloS one	Publication Date: Jul 8, 2016
Citations: 22	License type: CC BY 4.0

Affiliation: Second Affiliated Hospital of Zhejiang University

Abstract

Breast cancer is a worldwide threat to female health with patient outcomes varying widely. The exact correlation between global outcomes of breast cancer and the national socioeconomic status is still undetermined. Mortality-to-incidence ratio (MIR) of breast cancer was calculated with the contemporary age standardized incidence and mortality rates for countries with data available at GLOBOCAN 2012 database. The MIR matched national human development indexes (HDIs) and health system attainments were respectively obtained from Human Development Report and World Health Report. Correlation analysis, regression analysis, and Tukey-Kramer post hoc test were used to explore the effects of HDI and health system attainment on breast cancer MIR. Our results demonstrated that breast cancer MIR was inversely correlated with national HDI (r = -.950; P < .001) and health system attainment (r = -.898; P < .001). Countries with very high HDI had significantly lower MIRs than those with high, medium and low HDI (P < .001). Liner regression model by ordinary least squares also indicated negative effects of both HDI (adjusted R2 = .903, standardize β = -.699, P < .001) and health system attainment (adjusted R2 =. 805, standardized β = -.009; P < .001), with greater effects in developing countries identified by quantile regression analysis. It is noteworthy that significant health care disparities exist among countries in accordance with the discrepancy of HDI. Policies should be made in less developed countries, which are more likely to obtain worse outcomes in female breast cancer, that in order to improve their comprehensive economic strength and optimize their health system performance.

Highlights

Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 25% of all cancer cases and 15% of all cancer deaths worldwide [1]
Data on the Mortality-to-incidence ratio (MIR) of female breast cancer and corresponding national human development indexes (HDIs) were available in 172 countries
Correlation coefficients revealed that MIR was significantly inversely correlated with national HDI (r = -.950; P < .001) and its four indicators (S1 Table)

Summary

Introduction

Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 25% of all cancer cases and 15% of all cancer deaths worldwide [1]. The incidence rates were generally higher in more economically developed countries than those in developing ones. In the United States, one in eight women develops breast cancer in her lifetime[2]. Mortality-to-incidence ratio (MIR), an approximation of case-fatality rate, is a novel measurement widely used to evaluate whether a country has a higher mortality rate than that might be expected based on its incidence rate[4]. It has been applied as a valid proxy to estimate the 5-year survival of patients with breast cancer[5]

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