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

Cheng-Yu Huang,Hui-Hsiang Hsu,Sung-Lang Chen,Chi-Yu Liao,Kwong-Kwok Au,Yao-Chen Wang,Shao-Chuan Wang,Wen-Wei Sung

doi:10.3390/ijerph15122889

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.

Highlights

Lung cancer is recognized as the leading cause of cancer deaths around the globe [1]
Cancer incidence and mortality data including the numbers, crude rates, and age-standardized rates (ASR) were obtained from the GLOBOCAN 2012 database, which is maintained by the International Agency for Research on Cancer, IARC
Crude Rates of Incidence/Mortality According to Regions

Summary

Introduction

Lung cancer is recognized as the leading cause of cancer deaths around the globe [1]. In the USA, it accounts for 27% of cancer-related mortalities, killing more than 85,000 victims in a single year [2]. Part of lung cancer lethality is a result of its late diagnosis, as over half of lung cancer cases are diagnosed with distant metastasis [1]. The importance of screening for early stages of lung cancer cannot be overemphasized. Since the 1990s, clinical trials and research on lung cancer screening have flourished [3], and several guidelines have been established for effective screening [4]. Screening efficacy in different countries or regions is seldom compared, and screening

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