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. 2021 Aug 17:9:713895.
doi: 10.3389/fpubh.2021.713895. eCollection 2021.

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

Tzu-Wei Yang  1   2 , Chi-Chih Wang  1   2   3 , Wei-Cheng Hung  4   5 , Yu-Hsiang Liu  2 , Wen-Wei Sung  2   3   6 , Ming-Chang Tsai  1   2   3
Affiliations

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

Tzu-Wei Yang et al. Front Public Health. .

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.

Keywords: expenditure; gastric cancer; incidence; mortality; mortality-to-incidence ratio.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer XL declared a shared affiliation with the authors, to the handling editor at time of review.

Figures

Figure 1
Figure 1
The (A) human development index, (B) current health expenditure per capita, and (C) current health expenditure as a percentage of gross domestic product are significantly associated with the mortality-to-incidence ratio in gastric cancer.
Figure 2
Figure 2
Association between human development index (HDI), current health expenditure per capita, current health expenditure as percentage of gross domestic product and delta mortality-to-incidence ratio in gastric cancer in very high HDI countries (A–C) and others (D–F).
See this image and copyright information in PMC

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