發達的醫療照護系統有較佳的腎細胞癌之死亡發生比
簡宏祐、陳順郎、高育琳、王紹全、陳文榮、謝佐宜、宋文瑋
中山醫學大學泌尿科
Favorable mortality-to-incidence ratios of renal cancer are associated with advanced health care systems
Horn-yo Chien, Sung-Lang Chen, Yu-Lin Kao, Shao-Chung Wang, Wen-Jung Chen, Tzuo-Yi Hsieh,
Wen-Wei Sung
Department of Urology, Chung Shan Medical University Hospital, Taichung City, Taiwan
Purpose: We used the mortality-to-incidence ratio (MIR) as an indicator of clinical outcomes to compare World Health Organization (WHO) country rankings and total expenditures on health/gross domestic product (e/GDP).
Materials and Methods: We obtained cancer epidemiologic data from the GLOBOCAN 2012 database which is maintained by the International Agency for Research on Cancer. Health care expenditures and life expectancies were obtained from WHO’s World Health Statistics 2015, and the WHO rankings were obtained from WHO’s World’s Health Systems. Fifty-seven countries were enrolled. We evaluated the association between the MIRs and variants using linear regression and SPSS statistical software.
Results: More developed regions have higher crude and age-standardized rates of renal cancer incidence and mortality but a lower MIR compared to less developed regions. North America has the highest crude rates of incidence but the lowest MIRs, and Africa has the highest MIRs. Furthermore, favorable MIRs are correlated with countries with a good WHO ranking and high e/GDP (p<0.001 and p=0.013, respectively).
Conclusions: Renal cancer MIRs are associated with the ranking of health care systems and health care expenditures, probably due to better screening programs, early detection and proper intervention in countries with advanced healthcare system.