Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2017; 23(44): 7881-7887
Published online Nov 28, 2017. doi: 10.3748/wjg.v23.i44.7881
Health disparities are associated with gastric cancer mortality-to-incidence ratios in 57 countries
Ming-Chang Tsai, Chi-Chih Wang, Hsiang-Lin Lee, Cheng-Ming Peng, Tzu-Wei Yang, Hsuan-Yi Chen, Wen-Wei Sung, Chun-Che Lin
Ming-Chang Tsai, Chi-Chih Wang, Tzu-Wei Yang, Hsuan-Yi Chen, Chun-Che Lin, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Ming-Chang Tsai, Chi-Chih Wang, Hsiang-Lin Lee, Cheng-Ming Peng, Tzu-Wei Yang, Hsuan-Yi Chen, Wen-Wei Sung, Chun-Che Lin, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
Ming-Chang Tsai, Chi-Chih Wang, Hsiang-Lin Lee, Cheng-Ming Peng, Wen-Wei Sung, Chun-Che Lin, Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
Hsiang-Lin Lee, Cheng-Ming Peng, Department of Surgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Tzu-Wei Yang, Institute and Department of Biological Science and Technology, National Chiao Tung University, Hsinchu 30010, Taiwan
Wen-Wei Sung, Department of Urology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Wen-Wei Sung, Department of Medical Education, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Wen-Wei Sung, Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli 35664, Taiwan
Author contributions: Tsai MC and Wang CC contributed equally to this manuscript; Sung WW and Lin CC contributed equally to this manuscript; Sung WW contributed to conception and design; Lee HL and Peng CM contributed to acquisition of data; Tsai MC, Yang TW and Chen HY contributed to analysis and interpretation of data; Wang CC and Tsai MC drafted the manuscript; Lin CC and Sung WW critically revised the manuscript; Wang CC, Tsai MC and Sung WW performed the statistical analysis; Lin CC and Sung WW supervised the work.
Conflict-of-interest statement: There was no conflict of interest for all of the authors.
Data sharing statement: All data are available as mentioned in the section of Materials and Methods.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chun-Che Lin, MD, PhD, Attending Doctor, Chief Doctor, Professor, School of Medicine, Chung Shan Medical University, No. 110, Sec.1, Jianguo N. Road, Taichung 40201, Taiwan. cs1601@csmu.edu.tw
Telephone: +886-4-24730022-11603
Received: May 30, 2017
Peer-review started: June 2, 2017
First decision: June 20, 2017
Revised: July 11, 2017
Accepted: August 25, 2017
Article in press: August 25, 2017
Published online: November 28, 2017
Processing time: 180 Days and 22.8 Hours
Abstract
AIM

To evaluate the association between mortality-to-incidence ratios (MIRs) and health disparities.

METHODS

In this study, we used the GLOBOCAN 2012 database to obtain the cancer incidence and mortality data for 57 countries, and combined this information with the World Health Organization (WHO) rankings and total expenditures on health/gross domestic product (e/GDP). The associations between variables and MIRs were analyzed by linear regression analyses and the 57 countries were selected according to their data quality.

RESULTS

The more developed regions showed high gastric cancer incidence and mortality crude rates, but lower MIR values than the less developed regions (0.64 vs 0.80, respectively). Among six continents, Oceania had the lowest (0.60) and Africa had the highest (0.91) MIR. A good WHO ranking and a high e/GDP were significantly associated with low MIRs (P = 0.001 and P = 0.001, respectively).

CONCLUSION

The MIR variation for gastric cancer would predict regional health disparities.

Keywords: Gastric cancer; Mortality; Incidence; Mortality-to-incidence ratio; Gross domestic product; Expenditure; World Health Organization

Core tip: The mortality-to-incidence ratios (MIRs), defined as the ratio of the crude rate of mortality to the incidence, could reflect the clinical outcomes of disease. A total of 57 countries was included in this analysis to evaluate the association between MIR and health care disparities. The results showed the more developed regions had high gastric cancer incidence and mortality, but lower MIR than the less developed regions. Otherwise, good World Health Organization ranking and high total expenditures on health/gross domestic product were significantly associated with low MIRs. Therefore, the MIR variation for gastric cancer could predict regional health disparities.