1887
Volume 2023, Issue 4
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

Background: Cancer continues to be a significant worldwide health concern with substantial mortality. The cancer mortality-to-incidence ratio (MIR), a proxy measure of observed five-year survival, can serve as a valuable indicator of cancer management outcomes and healthcare disparities among countries. This study aims to determine the MIR trend for all cancers combined among Iraqi citizens during 2012-2020 for health expenditure percentages out of the gross domestic product (e/GDP (%)) and population growth rate.

Methods: The study used the Iraqi Cancer Registry annual reports for cancer data and World Bank data for health expenditure and population growth. Simple linear regression analysis examined the relationship between health expenditure, growth rate, and MIR, while joinpoint regression analysis examined the trend over time. The Ethics Committee of the College of Medicine at the University of Basrah approved the study.

Results: An increasing trend in crude incidence rates for all cancer types combined was seen with a decrease in mortality rates from 2012 to 2020 in both sexes. A non-statistically significant reduction in MIR was found with an average annual percent change (AAPC) of -3.1% (P = 0.100). The decrease in MIR was higher among females than males, with a statistically significant difference (P = 0.003). High health expenditure presented as e/GDP (%) was associated with a favorable cancer survival rate, but this was not statistically significant (R2 = 0.263, P = 0.158). In contrast, a low growth rate was significantly associated with cancer patients’ survival (R2 = 0.505, P = 0.032).

Conclusions: As indicated by the MIR and the MIR complement (1-MIR), the proxy five-year survival rate is improving in Iraq with time. Although not statistically significant, high health expenditure favorably affected overall cancer survival. A low growth rate, on the other hand, significantly improves cancer patients’ survival.

© 2023 Al-Asadi, Salman, Licensee HBKU Press.
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References

  1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al.. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71::209–49. doi: 10.3322/caac.21660.
     [Google الباحث العلمي]
  2. Wang Z, Zhou C, Feng X, Mo M, Shen J, Zheng Y. Comparison of cancer incidence and mortality between China and the United States. Pecis Cancer Med. 2021;4::31. doi: 10.21037/pcm-21-25.
     [Google الباحث العلمي]
  3. Hussain AM, Lafta RK. Cancer trends in Iraq 2000-2016. Oman Med J. 2021; 36::e219. doi: 10.5001/omj.2021.18.
     [Google الباحث العلمي]
  4. Al-Asadi JN, Ibrahim SJ. Childhood cancer in Basrah, Iraq during 2012-2016: incidence and mortality. Asian Pac J Cancer Prev. 2018; 19::2337–41. doi: 10.22034/apjcp.2018.19.8.2337.
     [Google الباحث العلمي]
  5. Iraqi Cancer Board, Ministry of Health and Environment, Republic of Iraq, 2020 [Internet]. Annual Report, Iraqi Cancer Registry, c2020 [cited 2022 Nov 30]. Available from: https://moh.gov.iq/?page=46
     [Google الباحث العلمي]
  6. Habib OS, J. Al-Elwe WM. Pattern of cancer: Comparison of risk in Basrah with national pattern. Med J Babylon. 2018; 15::195–6. doi: 10.4103/MJBL.MJBL_41_18.
     [Google الباحث العلمي]
  7. Amirkhah R, Naderi-Meshkin H, Mirahmadi M, Allahyari A, Sharifi HR. Cancer statistics in Iran: Towards finding priority for prevention and treatment. Cancer Press. 2017; 3::27–38. doi: 10.15562/tcp.42
     [Google الباحث العلمي]
  8. Ellis L, Woods LM, Estève J, Eloranta S, Coleman MP, Rachet B. Cancer incidence, survival and mortality: explaining the concepts. Int J Cancer. 2014; 135::1774–82. doi: 10.1002/ijc.28990.
     [Google الباحث العلمي]
  9. Vostakolaei FA, Karim-Kos HE, Janssen-Heijnen MLG, Visser O, Verbeek AL, Kiemeney LA. The validity of the mortality to incidence ratio as a proxy for site-specific cancer survival. Eur J Public Health. 2011:21::573–7. doi: 10.1093/eurpub/ckq120.
     [Google الباحث العلمي]
  10. World Health Organization [Internet] . Cancer Registration: Principles and Methods (IARC Scientific Publications No. 95), c1991 [cited 2022 Nov 30]. Available from: https://web.archive.org/web/20180514163527id_/https://www.iarc.fr/en/publications/pdfs-online/epi/sp95/SP95.pdf
     [Google الباحث العلمي]
  11. Sunkara V, Hébert JR. The colorectal cancer mortality-to-incidence ratio as an indicator of global cancer screening and care. Cancer. 2015; 121::1563–9.doi: 10.1002/cncr.29228.
     [Google الباحث العلمي]
  12. Stenning-Persivale K, Franco MJS, Cordero-Morales A, Cruzado-Burga J, Poquioma E, Nava ED, et al.. The mortality-incidence ratio as an indicator of five-year cancer survival in metropolitan Lima. Ecancermedicalscience. 2018;12::799. doi: 10.3332/ecancer.
     [Google الباحث العلمي]
  13. Ellis L, Belot A, Rachet B, Coleman MP. The mortality-to-incidence ratio is not a valid proxy for cancer survival. J Glob Oncol. 2019; 5::1–9. doi: 10.1200/JGO.19.00038.
     [Google الباحث العلمي]
  14. World Health Organization [Internet]. Guide to early cancer diagnosis, c2017 [cited 2022 Dec 12]. Available from: https://www.who.int/publications/i/item/9789241511940.
     [Google الباحث العلمي]
  15. Chen J, O’Brien MJ, Mennis J, Alos VA, Grande DT, Roby DH, et al.. Latino Population Growth and Hospital Uncompensated Care in California. Am J Public Health. 2015;105::1710-7. doi: 10.2105/AJPH.2015.302583.
     [Google الباحث العلمي]
  16. Wang SC, Chang NW, Chen WJ, Yang MH, Chen SL, Sung WW. Trends of testicular cancer mortality-to-incidence ratios in relation to health expenditure: An ecological study of 54 Countries. Int J Environ Res Public Health. 2021;18::1546. doi: 10.3390/ijerph18041546.
     [Google الباحث العلمي]
  17. Dong C, Fu JT, Wu HR, Chao YC, Chen YC, Sung WW, et al.. Mortality-to-incidence ratio for nasopharyngeal carcinoma is associated with health expenditure. Healthcare. 2022;10::1615. doi: 10.3390/healthcare10091615.
     [Google الباحث العلمي]
  18. Wang CC, Sung WW, Yan PY, Ko PY, Tsai MC. Favorable colorectal cancer mortality-to-incidence ratios in countries with high expenditures on health and development index: A study based on GLOBOCAN database. Medicine (Baltimore). 2021;100::e27414. doi: 10.1097/MD.0000000000027414.
     [Google الباحث العلمي]
  19. United Nations in Iraq [Internet] . Common Country Analysis, c2022 (Condensed version) [cited 2022 Dec 13]. Available from: https://iraq.un.org/sites/default/files/2022-07/CCA%20Iraq%20-%20Condensed.pdf.
     [Google الباحث العلمي]
  20. World Bank [Internet]. Current health expenditure per capita (current USD) – Iraq, c2003-2020 [cited 2022 Dec 14]. Available from: https://data.worldbank.org/indicator/SH.XPD.CHEX.PC.CD?locations=IQ Accessed on April 20, 2023.
     [Google الباحث العلمي]
  21. World Bank. Current health expenditure (% of GDP) – Iraq, c2003-2020 [cited 2022 Dec 14]. Available from: https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locations=IQ Accessed on April 20, 2023.
     [Google الباحث العلمي]
  22. World Bank [Internet]. Population growth (annual %) – Iraq, c1961-2022 [cited 2022 Dec 14]. Available from: https://data.worldbank.org/indicator/SP.POP.GROW?locations=IQ Accessed on April 20, 2023.
     [Google الباحث العلمي]
  23. Worldmeter [Internet]. What is GDP? [cited 2023 Oct 28]. Available from: https://www.worldometers.info/gdp/what-is-gdp/.
     [Google الباحث العلمي]
  24. Ades F, Senterre C, de Azambuja E, Sullivan R, Popescu R, Parent F, et al.. Discrepancies in cancer incidence and mortality and its relationship to health expenditure in the 27 European Union member states. Ann Oncol. 2013; 24::2897–902. doi: 10.1093/annonc/mdt352.
     [Google الباحث العلمي]
  25. World Health Organization [Internet]. The Global Health Observatory, Annual population growth rate [cited 2023 Oct 24]. Available from: https://www.who.int/data/gho/indicator-metadata-registry/imr-details/1120.
     [Google الباحث العلمي]
  26. Statistical Research and Applications Branch, National Cancer Institute [Internet]. Joinpoint Regression Program, version 4.9.1.0. Statistical Research and Applications Branch, National Cancer Institute, c2022. Available from: https://surveillance.cancer.gov/joinpoint/
     [Google الباحث العلمي]
  27. de Souza Reis R, Scaff AJM. Cancer survival in Brazil: Estimate through the mortality to incidence ratio. J. Public Health Epidemiol 2018; 10::295–302. doi: 10.5897/JPHE2018.1027.
     [Google الباحث العلمي]
  28. More at Cancer Australia [Internet]. National cancer indicators: Mortality-to-incidence ratio for all cancers combined (1982-2019), c2022 [cited 2023 Sep 21]. Available from: https://ncci.canceraustralia.gov.au/outcomes/mortality-incidence-ratio/mortality-incidence-ratio.
     [Google الباحث العلمي]
  29. Williams AO. Assessment of the completeness of births and deaths registration in an urban Nigerian community. African population studies. 2014;27::263-72. doi 10.11564/27-2-473.
     [Google الباحث العلمي]
  30. Al Alwan NAS. General Oncology Care in Iraq. Al-Shamsi HO, Abu-Gheida IH, Iqbal F, Al-Awadhi A. Cancer in the Arab World. Springer, Singapore. 2022: pp 63–82. doi:10.1007/978-981-16-7945-2_5.
     [Google الباحث العلمي]
  31. Zhua Y, Shaob X, Wanga X, Liuc L, Liang H. Sex disparities in cancer. Cancer Letters. 2019; 466::35–8. doi: 10.1016/j.canlet.2019.08.017
     [Google الباحث العلمي]
  32. Jackson SS, Marks MA, Katki HA, Cook MB, Hyun N, Freedman ND, et al.. Sex disparities in the incidence of 21 cancer types: Quantification of the contribution of risk factors. Cancer. 2022;128::353-40. doi: 10.1002/cncr.34390
     [Google الباحث العلمي]
  33. Lee H, Peng C, Huang C, Wu S, Tsai M, Wang C, et al.. Is mortality-to-incidence ratio associated with health disparity in pancreatic cancer? A cross-sectional database analysis of 57 countries. BMJ Open. 2018;8::e020618. doi: 10.1136/bmjopen-2017-020618.
     [Google الباحث العلمي]
  34. Batouli A, Jahanshahi P, Gross CP, Makarov DV, Yu JB. The global cancer divide: relationships between national healthcare resources and cancer outcomes in high-income vs. middle- and low-income countries. J Epidemiol Glob Health. 2014;4::115-24. doi: 10.1016/j.jegh.2013.10.004.
     [Google الباحث العلمي]
  35. Jarzebski MP, Elmqvist T, Gasparatos A,Fukushi K, Eckersten S, Haase D, et al.. Ageing and population shrinking: implications for sustainability in the urban century. npj Urban Sustain. 2021;1::17. doi: 10.1038/s42949-021-00023-z.
     [Google الباحث العلمي]
  36. Needham SL. Toward priorities for aging research. Rejuvenation Res. 2014; 17::154–56. doi: 10.1089/rej.2013.1508.
     [Google الباحث العلمي]
  37. Hashim D, Carioli G, Malvezzi M, Bertuccio P, Waxman S, Negri E, et al.. Cancer mortality in the oldest old: a global overview. Aging (Albany NY). 2020;12::16744-58. doi: 10.18632/aging.103503.
     [Google الباحث العلمي]
  38. Carioli G, Malvezzi M, Bertuccio P, Hashim D, Waxman S, Negri E, et al.. Cancer mortality in the elderly in 11 countries worldwide, 1970-2015. Ann Oncol. 2019; 30::1344–55. doi: 10.1093/annonc/mdz178.
     [Google الباحث العلمي]
  39. Hébert JR, Daguise VG, Hurley DM, Wilkerson RC, Mosley CM, Adams SA, et al.. Mapping cancer mortality-to-incidence ratios to illustrate racial and sex disparities in a high-risk population. Cancer. 2009; 115::2539–52. doi: 10.1002/cncr.24270.
     [Google الباحث العلمي]
  40. Akbari A, Khayamzadeh M, Salmanian R, Ghanbari Motlagh A, Roshandel G, Nouri M, et al.. National Cancer Mortality-to-Incidence Ratio (MIR) in Iran (2005 - 2014). Int J Cancer Manag. 2019;12::e94145. doi: org/10.5812/ijcm.94145.
     [Google الباحث العلمي]
  41. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73::17-48. doi: 10.3322/caac.21763.
     [Google الباحث العلمي]
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Cancer mortality-to-incidence ratio among Iraqi citizens: Nine-year National Estimates (2012-2020) and its relation to population growth rate and health expenditure
Qatar Medical Journal 2023, 38 (٢٠٢٤); https://doi.org/10.5339/qmj.2023.38
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  • نوع المستند: Research Article
الموضوعات الرئيسية cancer, Incidence, Iraq, mortality, mortality-to-incidence ratio and survival

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