The Increasing Risk of Mortality in Breast Cancer: A Socioeconomic Analysis Between Countries

M. Coccia
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引用次数: 3

Abstract

Abstract. The risk of mortality in breast cancer among women is a critical health issue worldwide. Scholars argue that breast cancer mortality rates have decreased in many advanced countries overall. However, about 50% of world population in 2017 was in poor and developing countries (more than 3,652 million with 50.24% female) and breast cancer mortality rates differ among nations also because of socioeconomic factors. This study investigates, at global level, breast cancer mortality in association with breast cancer incidence and some factors of socioeconomic ecosystem between poor and rich countries, to explain trends that can be used to gain insights into country-level “best practices” for health improvement. Global data regarding breast cancer incidence and mortality as the age standardized rate per 100,000 population in 78low-to-middle income countries (LMICs), 50 upper-to-middle-income countries (UMICs) and 63 high income countries (HCIs) were obtained from IARC/WHO for 2012 and 2018. Data regarding GDP per capita, population and mammography (MMG) were obtained from World Bank, United Nations and WHO. Data, transformed in log scale to have normal distribution, were analyzed with descriptive statistics, partial correlation, regression analyses and paired-Samples T Test procedure to assess the statistical significance of increase or decrease of mortality and incidence in breast cancer from 2012 to 2018.Results reveal that a 1% higher level of breast cancer incidence, increases the expected mortality by 0.79% ( p-value < .001) in LMICs, by 0.50% ( p-value <.001) in UMICs and by 0.31% ( p-value < .008) in HICs. These results, confirmed by other analyses here, seem to suggest that breast cancer mortality is increasing over time worldwide in rich and in particular developing countries. The global analysis here reveals that though an improvement of wealth and wellbeing worldwide, the risk of incidence and mortality in breast cancer is increasing. This result suggests that situational factors in the ecosystem of countries support the growing increase and mortality of breast cancer that improvement in healthcare and medicine of the last 40 years are not been sufficient to slowdown. These conclusions need for much more detailed research to investigate into the interaction between factors of socioeconomic systems, health improvement, and breast cancer causes. Keywords. Breast cancer, Wealth of nations, Epidemiology. JEL. I14, I15, I18, I39, O10, O3, O55, Q50.
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乳腺癌死亡风险的增加:国家间的社会经济分析
摘要妇女因乳腺癌死亡的风险是全世界的一个重大健康问题。学者们认为,在许多发达国家,乳腺癌死亡率总体上有所下降。然而,2017年约有50%的世界人口在贫穷和发展中国家(超过36.52亿,其中50.24%是女性),各国之间的乳腺癌死亡率也因社会经济因素而有所不同。本研究在全球范围内调查了乳腺癌死亡率与乳腺癌发病率之间的关系以及穷国和富国之间社会经济生态系统的一些因素,以解释可用于深入了解国家一级改善健康的“最佳做法”的趋势。从国际癌症研究机构/世卫组织获得了2012年和2018年全球78个中低收入国家(LMICs)、50个中高收入国家(UMICs)和63个高收入国家(hci)的乳腺癌发病率和死亡率(每10万人的年龄标准化率)数据。关于人均国内生产总值、人口和乳房x光检查(MMG)的数据来自世界银行、联合国和世卫组织。数据经对数尺度变换为正态分布后,采用描述性统计、偏相关分析、回归分析和配对样本T检验等方法分析2012 - 2018年乳腺癌死亡率和发病率上升或下降的统计学意义。结果显示,乳腺癌发病率每增加1%,低收入国家的预期死亡率增加0.79% (p值< 0.001),低收入国家增加0.50% (p值< 0.001),高收入国家增加0.31% (p值< 0.001)。这些结果得到了其他分析的证实,似乎表明,随着时间的推移,乳腺癌死亡率在全球范围内呈上升趋势,在富裕国家,尤其是在发展中国家。该报告的全球分析显示,尽管世界各地的财富和福祉都有所改善,但乳腺癌发病率和死亡率的风险正在增加。这一结果表明,各国生态系统中的环境因素支持了乳腺癌的不断增长和死亡率,而过去40年医疗保健和医学的改善不足以减缓这一趋势。这些结论需要更详细的研究,以调查社会经济系统、健康改善和乳腺癌病因因素之间的相互作用。关键词。乳腺癌,国富论,流行病学。冻胶。I14, i15, i18, i39, o10, o3, o55, q50。
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