Economic downturns, universal health coverage, and cancer mortality in high-income and middle-income countries, 1990–2010: a longitudinal analysis

Maruthappu, Mahiben; Watkins, Johnathan; Noor, Aisyah Mohd; Williams, Cheyenne; Ali, Raghib; Sullivan, Richard; Zeltner, Thomas; Atun, Rifat

doi:10.1016/s0140-6736(16)00577-8

Cited by 156 publications

(138 citation statements)

References 31 publications

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“…This method reduced the potential confounding effect caused by age. We calculated the world age-standardized rate according to Segi’s world standard population [18]. Cancer trends were calculated using the Joinpoint Regression Program and were reported using the annual percentage change (APC).…”

Section: Methodsmentioning

confidence: 99%

Long-term trends and survival analysis of esophageal and gastric cancer in Yangzhong, 1991-2013

et al. 2017

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ObjectiveTo describe the long-term trends of the incidence, mortality and survival of upper digestive tract cancers in a high-risk area of China.MethodsWe extracted esophageal and gastric cancer cases diagnosed from 1991 to 2013 through the Yangzhong Cancer Registry and calculated the crude and age-standardized incidence and mortality rates. Cancer trends were calculated using the Joinpoint Regression Program and were reported using the annual percentage change (APC). The cancer-specific survival rates were evaluated and compared between groups using the Kaplan-Meier method and log-rank test.ResultsThe age-standardized incidence rate of esophageal cancer declined from 107.06 per 100,000 person-years (male: 118.05 per 100,000 person-years; female: 97.42 per 100,000 person-years) in 1991 to 37.04 per 100,000 person-years (male: 46.43 per 100,000 person-years; female: 27.26 per 100,000 person-years) in 2013, with an APC of -2.5% (95% confidence interval (CI): -3.4%, -1.5%) for males and -4.9% (95% CI:-5.8%, -3.9%) for females. The age-standardized incidence rate of gastric cancer was 165.11 per 100,000 person-years (male: 225.39 per 100,000 person-years; female: 113.34 per 100,000 person-years) in 1991 and 53.46 per 100,000 person-years (male: 76.51 per 100,000 person-years; female: 32.43 per 100,000 person-years) in 2013, with the APC of -3.6% (95% CI: -4.5%, -2.7%) for males and -4.8% (95% CI: -5.7%, -3.9%) for females. The median survival time was 3.0 years for patients with esophageal or gastric cancer. Cancer cases detected after 2004 had a better prognosis.ConclusionsThe age-standardized incidence rates of both esophageal and gastric cancer continuously decreased since 1991 through 2013, whereas the mortality rate remained stable before 2004 and significantly declined following the massive endoscopic screening program initiated in 2004. The survival probability of patients with esophageal and gastric cancer has improved obviously in recent decades.

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Section: Methodsmentioning

confidence: 99%

Long-term trends and survival analysis of esophageal and gastric cancer in Yangzhong, 1991-2013

et al. 2017

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“…We classified educational attainment as less than high school, high school equivalent, and higher than high school. This information provided a proxy of socio-economic status which has been reported to impact ageing-related outcomes [47, 48]. We defined current smokers as those who had reported a history of smoking at least 100 cigarettes during their lifetime and, at the time of the interview, reported smoking either every day or some days.…”

Section: Methodsmentioning

confidence: 99%

Investigating the associations between adiposity, life course overweight trajectories, and telomere length

Wulaningsih

Watkins²,

Matsuguchi

et al. 2016

Aging

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Obesity may accelerate ageing through chronic inflammation. To further examine this association, we assessed current adiposity, adiposity at early adulthood and life course overweight trajectories in relation to leukocyte telomere length (LTL). We included a total of 7,008 nationally representative U.S. residents and collected information on objectively measured body mass index (BMI), waist circumference and percent body fat. BMI at age 25 and overweight trajectories were assessed using self-reported history. Leukocyte telomere length (LTL) relative to a standard DNA reference (T/S ratio) was quantified by polymerase chain reaction (PCR). Linear regression models were used to examine the difference in LTL across adiposity measures at examination, BMI at age 25, and overweight trajectories. A 0.2% decrease in telomere length (95% CI:−0.3 to −0.07%) was observed for every kg/m2 increase in BMI, whereas a unit increase in waist circumference (cm) and percent body fat contributed to a 0.09% and 0.01% decrease in LTL, respectively. Higher BMI and being obese at age 25 contributed to lower LTL at older ages. Associations between weight loss through life course and LTL were observed, which further marked the importance of life course adiposity dynamics as a determinant of ageing.

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“…For physicians, inappropriate treatment for one patient may divert time and attention from other patients with pressing clinical needs. And finally, in the context of important disparities in cancer care outcomes 78–81 that relate at least in part to unequal distribution of scarce resources, overuse represents squandered resources with negative returns.…”

Section: Implications Of Medication Overusementioning

confidence: 99%

Medication overuse in oncology: current trends and future implications for patients and society

Schleicher

Matsoukas

Korenstein

2018

The Lancet Oncology

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Summary: The high cost of cancer care worldwide is largely attributable to rising drugs prices. Despite their high costs and potential toxicities, anticancer treatments may be subject to overuse, defined as the provision of medical services that are more likely to harm than to benefit a patient. We found 30 studies documenting medication overuse in cancer, which included 16 examples of supportive medication overuse and 17 examples of anti-neoplastic medication overuse in oncology. Evaluated drugs were limited to relatively few specific agents, and no studies investigated overuse of the most toxic or expensive medications currently used in cancer treatment. While financial, psychological, or physical harms of medication overuse in cancer could be substantial, there is little literature addressing these harms so their magnitude is unclear. Further research is needed to better quantify rates of medication use, understand its implications, and help protect patients and the healthcare system from future overuse.

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Economic downturns, universal health coverage, and cancer mortality in high-income and middle-income countries, 1990–2010: a longitudinal analysis

Abstract: None.

Cited by 156 publications

References 31 publications

Long-term trends and survival analysis of esophageal and gastric cancer in Yangzhong, 1991-2013

Long-term trends and survival analysis of esophageal and gastric cancer in Yangzhong, 1991-2013

Investigating the associations between adiposity, life course overweight trajectories, and telomere length

Medication overuse in oncology: current trends and future implications for patients and society

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