Patterns of better breast cancer care in countries with higher human development index and healthcare expenditure: Insights from GLOBOCAN 2020

Abstract

BackgroundThe huge burden of breast cancer (BC) necessitates the profound and accurate knowledge of the most recent cancer epidemiology and quality of care provided. We aimed to evaluate BC epidemiology and quality of care and examine the effects of socioeconomic development and healthcare expenditure on disparities in BC care.MethodsThe results from the GLOBOCAN 2020 study were utilized to extract data on female BC, including incidence and mortality numbers, crude rates, and age-standardized rates [age-standardized incidence rates (ASIRs) and age-standardized mortality rates (ASMRs)]. The mortality-to-incidence ratio (MIR) was calculated for different locations and socioeconomic stratifications to examine disparities in BC care, with higher values reflecting poor quality of care and vice versa. In both descriptive and analytic approaches, the human development index (HDI) and the proportion of current healthcare expenditure (CHE) to gross domestic product (CHE/GDP%) were used to evaluate the values of MIR.ResultsGlobally, 2,261,419 (95% uncertainty interval (UI): 2,244,260–2,278,710) new cases of female BC were diagnosed in 2020, with a crude rate of 58.5/100,000 population, and caused 684,996 (675,493–694,633) deaths, with a crude rate of 17.7. The WHO region with the highest BC ASIR (69.7) was Europe, and the WHO region with the highest ASMR (19.1) was Africa. The very high HDI category had the highest BC ASIR (75.6), and low HDI areas had the highest ASMR (20.1). The overall calculated value of female BC MIR in 2020 was 0.30, with Africa having the highest value (0.48) and the low HDI category (0.53). A strong statistically significant inverse correlation was observed between the MIR and HDI values for countries/territories (Pearson's coefficient = −0.850, p-value < 0.001). A significant moderate inverse correlation was observed between the MIR and CHE/GDP values (Pearson's coefficient = −0.431, p-value < 0.001).ConclusionsThis study highlighted that MIR of BC was higher in less developed areas and less wealthy countries. MIR as an indicator of the quality of care showed that locations with higher healthcare expenditure had better BC care. More focused interventions in developing regions and in those with limited resources are needed to alleviate the burden of BC and resolve disparities in BC care.

Survival Patterns Among Patients With Breast Cancer in Sub-Saharan Africa

“…2 On the other hand, breast cancer mortality is higher in countries with low or medium HDI (age-standardized mortality rates, 17.1 and 14.3 cases/100 000, respectively) compared with countries with a high HDI (10.3 cases/100 000). 6 While high-income countries have made significant progress in reducing age-standardized breast cancer mortality by 40% over the past 4 decades, equivalent to an annual reduction of 2% to 4%, 7 low-and middle-income countries (LMIC) face challenges, as they have the highest mortalityto-incidence ratio (MIR), indicating a less responsive health care system and a significant disease burden. The MIR in LMIC stands at 0.55, while it was 0.16 in high-income countries.…”

“…Countries with a high HDI, such as the US and European countries, had an annual breast cancer incidence rate increase of less than 0.5% (age-standardized incidence rate, 75.6 cases/100 000 population), whereas low- and middle-HDI regions including sub-Saharan African (SSA) countries experienced an increase in age-standardized incidence rate of greater than 5% (low-HDI countries, 27.8 cases/100 000; middle-HDI countries, 36.1 cases/100 000) . On the other hand, breast cancer mortality is higher in countries with low or medium HDI (age-standardized mortality rates, 17.1 and 14.3 cases/100 000, respectively) compared with countries with a high HDI (10.3 cases/100 000) …”

“… 2 On the other hand, breast cancer mortality is higher in countries with low or medium HDI (age-standardized mortality rates, 17.1 and 14.3 cases/100 000, respectively) compared with countries with a high HDI (10.3 cases/100 000). 6 …”

Cancer-Related Fatigue and Circulating Biomarkers in Breast Cancer Survivors

“…Breast cancer (BC) has replaced lung cancer as the most commonly diagnosed malignancy in the world (Sung et al, 2021). Specifically, Europe is the World Health Organization region with the highest age standardized incidence rates of BC (Azadnajafabad et al, 2023). Improvements in diagnosis, management and treatment have reduced BC mortality and now, the relative 5-year survival rate in BC nears 100% for stage I, but declines to 29% for stage IV (Giaquinto et al, 2022;Miller et al, 2022).…”

Antiproliferative and Antimetastatic Properties of 16-Azidomethyl Substituted 3-O-Benzyl Estrone Analogs

“…The 2.26 million breast cancer cases diagnosed in 2020 show unequal geographical distribution, with the highest age-standardized incidence rate in Europe (69.7/100,000) and the lowest in South-East Asia (28.3/100,000). A statistically significant inverse correlation was observed between the mortality-to-incidence ratio (MIR) and the human development index (HDI), indicating poorer prognosis for patients living in less developed regions of the world [ 2 ]. All these epidemiological findings suggest that the prevention and treatment of female breast cancers are not yet resolved, despite the impressive therapeutic progress evidenced in past decades.…”