Trends of Testicular Cancer Mortality-to-Incidence Ratios in Relation to Health Expenditure: An Ecological Study of 54 Countries

Abstract

Favorable testicular cancer mortality-to-incidence ratios (MIRs) are associated with health care disparities, including health care expenditures, but the trends of testicular MIR and health care disparity remain unclear. We evaluated changes in MIR as the difference between 2012 and 2018, termed delta MIR (δMIR). Health care expenditures and the human development index (HDI) were obtained from the World Health Organization and the Human Development Report Office of the United Nations Development Programme. The association between the variables was analyzed by Spearman’s rank correlation coefficient. A total of 54 countries were included in the criteria of data quality reports and missing data. By continent, the most favorable MIR was in Oceania (0.03) while it was 0.36 in Africa. In these areas, the incidence rates were positively correlated to health care expenditure, but the mortality rates showed a reversed correlation. The MIR ranged from 0.01 to 0.34 and the δMIR ranged from −0.05 to 0.34. The favorable MIRs are correlated to high health care expenditure and HDI (all p < 0.001). Interestingly, favorable δMIRs tend to be seen in countries with relatively low health care expenditure and HDI (all p < 0.001). In conclusion, favorable testicular cancer MIRs are associated with high HDI and health care expenditure, but the improvement in MIR between 2012 and 2018 (δMIR) is negatively correlated with HDI and health care expenditure.

Risk Factors for Testicular Cancer: Environment, Genes and Infections—Is It All?

“…This data is consistent with adequate diagnosis and treatment protocols implemented in the highest-income countries since the 1970s, associated with reduced exposures to well-known risk factors such as cryptorchidism and pharmaceuticals during pregnancy [13,14]. Conversely, in lower HDI countries such as Latin America, testicular cancer mortality rates have increased in parallel to incidence due to inequitable distribution of specialists and centers and difficulties in accessing cancer care for rural and remote populations [15,16].…”

The global, regional, and national testicular cancer burden and trends from 1990 to 2019: results from the Global Burden of Disease Study 2019

“…In Central Europe, Southern Latin America, and Western Europe, ASIR, ASPR, ASDR, and age-standardized DALYs were all higher than expected. Previous research has discovered that TC primarily occurs in developing countries such as Western Europe, Northern Europe, and Latin America [27,28]. The central populations are Caucasian, Hispanic, and American Indian/Alaska Native, the regions and races with the highest TC incidence [3].…”

Healthcare Systems and Pharmaceutical Industry in Emerging and Developed Economies: China and Poland versus the US and the EU

“…Moreover, the relationship between expenditure on healthcare goods and services and total spending in the economy fluctuate over time as a result of variances in the growth of health spending compared to overall economic growth (OECD/WHO, 2020). One of the crucial factors affecting healthcare capacity in different countries may be attributed to the level of health expenditure as a percentage of GDP (e.g., Khan, 2020;Ray & Linden, 2020;Wang et al, 2021). Long-term comparisons of current health expenditures as a share in GDP and per capita in China and Poland, in relation to the United States and the European Union, are presented in Table 8.1.…”