Human development index is associated with mortality-to-incidence ratios of gastrointestinal cancers

作     者：Qi-Da Hu Qi Zhang Wei Chen Xue-Li Bai Ting-Bo Liang 

作者机构：Department of Surgerythe Second Affiliated HospitalSchool of MedicineZhejiang University 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2013年第19卷第32期

页      面：5261-5270页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Supported by The National Natural Science Funds for Distinguished Young Scholars No.30925033 the Innovation and High-Level Talent Training Program of Department of Health of Zhejiang Province China 

主　　题：Gastrointestinal neoplasms Mortality-toincidence ratio Human development index Healthcare disparities Socioeconomic factors 

摘      要：AIM:To identify the role of human development in the incidence and mortality rates of gastrointestinal cancers ***:The age-standardized incidence and mortality rates for gastrointestinal cancers,including cancers of the esophagus,stomach,pancreas,liver,gallbladder,and colorectum,were obtained from the GLOBOCAN 2008 database and United States Cancer Statistics(USCS)*** human development index(HDI)data were calculated according to the 2011 Human Development *** estimated the mortality-toincidence ratios(MIRs)at the regional and national levels,and explored the association of the MIR with development levels as measured by the HDI using a modifieddrug dose to inhibition response***,countries were divided into four groups according to the HDI distribution,and the MIRs of the four HDI groups were compared by one-way ANOVA followed by the Tukey-Kramer post-hoc *** MIRs in the United States were predicted from the estimated HDI using the fitted non-linear model,and were compared with the actual MIRs calculated from data in the USCS ***:The worldwide incidence and mortality rates of gastrointestinal cancers were as high as 39.4and 54.9 cases per 100000 individuals,*** and non-linear regression analyses revealed an inverse correlation between the MIR of gastrointestinal cancers and the HDI at the regional and national levels(0;P=0.0028 for regional level and0.0001 for national level,ANOVA).The MIR differed significantly among the four HDI areas(very high HDI,0.620±0.033;high HDI,0.807±0.018;medium HDI,0.857±0.021;low HDI,0.953±0.011;P0.001,oneway ANOVA).Prediction of the MIRs for individual United States states using best-fitted non-linear models showed little deviation from the actual MIRs in the United *** for 28 data points(9.93%of282),the actual MIRs of all gastrointestinal cancers were mostly located in the prediction intervals via the best-fit non-linear regression models.C