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

Shao-Chuan Wang, Nai-Wen Chang, Wen-Jung Chen, Min-Hsin Yang, Sung-Lang Chen and Wen-Wei Sung
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Shao-Chuan Wang: Department of Urology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Nai-Wen Chang: Department of Urology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Wen-Jung Chen: Department of Urology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Min-Hsin Yang: Department of Urology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Sung-Lang Chen: Department of Urology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Wen-Wei Sung: Department of Urology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan

IJERPH, 2021, vol. 18, issue 4, 1-10

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 ( ? MIR). 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 ? MIR 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 ? MIRs 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 ( ? MIR) is negatively correlated with HDI and health care expenditure.

Keywords: testicular neoplasms; mortality; incidence; health expenditures (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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