Abstract：
BACKGROUND: Achieving universal health coverage (UHC) involves all individuals attaining accessible health interventions at an affordable cost. We examined current patterns and temporal trends of cancer mortality and UHC across sociodemographic index (SDI) settings, and quantified these association.
METHODS: We used data from the Global Burden of Disease Study 2019 and Our World in Data. The UHC effective coverage index was obtained to assess the potential population health gains delivered by health systems. The estimated annual percentage change (EAPC) with a 95% confidence interval (CI) was calculated to quantify the trend of cancer age-standardized mortality rate (ASMR). A generalized linear model was applied to estimate the association between ASMR and UHC.
RESULTS: The high (EAPC = -0.9% [95% CI, -1.0%, -0.9%]) and high-middle (-0.9% [-1.0%, -0.8%]) SDI regions had the fastest decline in ASMR (per 100,000) for total cancers from 1990 to 2019. The overall UHC effective coverage index increased by 27.9% in the high-SDI quintile to 62.2% in the low-SDI quintile. A negative association was observed between ASMR for all-cancer (adjusted odds ratio [OR] = 0.87 [0.76, 0.99]), stomach (0.73 [0.56, 0.95]), breast (0.64 [0.52, 0.79]), cervical (0.42 [0.30, 0.60]), lip and oral cavity (0.55 [0.40, 0.75]), and nasopharynx (0.42 [0.26, 0.68]) cancers and high UHC level (the lowest as the reference).
CONCLUSIONS: Our findings strengthen the evidence base for achieving UHC to improve cancer outcomes.
BACKGROUND: This work is funded by the China National Natural Science Foundation and Chinese Academy of Medical Sciences Innovation Fund for Medical Science.
METHODS: We used data from the Global Burden of Disease Study 2019 and Our World in Data. The UHC effective coverage index was obtained to assess the potential population health gains delivered by health systems. The estimated annual percentage change (EAPC) with a 95% confidence interval (CI) was calculated to quantify the trend of cancer age-standardized mortality rate (ASMR). A generalized linear model was applied to estimate the association between ASMR and UHC.
RESULTS: The high (EAPC = -0.9% [95% CI, -1.0%, -0.9%]) and high-middle (-0.9% [-1.0%, -0.8%]) SDI regions had the fastest decline in ASMR (per 100,000) for total cancers from 1990 to 2019. The overall UHC effective coverage index increased by 27.9% in the high-SDI quintile to 62.2% in the low-SDI quintile. A negative association was observed between ASMR for all-cancer (adjusted odds ratio [OR] = 0.87 [0.76, 0.99]), stomach (0.73 [0.56, 0.95]), breast (0.64 [0.52, 0.79]), cervical (0.42 [0.30, 0.60]), lip and oral cavity (0.55 [0.40, 0.75]), and nasopharynx (0.42 [0.26, 0.68]) cancers and high UHC level (the lowest as the reference).
CONCLUSIONS: Our findings strengthen the evidence base for achieving UHC to improve cancer outcomes.
BACKGROUND: This work is funded by the China National Natural Science Foundation and Chinese Academy of Medical Sciences Innovation Fund for Medical Science.
摘要：
背景：实现全民健康覆盖（UHC）涉及所有个人以负担得起的成本获得可获得的健康干预措施。我们检查了社会人口统计学指数（SDI）设置中癌症死亡率和UHC的当前模式和时间趋势，并量化了这些关联。
方法：我们使用了2019年全球疾病负担研究和我们的世界的数据。获得了UHC有效覆盖指数，以评估卫生系统带来的潜在人群健康收益。计算具有95％置信区间（CI）的估计年度百分比变化（EAPC），以量化癌症年龄标准化死亡率（ASMR）的趋势。应用广义线性模型来估计ASMR和UHC之间的关联。
结果：高（EAPC=-0.9%[95%CI，-1.0%，-0.9%]）和中高（-0.9%[-1.0%，-0.8%]）从1990年到2019年，SDI地区的总癌症ASMR（每10万人）下降最快。总体UHC有效覆盖指数在高SDI五分位数中增加了27.9％，在低SDI五分位数中增加了62.2％。在所有癌症的ASMR之间观察到负相关（调整后的比值比[OR]=0.87[0.76，0.99]），胃（0.73[0.56,0.95]），乳房(0.64[0.52,0.79])，子宫颈（0.42[0.30,0.60]），唇和口腔（0.55[0.40,0.75]），和鼻咽（0.42[0.26，0.68]）癌症和高UHC水平（作为参考最低）。
结论：我们的发现加强了实现UHC改善癌症预后的证据基础。
背景：这项工作得到了国家自然科学基金和中国医学科学院医学创新基金的资助。
方法：我们使用了2019年全球疾病负担研究和我们的世界的数据。获得了UHC有效覆盖指数，以评估卫生系统带来的潜在人群健康收益。计算具有95％置信区间（CI）的估计年度百分比变化（EAPC），以量化癌症年龄标准化死亡率（ASMR）的趋势。应用广义线性模型来估计ASMR和UHC之间的关联。
结果：高（EAPC=-0.9%[95%CI，-1.0%，-0.9%]）和中高（-0.9%[-1.0%，-0.8%]）从1990年到2019年，SDI地区的总癌症ASMR（每10万人）下降最快。总体UHC有效覆盖指数在高SDI五分位数中增加了27.9％，在低SDI五分位数中增加了62.2％。在所有癌症的ASMR之间观察到负相关（调整后的比值比[OR]=0.87[0.76，0.99]），胃（0.73[0.56,0.95]），乳房(0.64[0.52,0.79])，子宫颈（0.42[0.30,0.60]），唇和口腔（0.55[0.40,0.75]），和鼻咽（0.42[0.26，0.68]）癌症和高UHC水平（作为参考最低）。
结论：我们的发现加强了实现UHC改善癌症预后的证据基础。
背景：这项工作得到了国家自然科学基金和中国医学科学院医学创新基金的资助。
