Government Healthcare Spending and Cancer Mortality: A Statistical Analysis Over 15 Years in 18 Countries
DOI:
https://doi.org/10.54536/jir.v3i2.4201Keywords:
Cancer Mortality, Continental Healthcare Comparison, Public Health Investment, Regional Disparities, Regional Health PolicyAbstract
This study examines healthcare spending in 18 countries in Asia, Europe and the Americas from 2001 to 2015 and finds notable variations in cancer mortality. Gender-specific effects were demonstrated by significantly lower mortality-to-incidence ratios in countries with more investment, particularly among women. Interestingly, despite more spending, male mortality remained higher, exposing unrecognized inequalities in healthcare consumption. This work reveals the critical relationships between public investment, policy efficacy, and cancer outcomes. This study offers policymakers helpful recommendations on how to enhance health outcomes and eliminate disparities in cancer treatment worldwide.
References
Abudu, R., Bouche, G., Bourougaa, K., Davies, L., Duncan, K., Estaquio, C., Font, A. D., Hurlbert, M. S., Jackson, P., Kroeskop-Bossenbroek, L., Lewis, I., Mitrou, G., Mutabbir, A., Pettigrew, C. A., Turner, L., Weerman, A., & Wojtanik, K. (2021). Trends in international cancer research investment 2006-2018. JCO Global Oncology, 7, 602–610. https://doi.org/10.1200/GO.20.00591
Ahmad, I., Jasim, S. A., Sharma, M. K., S, R. J., Hjazi, A., Mohammed, J. S., Sinha, A., Zwamel, A. H., Hamzah, H. F., & Mohammed, B. A. (2024). New paradigms to break barriers in early cancer detection for improved prognosis and treatment outcomes. The Journal of Gene Medicine, 26(8), e3730. https://doi.org/10.1002/jgm.3730
Asensio, M., & Amaral, E. (2024). Disparities in cancer outcomes: A comprehensive analysis of cancer incidence, mortality, and prevalence in Europe. Global Health Economics and Sustainability, 2(2), 3216. https://doi.org/10.36922/ghes.3216
Basavaiah, G., Rent, P. D., Rent, E. G., Sullivan, R., Towne, M., Bak, M., Sirohi, B., Goel, M., & Shrikhande, S. V. (2018). Financial Impact of Complex Cancer Surgery in India: A Study of Pancreatic Cancer. Journal of Global Oncology, 4, 1–9. https://doi.org/10.1200/JGO.17.00151
Batouli, A., Jahanshahi, P., Gross, C. P., Makarov, D. V., & Yu, J. B. (2013). The global cancer divide: Relationships between national healthcare resources and cancer outcomes in high-income vs. middle- and low-income countries. Journal of Epidemiology and Global Health, 4(2), 115. https://doi.org/10.1016/j.jegh.2013.10.004
Brawley, O. W. (2017). The role of government and regulation in cancer prevention. The Lancet Oncology, 18(8), e483–e493. https://doi.org/10.1016/S1470-2045(17)30374-1
Bray, F., Laversanne, M., Weiderpass, E., & Soerjomataram, I. (2021). The ever‐increasing importance of cancer as a leading cause of premature death worldwide. Cancer, 127(16), 3029–3030. https://doi.org/10.1002/cncr.33587
Budhdeo, S., Watkins, J., Atun, R., Williams, C., Zeltner, T., & Maruthappu, M. (2015). Changes in government spending on healthcare and population mortality in the European union, 1995–2010: A cross-sectional ecological study. Journal of the Royal Society of Medicine, 108(12), 490–498. https://doi.org/10.1177/0141076815600907
Bugazia, S., & Boshnaf, M. (2023). 1739P Lung cancer mortality patterns of tobacco users in the United States: A 21-year analysis (1999-2020). Annals of Oncology, 34, S944. https://doi.org/10.1016/j.annonc.2023.09.2693
Chang, T.-S., Huang, K.-Y., Chang, C.-M., Lin, C.-H., Su, Y.-C., & Lee, C.-C. (2014). The Association of Hospital Spending Intensity and Cancer Outcomes: A Population-Based Study in an Asian Country. The Oncologist, 19(9), 990–998. https://doi.org/10.1634/theoncologist.2014-0013
Chen, X., Trafimow, D., Wang, T., Tong, T., & Wang, C. (2021). The APP procedure for estimating the Cohen’s effect size. Asian Journal of Economics and Banking, 5(3), 289–306. https://doi.org/10.1108/AJEB-08-2021-0095
Ciuba, A., Wnuk, K., Nitsch-Osuch, A., & Kulpa, M. (2022). Health Care Accessibility and Breast Cancer Mortality in Europe. International Journal of Environmental Research and Public Health, 19(20), 13605. https://doi.org/10.3390/ijerph192013605
Dhungana, B. R. (2023). Government Health Expenditure and Policy for Public Health Outcomes: A Systematic Literature Review. MedS Alliance Journal of Medicine and Medical Sciences, 3(6), 84–91. https://doi.org/10.3126/mjmms.v3i6.66615
Doyle-Lindrud, S. (2022). Personalized cancer care. Journal of the American Association of Nurse Practitioners, 34(11), 1184–1186. https://doi.org/10.1097/JXX.0000000000000793
El Amine Youcef Ali, M., Nusselder, W., Weiderpass, E., Corbex, M., Bray, F., & Vaccarella, S. (2023). Inequities in cancer outcomes. Bulletin of the World Health Organization, 101(09), 550–550. https://doi.org/10.2471/BLT.23.290661
El Mathari, A., Ouqassou, H. A., Sehhar, M. A., Chmitah, T., Soltani, S., Idrissi, K. S., & El Bouaiti, L. Effectiveness of public health measures in reducing the incidence and lethality of cancer: A systematic review and meta-analysis. World Journal of Advanced Research and Reviews, 23(2), 371–393. https://doi.org/10.30574/wjarr.2024.23.2.2354
Eniu, A., Cherny, N. I., Bertram, M., Thongprasert, S., Douillard, J.-Y., Bricalli, G., Vyas, M., & Trapani, D. (2019). Cancer medicines in Asia and Asia-Pacific: What is available, and is it effective enough? ESMO Open, 4(4), e000483. https://doi.org/10.1136/esmoopen-2018-000483
Erlangga, D., Powell-Jackson, T., Balabanova, D., & Hanson, K. (2023). Determinants of government spending on primary healthcare: A global data analysis. BMJ Global Health, 8(11), e012562. https://doi.org/10.1136/bmjgh-2023-012562
Frieden, T. R., Myers, J. E., Krauskopf, M. S., & Farley, T. A. (2008). A Public Health Approach to Winning the War Against Cancer. The Oncologist, 13(12), 1306–1313. https://doi.org/10.1634/theoncologist.2008-0157
Garton, E. M., Cheetham, M., Cira, M. K., Davies, L., Mitrou, P., Perin, D. P., Ross, A. L., Zafar, S. N., & Duncan, K. (2023). Cancer research funding data to drive collaboration and inform action. The Lancet Oncology, 24(6), 584–586. https://doi.org/10.1016/S1470-2045(23)00153-5
Ghoncheh, M., Pournamdar, Z., & Salehiniya, H. (2016). Incidence and Mortality and Epidemiology of Breast Cancer in the World. Asian Pacific Journal of Cancer Prevention, 17(sup3), 43–46. https://doi.org/10.7314/APJCP.2016.17.S3.43
Global Health Expenditure Database. (2016). Government health expenditure data, 2001-2015 [Dataset]. Global Health Expenditure Database, World Health Organization. https://doi.org/10.6084/m9.figshare.27214161.v1
Goodarzi, E., Beiranvand, R., Mosavi-Jarrahi, A., Naemi, H., & Khazaei, Z. (2019). Epidemiology Incidence and Mortality Worldwide Common cancers in males and Their Relationship with the Human Development Index (HDI): An Ecological Study Updated in the World: Incidence and Mortality Worldwide Common cancers in males and Human Development Index (HDI). Journal of Contemporary Medical Sciences, 5(6), 281–303. https://doi.org/10.22317/jcms.v5i6.664
Hawkes, N. (2015). Many cancer deaths could be eliminated by greater awareness and access to latest treatments, report says. BMJ, 350(jan14 3), h223–h223. https://doi.org/10.1136/bmj.h223
International Agency for Research on Cancer. (2016). Cancer incidence and mortality data, 2001–2015 [Dataset]. International Agency for Research on Cancer, World Health Organization. https://doi.org/10.6084/m9.figshare.27214161.v1
Jandorf, L., Fatone, A., Borker, P. V., Levin, M., Esmond, W. A., Brenner, B., Butts, G., & Redd, W. H. (2006). Creating alliances to improve cancer prevention and detection among urban medically underserved minority groups: The East Harlem Partnership for Cancer Awareness. Cancer, 107(S8), 2043–2051. https://doi.org/10.1002/cncr.22153
Jena, S., Epari, V., Sahoo, K. C., Pradhan, S. P., Agrawala, S., & Padhi, S. (2024). Learning from the Active Hospital-Based Cancer Registry in India: An Ethnography Study. Discover Public Health, 21(1), 2. https://doi.org/10.1186/s12982-024-00123-y
Jung, Y. L., Yoo, H. S., & Kim, E. S. (2019). The relationship between government research funding and the cancer burden in South Korea: Implications for prioritising health research. Health Research Policy and Systems, 17(1), 103. https://doi.org/10.1186/s12961-019-0510-6
Keating, N. L., Huskamp, H. A., Kouri, E., Schrag, D., Hornbrook, M. C., Haggstrom, D. A., & Landrum, M. B. (2018). Factors Contributing To Geographic Variation In End-Of-Life Expenditures For Cancer Patients. Health Affairs, 37(7), 1136–1143. https://doi.org/10.1377/hlthaff.2018.0015
Keating, N. L., Landrum, M. B., Lamont, E. B., Bozeman, S. R., & McNeil, B. J. (2012). Area-Level Variations in Cancer Care and Outcomes. Medical Care, 50(5), 366–373. https://doi.org/10.1097/MLR.0b013e31824d74c0
Lee, H.-L., Peng, C.-M., Huang, C.-Y., Wu, S.-Y., Tsai, M.-C., Wang, C.-C., Chen, S.-L., Lin, C.-C., Huang, C.-N., & Sung, W.-W. (2018). Is mortality-to-incidence ratio associated with health disparity in pancreatic cancer? A cross-sectional database analysis of 57 countries. BMJ Open, 8(7), e020618. https://doi.org/10.1136/bmjopen-2017-020618
Liu, X., Li, N., Liu, C., Ren, X., Liu, D., Gao, B., & Liu, Y. (2016). Urban–rural disparity in utilization of preventive care services in China. Medicine, 95(37), e4783. https://doi.org/10.1097/MD.0000000000004783
Luengo-Fernandez, R., Leal, J., & Gray, A. (2015). UK research spend in 2008 and 2012: Comparing stroke, cancer, coronary heart disease and dementia. BMJ Open, 5(4), e006648. https://doi.org/10.1136/bmjopen-2014-006648
Luxon, L. (2015). Infrastructure – the key to healthcare improvement. Future Hospital Journal, 2(1), 4–7. https://doi.org/10.7861/futurehosp.15.002
Mankar, D., Sagar, N., & Patil, P. (2024). Enhancing hospital infrastructure: A comprehensive strategy for planning of supportive services. In K. N. Marimuthu, L. Kanagalakshmi, C. Vallabhapurapu, & K. R. Kumar (Eds.), Futuristic trends in management Volume 3 Book 24 (1st ed., pp. 227–237). Iterative International Publisher, Selfypage Developers Pvt Ltd. https://doi.org/10.58532/V3BHMA24CH28
Maruthappu, M., Ng, K., Williams, C., Atun, R., Agrawal, P., & Zeltner, T. (2015). The association between government healthcare spending and maternal mortality in the E uropean U nion, 1981–2010: A retrospective study. BJOG: An International Journal of Obstetrics & Gynaecology, 122(9), 1216–1224. https://doi.org/10.1111/1471-0528.13205
Mays, G. P., & Smith, S. A. (2011). Evidence Links Increases In Public Health Spending To Declines In Preventable Deaths. Health Affairs, 30(8), 1585–1593. https://doi.org/10.1377/hlthaff.2011.0196
McIntosh, S. A., Alam, F., Adams, L., Boon, I. S., Callaghan, J., Conti, I., Copson, E., Carson, V., Davidson, M., Fitzgerald, H., Gautam, A., Jones, C. M., Kargbo, S., Lakshmipathy, G., Maguire, H., McFerran, K., Mirandari, A., Moore, N., Moore, R., … Head, M. G. (2023). Global funding for cancer research between 2016 and 2020: A content analysis of public and philanthropic investments. The Lancet Oncology, 24(6), 636–645. https://doi.org/10.1016/S1470-2045(23)00182-1
Min, H. S., Yang, H. K., & Park, K. (2018). Supporting Low-income Cancer Patients: Recommendations for the Public Financial Aid Program in the Republic of Korea. Cancer Research and Treatment, 50(4), 1074–1083. https://doi.org/10.4143/crt.2017.401
Monnery, D., & Droney, J. (2024). Enhanced supportive care. British Journal of Hospital Medicine, 85(3), 1–8. https://doi.org/10.12968/hmed.2023.0416
Numasaki, H., Shibuya, H., Nishio, M., Ikeda, H., Sekiguchi, K., Kamikonya, N., Koizumi, M., Tago, M., Ando, Y., Tsukamoto, N., Terahara, A., Nakamura, K., Mitsumori, M., Nishimura, T., Hareyama, M., Teshima, T., & And Of Committee, J. S. T. R. (2011). Japanese Structure Survey of Radiation Oncology in 2007 with Special Reference to Designated Cancer Care Hospitals. Strahlentherapie Und Onkologie, 187(3), 167–174. https://doi.org/10.1007/s00066-010-2205-3
Olver, I., Keefe, D., Herrstedt, J., Warr, D., Roila, F., & Ripamonti, C. I. (2020). Supportive care in cancer—A MASCC perspective. Supportive Care in Cancer, 28(8), 3467–3475. https://doi.org/10.1007/s00520-020-05447-4
Oster, C., McGuiness, C., Duncan, A., & Turnbull, D. (2015). Masculinity and men’s participation in colorectal cancer screening. Psychology of Men & Masculinity, 16(3), 254–263. https://doi.org/10.1037/a0038154
Patafio, F. M., Brooks, S. C., Wei, X., Peng, Y., Biagi, J., & Booth, C. M. (2016). Research Output and the Public Health Burden of Cancer: Is There Any Relationship? Current Oncology, 23(2), 75–80. https://doi.org/10.3747/co.23.2935
Ramsey, S. D., Bansal, A., Fedorenko, C. R., Blough, D. K., Overstreet, K. A., Shankaran, V., & Newcomb, P. (2016). Financial Insolvency as a Risk Factor for Early Mortality Among Patients With Cancer. Journal of Clinical Oncology, 34(9), 980–986. https://doi.org/10.1200/JCO.2015.64.6620
ReFaey, K., Tripathi, S., Grewal, S. S., Quinones, D. J., Chaichana, K. L., Antwi, S. O., Cooper, L. T., Meyer, F. B., Dronca, R. S., Diasio, R. B., & Quinones-Hinojosa, A. (2019). Current Leading Cause of Death in the World: Cancer versus Cardiovascular Disease. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3396025
Shear, B. R., Nordstokke, D. W., & Zumbo, B. D. (2018). A Note on Using the Nonparametric Levene Test When Population Means Are Unequal. https://doi.org/10.7275/BWVG-D091
Siegel, R. L., Miller, K. D., Wagle, N. S., & Jemal, A. (2023). Cancer statistics, 2023. CA: A Cancer Journal for Clinicians, 73(1), 17–48. https://doi.org/10.3322/caac.21763
Sikora, K., & Evans, P. (2025). Future Organization of Cancer Care. In International Encyclopedia of Public Health (pp. 272–281). Elsevier. https://doi.org/10.1016/B978-0-323-99967-0.00155-1
Stevens, W., Philipson, T. J., Khan, Z. M., MacEwan, J. P., Linthicum, M. T., & Goldman, D. P. (2015). Cancer Mortality Reductions Were Greatest Among Countries Where Cancer Care Spending Rose The Most, 1995–2007. Health Affairs, 34(4), 562–570. https://doi.org/10.1377/hlthaff.2014.0634
Stewart, S. L., Hayes, N. S., Moore, A. R., Ii, R. B., Brown, P. M., & Wanliss, E. (2018). Combating cancer through public health practice in the United States: An in-depth look at the National Comprehensive Cancer Control Program. In Md. A. A. Majumder, R. Kabir, & S. Rahman (Eds.), Public health—Emerging and re-emerging issues. InTech. https://doi.org/10.5772/intechopen.78582
Sung, W., Au, K., Wu, H., Yu, C., & Wang, Y. (2021). Improved trends of lung cancer mortality‐to‐incidence ratios in countries with high healthcare expenditure. Thoracic Cancer, 12(11), 1656–1661. https://doi.org/10.1111/1759-7714.13912
Thompson, L., Reeder, T., & Abel, G. (2012). ‘I can’t get my husband to go and have a colonoscopy’: Gender and screening for colorectal cancer. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 16(3), 235–249. https://doi.org/10.1177/1363459311403948
Torres, Á., Oliver, J., Frecha, C., Montealegre, A. L., Quezada-Urbán, R., Díaz-Velásquez, C. E., Vaca-Paniagua, F., & Perdomo, S. (2017). Cancer Genomic Resources and Present Needs in the Latin American Region. Public Health Genomics, 20(3), 194–201. https://doi.org/10.1159/000479291
Wilking, N., Karolinska Institutet, Solna, Sweden, Lopes, G., Sylvester Comprehensive Cancer Center, University of Miami, FL, US, Meier, K., HKK Soltau, Lower Saxony & Heidekreis-Klinikum GmbH, Soltau, Germany, Simoens, S., KU Leuven, Leuven, Belgium, Van Harten, W., University Twente, Enschede, The Netherlands, Rijnstate Hospital, Arnhem, The Netherlands, Vulto, A., & Erasmus University Medical Center, Rotterdam, The Netherlands. (2017). Can we Continue to Afford Access to Cancer Treatment? European Oncology & Haematology, 13(02), 114. https://doi.org/10.17925/EOH.2017.13.02.114
Xu, B. (2024). Progress in Therapy of Lung Cancer. Highlights in Science, Engineering and Technology, 109, 103–108. https://doi.org/10.54097/wxpa7677
Yu, Z., Li, W., Shangguan, X., Cai, Y., Gao, Q., Wang, X., Chen, Y., Liu, D., & Zhang, C. (2022). Knowledge, Practices, and Perceived Barriers in Cancer Pain Management at Oncology Units: A Cross-Sectional Survey of Medical Staff in China. Journal of Pain Research, Volume 15, 159–169. https://doi.org/10.2147/JPR.S339377
Zhu, J., Li, S., Li, X., Wang, L., Du, L., & Qiu, Y. (2024). Impact of population ageing on cancer-related disability-adjusted life years: A global decomposition analysis. Journal of Global Health, 14, 04144. https://doi.org/10.7189/jogh.14.04144
Zlatareva, A., Krahtova, K., & Kazak, Tch. (2017). The Cost of Oncology Medicines. Acta Medica Bulgarica, 44(1), 22–29. https://doi.org/10.1515/amb-2017-0004
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