National Cancer System Characteristics and Prostate Cancer Outcomes: An Analysis of Global Data

Area of Science:

• Global Health
• Oncology
• Health Systems Research

Background:

• Prostate cancer is a leading global cancer in men, with cases projected to double by 2040.
• Understanding health system factors is crucial for effective prostate cancer control planning.

Purpose of the Study:

• To identify health system metrics associated with prostate cancer mortality-to-incidence ratios (MIR).
• To inform health system planning for the increasing global burden of prostate cancer.

Main Methods:

• Ecological cross-sectional study using national health system metrics and prostate cancer data from the International Agency for Research on Cancer (IARC).
• Analysis included mortality-to-incidence ratios (MIR) and factors like GDP, UHC index, surgical workforce, and radiotherapy centers.
• Univariable and multivariable linear regression models were used to assess associations.

Main Results:

• 185 countries' data were analyzed; 123 had complete data for the final multivariable model.
• Surgical workforce, UHC index, radiotherapy centers per 1000 population, and GDP per capita were independently associated with lower (improved) prostate cancer MIR.
• The final multivariable model explained 84.08% of the variation in MIR (R²=0.8408).

Conclusions:

• Improved prostate cancer outcomes are associated with a robust surgical workforce, universal health coverage (UHC), accessible radiotherapy, and higher GDP per capita.
• These findings highlight key areas for health system strengthening to address the growing global burden of prostate cancer.
• Prioritizing access to surgery and radiotherapy within equitable cancer care systems is recommended for public health efforts.