Global, regional, and national trends in 34 cancers through a novel burden-quality-of-care framework - A cross-sectional study

Q: What problem does the study address in existing cancer evaluation systems?

Existing approaches rely on unidimensional cancer evaluation systems that limit precise cancer control. The study proposes a framework integrating burden and quality of care to evaluate management effectiveness more accurately.

Q: How is the quality-of-care index (QCI) created in this research?

QCI is derived from principal component analysis of six standardized indicators using Global Burden of Disease data from 1990 to 2021.

Q: What disparities are found regarding socioeconomic factors and gender?

Socioeconomic factors significantly shape intervention equity: SDI correlates strongly and positively with QCI, while correlates negatively with gender disparity ratios. Gender disparities are pervasive, with females receiving better-quality care for most cancers across most regions.

Sep 22, 2026

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Global cancer control is constrained by unidimensional evaluation systems that inadequately capture management effectiveness across settings. This cross-sectional study develops a multidimensional burden–quality-of-care framework by integrating disease burden with a quality-of-care index (QCI) derived from principal component analysis of six standardized indicators using Global Burden of Disease data (1990–2021). It maps inequities via SDI and gender disparity ratios across 204 countries/regions for 34 cancers.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Background

Methods

Quality-of-care index construction

Burden–quality quadrants and inequality assessment

Results

Conclusion

Global, regional, and national trends in 34 cancers through a novel burden–quality-of-care framework: a cross-sectional study Lingkang Dong, MDa,b , Qiang Ma, MDa,b ,*, Jiaxin Yang, MSca,b,c , Yihan Cheng, MSd , Wenqi Dong, MDa,b , Boya Zhang, MSca,b , Yuli Hu, MSca,b,c , Chao Du, MSce , Wen Lu, MDa,b ,*, Dongzhen Yu, MD, PhDa,b ,*, Haibo Shi, MD, PhDa,b ,* Background: Current unidimensional cancer evaluation systems limit precise cancer control. This study establishes a novel burden–quality framework that integrates disease burden and quality-of-care index (QCI) to better assess cancer management effectiveness globally. Methods: The QCI was derived by principal component analysis of six standardized indicators using the Global Burden of Disease data (1990–2021) . A four-quadrant framework integrated QCI with disease burden to classify 34 cancers across 204 countries/ regions. The sociodemographic index (SDI) and gender disparity ratios (GDR) were used to assess inequalities. Results: Substantial heterogeneity exists in the burden and QCI across 34 cancers. Highly fatal cancers such as TBL cancers (tracheal, bronchus, and lung cancers) and pancreatic cancers are persistently trapped in a “high burden-low quality” dilemma. In contrast, high-burden breast cancer and low-burden thyroid cancer demonstrate superior QCI, though the latter may carry overtreatment risks. Socioeconomic factors have a profound influence on intervention equity, with SDI exhibiting a strong positive correlation with QCI (r = 0.90, P < 0.001) but a significant negative correlation with GDR (r = −0 .71, P < 0.001) . Notably, the trend of QCI improvement and overall reduction in cancer burden is asynchronous: high-survival cancers and high-SDI regions showed slow QCI gains, middle-SDI regions exhibited substantial increases, while low-SDI areas remained persistently disadvantaged. Demographic disparities further exacerbated these inequities – older populations bore a disproportionate disease burden yet achieved the fastest QCI improvements, whereas adolescent groups maintained high baseline quality but stagnated in progress. Additionally, gender disparities were pervasive, with females receiving better-quality care for most cancers and across most regions. Conclusion: This multidimensional burden–quality framework shifts cancer evaluation from singular evaluation to precision intervention. It emphasizes: (1) optimizing resources for high-burden–low-quality cancers,(2) avoiding overtreatment in low-burden cancers, and (3) reducing inequities linked to socioeconomic disparities and vulnerable groups (especially elderly and male patients) . This research provides a foundation for precise and equitable global cancer control. Keywords: burden, cancer, cross-sectional study, global burden of disease, multidimensional framework, quality of care Introduction Cancer prevention and control, as a core issue of global public health, confronts dual challenges of escalating disease burden and imbalanced resource allocation [1] . In 2022, global new aDepartment of Otolaryngology Head & Neck Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China, bOtolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China, cDepartment of Nursing, The Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China, dDepartment of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China and eDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China Lingkang Dong, Qiang Ma, Jiaxin Yang, and Yihan Cheng contributed equally to this work. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. *Corresponding authors. Address: Department of Otolaryngology Head & Neck Surgery, Shanghai Sixth People’s Hos

FAQs

What problem does the study address in existing cancer evaluation systems?

Existing approaches rely on unidimensional cancer evaluation systems that limit precise cancer control. The study proposes a framework integrating burden and quality of care to evaluate management effectiveness more accurately.

How is the quality-of-care index (QCI) created in this research?

QCI is derived from principal component analysis of six standardized indicators using Global Burden of Disease data from 1990 to 2021.

What disparities are found regarding socioeconomic factors and gender?

Socioeconomic factors significantly shape intervention equity: SDI correlates strongly and positively with QCI, while correlates negatively with gender disparity ratios. Gender disparities are pervasive, with females receiving better-quality care for most cancers across most regions.

Sep 22, 2026

Upload by Miles