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Cancer mortality-to-incidence ratio among Iraqi citizens: Nine-year National Estimates (2012-2020) and its relation to population growth rate and health expenditure
Background: Cancer continues to be a significant worldwide health concern with substantial mortality. The cancer mortality-to-incidence ratio (MIR) a proxy measure of observed five-year survival can serve as a valuable indicator of cancer management outcomes and healthcare disparities among countries. This study aims to determine the MIR trend for all cancers combined among Iraqi citizens during 2012-2020 for health expenditure percentages out of the gross domestic product (e/GDP (%)) and population growth rate.
Methods: The study used the Iraqi Cancer Registry annual reports for cancer data and World Bank data for health expenditure and population growth. Simple linear regression analysis examined the relationship between health expenditure growth rate and MIR while joinpoint regression analysis examined the trend over time. The Ethics Committee of the College of Medicine at the University of Basrah approved the study.
Results: An increasing trend in crude incidence rates for all cancer types combined was seen with a decrease in mortality rates from 2012 to 2020 in both sexes. A non-statistically significant reduction in MIR was found with an average annual percent change (AAPC) of -3.1% (P = 0.100). The decrease in MIR was higher among females than males with a statistically significant difference (P = 0.003). High health expenditure presented as e/GDP (%) was associated with a favorable cancer survival rate but this was not statistically significant (R2 = 0.263 P = 0.158). In contrast a low growth rate was significantly associated with cancer patients’ survival (R2 = 0.505 P = 0.032).
Conclusions: As indicated by the MIR and the MIR complement (1-MIR) the proxy five-year survival rate is improving in Iraq with time. Although not statistically significant high health expenditure favorably affected overall cancer survival. A low growth rate on the other hand significantly improves cancer patients’ survival.
The role of non-HDL cholesterol and atherogenic indices in predicting poor glycemic control among type 2 diabetic patients in Basrah, Iraq
Background: Dyslipidaemia is frequently associated with type 2 diabetes mellitus and it is the major contributor to cardiovascular diseases among type 2 diabetic patients. Despite the fact that several researches have proven the association between glycemic control and dylipidemia in type 2 diabetic patients the results are rather varied.
Objectives: The aim of the study is to investigate the clinical relevance of lipid profile as predictive biochemical model for glycemic control in type 2 diabetic patients.
Methods: A cross-sectional study including 329 type 2 diabetic patients was done in Al-Sadr Teaching Hospital Basrah Iraq. Brief history clinical examination and investigations including fasting plasma glucose lipid profile and glycosylated hemoglobin were done. HbA1c >7% was considered as poor glycemic control. Receiver operator characteristics (ROC) analysis and logistic regression analysis were used to evaluate the association between lipid profile and HbA1c level.
Results: Out of 329 diabetic patients 278 (84.5%) showed poor glycemic control. The univariate analysis showed a significant association between lipid parameters and poor glycemic control. ROC and logistic regression analyses found that TC/HDL (OR: 4.94; 95% CI: 2.35–10.41; P < 0.001) and LDL/HDL (OR: 4.63; 95% CI: 1.96–10.98; P < 0.001) were the only significant independent predictors of glycemic control while non-HDL cholesterol was a weak predictor of glycemic control despite its significant association (P = 0.02).
Conclusion: LDL/HDL and TC/HDL ratios reveal promising indicators for predicting glycemic control in type 2 diabetic patients.