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Article

Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019

Global Burden of Disease 2019 Cancer Collaboration
Author Global Burden of Disease 2019 Cancer Collaboration
Kocarnik, Jonathan M
Author Kocarnik, Jonathan M Institute for Health Metrics and Evaluation, University of Washington, Seattle
Compton, Kelly
Author Compton, Kelly Institute for Health Metrics and Evaluation, University of Washington, Seattle
Dean, Frances E
Author Dean, Frances E Institute for Health Metrics and Evaluation, University of Washington, Seattle
Fu, Weijia
Author Fu, Weijia Institute for Health Metrics and Evaluation, University of Washington, Seattle
Gaw, Brian L
Author Gaw, Brian L Institute for Health Metrics and Evaluation, University of Washington, Seattle
Harvey, James D
Author Harvey, James D Institute for Health Metrics and Evaluation, University of Washington, Seattle
Henrikson, Hannah Jacqueline
Author Henrikson, Hannah Jacqueline Department of Global Health, Boston University, Boston, Massachusetts Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
Lu, Dan
Author Lu, Dan Institute for Health Metrics and Evaluation, University of Washington, Seattle
Pennini, Alyssa
Author Pennini, Alyssa Institute for Health Metrics and Evaluation, University of Washington, Seattle

JAMA oncology. 2022 ; 8 (3) : 420-444. [pub] 2022Mar01

JAMA Oncol
ISSN 2374-2445
Medvik
Source

IMPORTANCE: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW: The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS: In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE: The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.

Web resource

In the wake of the pandemic : preparing for long COVID

Health systems and policy analysis. Policy brief ; 39

25 stran : ilustrace

Article

The best person (or machine) for the job: Rethinking task shifting in healthcare

Health policy. 2020 ; 124 (12) : 1379-1386. [pub] 20200830

Health Policy
ISSN 1872-6054
Medvik
Source

Globally, health systems are faced with the difficult challenge of how to get the best results with the often limited number of health workers available to them. Exacerbating this challenge is the task of meeting ever-changing needs of service users and managing unprecedented technological advances. The process of matching skills to changing needs and opportunities is termed task shifting. It involves questioning health service goals, what health workers do, asking if it can be done in a better way, and implementing change. Task shifting in healthcare is often conceptualised as a process of transferring responsibility for 'simple' tasks from high-skilled but scarce health workers to those with less expertise and lower pay, and predominantly viewed as a means to reduce costs and promote efficiency. Here we present a position paper based on the work and expertise of the European Commission Expert Panel on Effective ways of Investing in Health. It contends that this is over simplistic, and aims to provide a new task shifting framework, informed by relevant evidence, and a series of recommendations. While far from comprehensive, there is a growing body of evidence that certain tasks traditionally undertaken by one type of health worker can be undertaken by others (or machines), in some cases to a higher standard, thus challenging the persistence of rigid professional boundaries. Task shifting has the potential to contribute to health systems strengthening when accompanied by adequate planning, resources, education, training and transparency.

Web resource

The changing role of the hospital in European health systems

European Observatory on Health Systems and Policies Series

xix, 305 stran : ilustrace, grafy

Hospitals today face a huge number of challenges, including new patterns of disease, rapidly evolving medical technologies, ageing populations and continuing budget constraints. This book is written by clinicians for clinicians and hospital managers, and those who design and operate hospitals. It sets out why hospitals need to change as the patients they treat and the technology to treat them changes. In a series of chapters by leading authorities in their field, it challenges existing models, reviews best practice from many countries and presents clear policy recommendations for policymakers and hospital administrators. It covers the main patient groups and conditions as well as those departments that make modern effective care possible, in imaging and laboratory medicine. Each chapter looks at patient pathways, aspects of workforce, required levels of specialisation and technology, and the opportunities and challenges for optimising the delivery of services in the hospital of the future. Hospitals must change in the face of changing technologies and patient needs. This book is written by clinicians who work in hospitals and know them best and is designed for hospital professionals, giving them the evidence they need to call for change, and for policy-makers and planners charged with designing and operating hospitals now and in the future.