Mg. Aguilera-Eguía, Raúl

Objectives To assess the association between the Human Development Index (HDI) and covariates on the mortality- to- incidence ratio (MIR) of lips and oral cavity cancer (LOCC) in Mexico. Design Ecological study. Setting Data from 32 Mexican states for year 2019. Participants Data set of male and female populations from Mexico. Exposures Socioeconomic conditions based on HDI and covariates related to healthcare system capacity (total health spending per capita, school dropout and ratio of medical personnel in direct contact with patients). Primary and secondary outcome measures MIR of LOCC by state and sex was calculated from the Global Burden of Disease Study website for year 2019. Data for calculating HDI 2019 by state and covariates were obtained from the National Institute of Statistics and Geography. A multiple regression model was constructed to measure the effects of HDI and covariates on LOCC- MIR. Results Among the states with the highest HDI (>0.780), Colima had the highest aged- standardised rates per 100.000 in men for incidence (5.026) and mortality (3.118). The greatest burden of the disease was found on men, with the highest Men:Women MIR in Colima (3.10) and Baja California Sur (2.73). The highest MIR (>0.65) was found among the states with the lowest HDI (Oaxaca and Chiapas). For each unit of increase of the HDI there was a decrease in the LOCC- MIR of −0.778, controlling for the covariates. The most suitable regression model explained the 57% (F (p): 0.000) of the variance. Conclusions Men were most affected by LOCC in Mexican states. The highest MIRs of LOCC were found in the states with the highest HDI. But a worse prognosis of the disease, expressed as a higher MIR, is expected in contexts with lower HDI in the country, even with lower MIRs.

To evaluate the relationship between the Human Development Index (HDI) and its components with oral cancer (OC) in Latin America. Ecological study in 20 Latin American countries in 2010 and 2017, which evaluated the relationship between the AgeStandardized Rates (ASRs) of incidence and mortality from oral cancer and the following indicators: HDI, with its components (income, education, and health indexes); and the Gini and Theil-L indexes. Among the countries with the highest HDI, men from Brazil and Cuba had the highest incidence and mortality ASRs per 100,000 inhabitants (ASR incidence >7.5 and mortality >4.5). Among those with the lowest HDI, Haiti was the most affected country (ASR incidence >4.1 and mortality >3.0). The highest male:female ratio was in Paraguay in both years (incidence >3.5 and mortality >4.0). Mortality from oral cancer is negatively related to the global HDI in both years, with regression coefficients (95% confidence interval) being −5.78 (−11.77, 0.20) in 2010 and −5.97 (−11.38, −0.56) in 2017; and separate (independent) from the income [−4.57 (−9.92, 0.77) in 2010 and −4.84 (−9.52, −0.17) in 2017] and health indexes [−5.81 (−11.10, −0.52) and −6.52 (−11.32, −1.72) in 2017] (p < 0.05) in the countries with lower HDI. Oral cancer incidence and mortality rates vary both among and within Latin American countries according to sex, with a greater burden on men. The HDI is negatively related to mortality from oral cancer in the countries of medium and low HDI.