A Health Systems Analysis of Global Head and Neck Cancer Outcomes
4
Issued Date
2026-01-01
Resource Type
ISSN
0023852X
eISSN
15314995
Scopus ID
2-s2.0-105034979192
Journal Title
Laryngoscope
Rights Holder(s)
SCOPUS
Bibliographic Citation
Laryngoscope (2026)
Suggested Citation
Dee E.C., Go A.E., Feliciano E.J.G., Wu J.F., Willmann J., Lapen K., Treechairusame T., Patel M.S., Ranganathan S., Hammond A., Wu Y., Singh A., Wong A.M., Jacomina L.E., Ma J., Iyengar P., Estilo C.L., Kingham T.P., Lee N.Y. A Health Systems Analysis of Global Head and Neck Cancer Outcomes. Laryngoscope (2026). doi:10.1002/lary.70534 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116168
Title
A Health Systems Analysis of Global Head and Neck Cancer Outcomes
Author's Affiliation
The University of Texas at Austin
Harvard University
Yale University
National Taiwan University
Icahn School of Medicine at Mount Sinai
Memorial Sloan-Kettering Cancer Center
Medical College of Wisconsin
UniversitatsSpital Zurich
Siriraj Hospital
Department of Medicine
University of Santo Tomas Hospital
Cebu Institute of Medicine
Harvard University
Yale University
National Taiwan University
Icahn School of Medicine at Mount Sinai
Memorial Sloan-Kettering Cancer Center
Medical College of Wisconsin
UniversitatsSpital Zurich
Siriraj Hospital
Department of Medicine
University of Santo Tomas Hospital
Cebu Institute of Medicine
Corresponding Author(s)
Other Contributor(s)
Abstract
Objectives: Head and neck cancer (HNC) remains a major global cause of cancer morbidity and mortality, with disproportionately poor outcomes in low- and middle-income countries. Substantial cross-national disparities suggest an important role for health system strengthening. We evaluated associations between national health system characteristics and global HNC outcomes. Methods: We conducted a cross-sectional ecological analysis of 185 countries using sex-stratified, age-standardized incidence and mortality estimates from the International Agency for Research on Cancer (IARC) GLOBOCAN 2022 database. The primary outcome was the composite mortality-to-incidence ratio (MIR) for aggregated HNCs, including cancers of the lip and oral cavity, oropharynx, larynx, nasopharynx, hypopharynx, and salivary gland. Eleven national health system indicators capturing health financing, workforce density, service availability, socioeconomic development, and gender equity were evaluated. Univariable linear regressions identified candidate variables using Bonferroni correction (p < 0.0045), followed by multivariable modeling with assessment for multicollinearity using variance inflation factors. Results: All 11 health system indicators were significantly associated with HNC MIR on univariable analysis (p < 0.001 for all). In multivariable analysis of 123 countries with complete data, higher Universal Health Coverage (UHC) service coverage index and higher gross domestic product (GDP) per capita were independently associated with lower (improved) HNC MIR (model R<sup>2</sup> = 0.70). Findings were consistent in sex-stratified analyses. Conclusions: Across countries, progress toward universal health coverage and greater national economic capacity was independently associated with improved HNC outcomes. These findings may help to inform efforts at the level of health systems to improve HNC outcomes worldwide. Level of Evidence: N/A.