Working Paper of Public Health Volume 2012 - Azienda Ospedaliera ...

More documents

Recommendations

Info

Azienda Ospedaliera Nazionale“SS. Antonio e Biagio e Cesare Arrigo”Working Paper of Public Healthnr. 7/2012Incidence of breast cancer based on Age-standardized rate (ASW), that is thenumber of new cases per 100 000 persons per year. An age-standardized rate is therate that a population would have if it had a standard age structure. Standardizationis necessary when comparing several populations that differ with respect to agebecause age has a powerful influence on the risk of cancer. Data of worldwidebreast cancer are based on 2008 year from the source GLOBOCAN (2008).Gross domestic product (GDP) per capita by purchasing power parity - PPP(current international $) 1994-2000 period (arithmetic mean). Gross domesticproduct (GDP) is a measure of the economic activity. It is defined as the value ofall goods and services produced minus the value of any goods or services used intheir creation. Data are from World Development Indicators by World Bank 2008.Medical equipment for cancer diagnosis is measured by Computed Tomography(CT) - Total density per 1 000 000 population. As worldwide data on screeningmammography examinations are not available, the presence of this medicalequipment is a main proxy to assess the general capacity of screening amongcountries. In addition, this indicator also shows the quality of health service indiagnostics and also therapeutics, associated to the level of development ofcountries. Several research reports the effectiveness of magnetic resonance imaging(MRI) in making diagnosis, however MRI scanner can provide difference indiagnostic accuracy. The CT scanner does not generate a difference in performancefor daily clinical use and provides; “images in the surgical position, and it has beenreported as a useful diagnosing in the extent of breast cancer” (Kuroki-Suzuki,2010, p. 15). For this reasons, we use CT as main marker of screening capacity ofbreast cancer across countries. Data consider 2008 period and are by World HealthOrganization (2012).Data are based on 109 countries that have been subjected to a process of horizontal andvertical cleaning, eliminating outliers. Final dataset, with all variables, includes 52 countries.The normal distribution of variables is checked by Curtosi and Skewness coefficients, as wellas by the normal Q-Q plot (tab.4), using the statistics software SPSS (Statistical Package forthe Social Sciences). Data are analyzed through descriptive statistics, correlation andregression analysis, and ANOVA to measure the interaction between breast cancer andwealth across countries. In particular, correlation analyzes the association by bivariate8
Azienda Ospedaliera Nazionale“SS. Antonio e Biagio e Cesare Arrigo”Working Paper of Public Healthnr. 7/2012correlation and partial correlation, with control variables latitude, computed tomography (CT)and magnetic resonance imaging (MRI); coefficient of correlation r has a range 1 r +1.Regression analysis is based on the functional relationship:Incidence of Breast Cancer i, t = f (GDP i, t-n, Medical Equipment -CT i, t)Assumption 1: The level of wealth of countries at time t-n affects the breast cancer trends ofthe country i, at time t.Assumption 2: Medical equipment at time t plays a vital role for screening the breast cancer attime t of the country i.The specification is based on a multiple regression Log Linear model with two explanatoryvariables:LN BREAST Cancer( ASR)i, 2008 0 1LNGDP PPPi,(19942000) 2LN Medical Equipment(CT )i,2008 ui,tRemark: the i subscript indicates the country and t the time; GDP-PPP is the arithmetic meanover 1994-2000.In addition, the study here considers two sets (1 and 2), each of size n, represented by: 1)countries within the temperate zone North and South (from 23.5 degrees North latitude to theapproximately 66.5 degrees north latitude and from approximately 23.5 degrees south latitudeto the Antarctic Circle: at approximately 66.5 degrees south latitude) and 2) complementaryset of countries not in the temperate zone.Assumption: countries of temperate zone have better socio-economic-environmental locationsthat spur fruitful patterns of economic growth.Remarks: The favorable geo-economic location of countries in temperate zone, due to higherlatitude, support economic growth, consumptions, needs, habits and style of life typical ofadvanced countries.Statistical hypotheses, to test Hp 1 by the average GDP per capita within these sets 1 and 2,are:H 0 = 1 (average incidence of breast cancer ASW) = 2 (average incidence of breast cancer ASW)H 1 : 1 (average incidence of breast cancer ASW) 2 (average incidence of breast cancer ASW)It will be assumed that the sample variances are all equal. From the analysis of variance(ANOVA), considering the null hypothesis and F-distribution, we would expect a large valuefor the F-test in order to reject H 0 in favor of H 1. These statistical analyses are carried out bySPSS software.9
Page 2 and 3:
La serie di Working Paper of Public
Page 4 and 5:
Azienda Ospedaliera Nazionale“SS.
Page 6 and 7:
Page 8 and 9:
Page 10 and 11:
Page 12 and 13:
Page 14 and 15:
Page 16 and 17:
Page 18 and 19:
Page 20 and 21:
Page 22 and 23:
Page 24 and 25:
Azienda Ospedaliera NazionaleSS. An
Page 26 and 27:
Page 28 and 29:
Page 30 and 31:
Page 32 and 33: Azienda Ospedaliera Nazionale“SS.
Page 132 and 133:
Page 134 and 135:
Page 136 and 137:
Page 138 and 139:
Page 140 and 141:
Page 142 and 143:
Page 144 and 145:
Page 146 and 147:
Page 148 and 149:
Page 150 and 151:
Page 152 and 153:
Page 154 and 155:
Page 156 and 157:
Page 158 and 159:
Page 160 and 161:
Page 162 and 163:
Page 164 and 165:
Page 166 and 167:
Page 168 and 169:
Page 170 and 171:
Page 172 and 173:
Page 174 and 175:
Page 176 and 177:
Page 178 and 179:
Page 180 and 181:
Page 182 and 183:
Page 184 and 185:
Page 186 and 187:
Page 188 and 189:
Page 190 and 191:
Page 192 and 193:
Page 194 and 195:
Page 196 and 197:
Page 198 and 199:
Page 200 and 201:
Page 202 and 203:
Page 204 and 205:
Page 206 and 207:
Page 208 and 209:
Page 210 and 211:
Page 212 and 213:
Page 214 and 215:
Page 216 and 217:
Page 218 and 219:
Page 220 and 221:
Page 222 and 223:
Page 224 and 225:
Page 226 and 227:
Page 228 and 229:
Page 230 and 231:
Page 232 and 233:
Page 234 and 235:
Page 236 and 237:
Page 238 and 239:
Page 240 and 241:
Page 242 and 243:
Page 244 and 245:
Page 246 and 247:
Page 248 and 249:
Page 250 and 251:
show all

Working Paper of Public Health Volume 2012 - Azienda Ospedaliera ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?