Cancer mortality differences among urban and rural residents in Lithuania

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to describe and to compare the cancer mortality rates in urban and rural residents in Lithuania.</p> <p>Methods</p> <p>Cancer mortality has been studied using the materials of the Lithuanian cancer registry. For the period 1993–2004 age-standardized urban and rural population mortality rates (World standard) were calculated for all malignant neoplasm's and for stomach, colorectal, lung, prostate, breast and cervical cancers. The annual percentage change (APC) was calculated using log-linear regression model, two-sided Mantel-Haenzel test was used to evaluate differences in cancer mortality among rural and urban populations.</p> <p>Results</p> <p>For males in rural population cancer mortality was higher than in urban (212.2 and 197.0 cases per 100000) and for females cancer mortality was higher in urban population (103.5 and 94.2 cases per 100000, p < 0.05). During the study period the age-standardized mortality rates decreased in both sexes in urban residents. The decreasing mortality trend in urban population was contributed by decline of the rates of lung and stomach cancer in male and breast, stomach and colorectal cancer in female. Mortality rates in both urban and rural population were increasing for prostate and cervical cancers.</p> <p>Conclusion</p> <p>This study shows that large rural and urban inequalities in cancer mortality exist in Lithuania. The contrast between the health of residents in urban and rural areas invites researchers for research projects to develop, implement, and enhance cancer prevention and early detection intervention strategies for rural populations.</p

Cost of diabetes care in out-patient clinics of Karachi, Pakistan

<p>Abstract</p> <p>Background</p> <p>Diabetes Mellitus (DM) is a growing epidemic and the cost of treating diabetes is largely increasing. The objective of this study was to estimate the cost-of-illness of DM among attendees of out-patient clinics in Karachi, Pakistan. This is the first study conducted from a societal perspective to estimate the cost of managing diabetes in Pakistan.</p> <p>Methods</p> <p>A prevalence-based 'Cost-of-Illness' study for diabetes care was conducted in six different out-patient clinics of Karachi, Pakistan from July to September 2006. A pre-tested questionnaire was administered to collect the data from 345 randomly selected persons with diabetes.</p> <p>Results</p> <p>The annual mean direct cost for each person with diabetes was estimated to be Pakistani rupees 11,580 (US$ 197). Medicines accounted for the largest share of direct cost (46%), followed by laboratory investigations (32%). We found that increased age, the number of complications and longer duration of the disease significantly increase the burden of cost on society (p < 0.001). Comparing cost with family income it was found that the poorest segment of society is spending 18% of total family income on diabetes care.</p> <p>Conclusion</p> <p>This study concluded that substantial expenditure is incurred by people with diabetes; with the implication that resources could be saved by prevention, earlier detection and a reduction in diabetes co-morbidities and complications through improved diabetes care. Large scale and cost-effective prevention programs need to be initiated to maximise health gains and to reverse the advance of this epidemic.</p