Assessment and future projection of brain and central nervous system cancer burden using a modified quality care index: evidence from the Global Burden of Disease 2021

Abstract

Purpose

This study aimed to assess global central nervous system (CNS) cancer care quality and predict future trends, focusing on age, sex, and socioeconomic determinants.

Methods

A cross-sectional study was conducted using data from the Global Burden of Disease (GBD) database (1990–2021). Principal component analysis (PCA) was applied to develop a composite quality of care index (QCI). Stratified analyses were performed by sociodemographic index (SDI), sex, and age groups. Linear mixed-effects models (LMM) were used to evaluate associations, and Bayesian age-period-cohort (BAPC) analysis projected QCI trends from 2022 to 2050.

Results

From 1990 to 2021, global CNS cancer QCI improved but showed significant regional heterogeneity. Japan had the highest QCI (100), while China exhibited the fastest annual growth rate (3.41 %). Females consistently had higher QCI (37.49) compared to males (32.98). QCI declined with advancing age (5–9 years: β = −0.309; 95+ years: β = −2.385) and increased with higher SDI levels (low-middle SDI: β = 0.156; high SDI: β = 1.669). High-SDI countries accounted for 53.13 % of age-related QCI improvements. Projections indicated a sustained increase in global QCI from 2022 to 2050.

Conclusions

This study introduced a novel QCI framework to evaluate global CNS cancer care quality, projecting continued improvements until 2050. High-SDI regions demonstrated superior healthcare outcomes compared to low-SDI areas, with distinct age-related patterns. The findings highlight the urgent need for targeted healthcare investments in low-SDI regions and global collaborations to reduce disparities and enhance healthcare delivery worldwide.