{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:23:40Z","timestamp":1793197420116,"version":"4.5.0"},"reference-count":55,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T00:00:00Z","timestamp":1578355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to describe the mortality burden and macroeconomic effects of head and neck cancer as well as delineate the role of surgical workforce in improving head and neck cancer outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Statistical and economic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Research group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects and Methods<\/jats:title>\n                    <jats:p>We conducted a statistical analysis on data from the World Development Indicators and the 2016 Global Burden of Disease study to describe the relationship between surgical workforce and global head and neck cancer mortality\u2010to\u2010incidence ratios. A value of lost output model was used to project the global macroeconomic effects of head and neck cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant differences in mortality\u2010to\u2010incidence ratios existed between Global Burden of Disease study superregions. An increase of surgical, anesthetic, and obstetric provider density by 10% significantly correlated with a reduction of 0.76% in mortality\u2010to\u2010incidence ratio (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;. 0001; adjusted\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0.84). There will be a projected global cumulative loss of $535 billion US dollars (USD) in economic output due to head and neck cancer between 2018 and 2030. Southeast Asia, East Asia, and Oceania will suffer the greatest gross domestic product (GDP) losses at $180 billion USD, and South Asia will lose $133 billion USD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The mortality burden of head and neck cancer is increasing and disproportionately affects those in low\u2010 and middle\u2010income countries and regions with limited surgical workforces. This imbalance results in large and growing economic losses in countries that already face significant resource constraints. Urgent investment in the surgical workforce is necessary to ensure access to timely surgical services and reverse these negative trends.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0194599819897265","type":"journal-article","created":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T04:42:11Z","timestamp":1578372131000},"page":"296-303","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":125,"title":["Global Burden of Head and Neck Cancer: Economic Consequences, Health, and the Role of Surgery"],"prefix":"10.1002","volume":"162","author":[{"given":"Rolvix H.","family":"Patterson","sequence":"first","affiliation":[{"name":"Program in Global Surgery and Social Change Harvard Medical School Boston Massachusetts USA"},{"name":"Tufts University School of Medicine Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria G.","family":"Fischman","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Wasserman","sequence":"additional","affiliation":[{"name":"Program in Global Surgery and Social Change Harvard Medical School Boston Massachusetts USA"},{"name":"Icahn School of Medicine at Mount Sinai New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Siu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Toronto Toronto Ontario Canada"},{"name":"Harvard T. 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Chan School of Public Health Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark G.","family":"Shrime","sequence":"additional","affiliation":[{"name":"Program in Global Surgery and Social Change Harvard Medical School Boston Massachusetts USA"},{"name":"Center for Global Surgery Evaluation Massachusetts Eye and Ear Infirmary Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes J.","family":"Fagan","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology University of Cape Town Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Johns Hopkins University Baltimore Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blake C.","family":"Alkire","sequence":"additional","affiliation":[{"name":"Program in Global Surgery and Social Change Harvard Medical School Boston Massachusetts USA"},{"name":"Center for Global Surgery Evaluation Massachusetts Eye and Ear Infirmary Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32154-2"},{"key":"e_1_2_9_3_1","unstructured":"World Health Organization.Global strategy and action plan on ageing and health.2017.https:\/\/www.who.int\/ageing\/WHO\u2010GSAP\u20102017.pdf?ua=1. 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