According to GLOBOCAN 2022 data, Tracheal, Bronchus, and Lung (TBL) cancer continues to pose a critical threat to public health, ranking at the peak of global cancer mortality with 2.48 million new cases and 1.82 million deaths. This study aims to systematically analyze the quality standards in TBL cancer management and the performance of health systems on a global scale and specifically for Türkiye between 1990 and 2023. To measure care quality from a multidimensional perspective, four fundamental secondary indicators consisting of Mortality-to-Incidence (MIR), DALYs-to-Prevalence, Prevalence-to-Incidence, and YLLs-to-YLDs ratios were synthesized using Principal Component Analysis (PCA) to derive normalized Quality of Care Index (QCI) scores on a 0-100 scale. The analyses were deepened along the axes of the Socio-demographic Index (SDI) indicating the development levels of countries, gender, and age groups. Research findings reveal that while the global TBL cancer burden (DALY) decreased by 27.5% during the 1990-2023 period, the global QCI score increased from 64.24 to 81.74, indicating a significant improvement in treatment processes. When gender dynamics were examined, it was observed that the QCI score of women (87.28) was systematically higher than that of men (78.71) globally, and the "female advantage" phenomenon in care quality became evident. Data specific to Türkiye presents a complex picture; in the same period, the disease burden (DALY) decreased by 23.1%, and the QCI score increased from 51.61 to 63.57. However, despite Türkiye raising its Socio-demographic Index (SDI) value from 0.59 to 0.80 and achieving a significant economic class upgrade, it was determined that the obtained QCI (63.57) and Healthcare Access and Quality (HAQI: 64.8) scores remained behind both the global average and countries with similar development levels. Furthermore, the Gender Disparity Ratio (GDR), which showed perfect equality (1.00) in 1990, evolved in favor of women to 1.07 in 2023, pointing to the intensity of risk factors in the male population. In conclusion, although TBL cancer care quality has increased on a global scale, inter-regional inequalities are deepening. Specifically for Türkiye, it is observed that the achieved economic development and infrastructure investments are not fully reflected in oncological care quality, creating a structural efficiency problem. For Türkiye to raise its clinical standards to global norms, it is necessary to prioritize the tightening of tobacco control policies, the management of environmental risk factors, and structural improvements targeting not only diagnosis but also post-diagnosis treatment and care processes.
Arzu Yiğit (Sat,) studied this question.