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

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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.