A landmark study led by Maltese surgeon Malcolm West, published in The Lancet, has found that patients from low-income countries are up to six times more likely to die following cancer surgery than those from middle-income nations.
And cancer patients from middle-income countries are more than four times more likely to die than high-income countries.
West, from the University of Southampton, said the team of researchers wanted to put numbers behind the phenomenon of how one is less likely to die or have complications while being cared for in a high-income country.
“The concept is that low-income countries experience this mortality rate because they are plagued by innate problems while high-income countries have better resources and better medical management of patients,” he said.
“We want to stress the failure to rescue is a matter of global importance and we need to do what we can to strengthen care, with a focus on rehabilitation to dampen some of the side effects that come with major surgery.”
Specialising in colorectal surgery, West is a fellow of the Royal College of Surgeons of England.
He completed a PhD in exercise physiology, perioperative surgical risk stratification and mitochondrial energetics, during which time he also served as the clinical lead for the perioperative cardio-pulmonary exercise testing service at University Hospitals Aintree.
Carried out between April 2018 and January 2019, the study looked at 15,958 patients from 428 hospitals in 82 countries undergoing surgery for breast, colorectal or gastric cancer, including Maltese patients receiving treatment at Mater Dei Hospital.
Researchers analysed whether it was common for patients to die or experience major complications within 30 days of surgery. Some 53% (8,406) of patients underwent surgery for breast cancer, 39% (6,215) for colorectal cancer and 8% (1,337) for gastric cancer.
Of the participating hospitals, 9,106 patients from 31 countries were considered to be high income, 2,721 patients from 23 countries were classed as middle-income while 4,131 patients from 28 countries were seen as low income.
Deaths among gastric cancer patients were more than three times higher in low/lower- middle-income countries and patients with colorectal cancer in low/lower- middle-income countries were also more than four times more likely to die compared with those in high-income countries.
No difference in 30-day mortality was seen following breast cancer surgery.
“It was a great privilege for me to contribute to this landmark study. I also hoped that I could give something back to Malta in this regard,” West told Times of Malta.