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Background  The mortality-to-incidence ratio (MIR) is a marker that reflects the clinical outcome of cancer treatment. MIR as a prognostic marker is more accessible when compared with long-term follow-up survival surveys. Theoretically, countries with good health care systems would have favorable outcomes for cancer; however, no report has yet demonstrated an association between gallbladder cancer MIR and the World’s Health System ranking.    Methods  We used linear regression to analyze the correlation of MIRs with the World Health Organization (WHO) rankings and total expenditures on health/gross domestic product (e/GDP) in 57 countries selected according to the data quality.    Results  The results showed high crude rates of incidence/mortality but low MIR in more developed regions. Among continents, Europe had the highest crude rates of incidence/mortality, whereas the highest age-standardized rates (ASR) of incidence/mortality were in Asia. The MIR was lowest in North America and highest in Africa (0.40 and 1.00, respectively). Furthermore, favorable MIRs were correlated with good WHO rankings and high e/GDP ( p  = 0.01 and  p  = 0.030, respectively).    Conclusions  The MIR variation for gallbladder cancer is therefore associated with the ranking of the health system and the expenditure on health.    Electronic supplementary material  The online version of this article (10.1186/s12889-019-7160-z) contains supplementary material, which is available to authorized users.

Favorable gallbladder cancer mortality-to-incidence ratios of countries with good ranking of world’s health system and high expenditures on health