Review of: "Cancer Mortality Among Women in the European Union: A Comprehensive Analysis of Economic, Social, and Health Factors"

This study provides a comprehensive and ambitious macro-level investigation of determinants of cancer mortality among women across European Union countries, integrating socioeconomic, environmental, healthcare, lifestyle, and political representation variables using panel econometric techniques.The use of pooled OLS combined with quantile regression strengthens robustness and allows examination of heterogeneity across mortality distributions, while the multi-country dataset enhances policy relevance and cross-national comparability.The study also contributes by integrating gender inequality indicators with environmental and healthcare access variables, offering a multidisciplinary public health perspective.However, several methodological and interpretative issues should be addressed to improve scienti c validity and causal interpretability.First, reliance on pooled OLS without xed-effects or random-effects panel modeling risks omitted variable bias and fails to control for unobserved countryspeci c heterogeneity and temporal structural differences across EU healthcare systems.Second, the ecological design limits causal inference and introduces potential ecological fallacy when linking macrolevel education or lifestyle indicators to individual cancer mortality outcomes.Third, several counterintuitive ndings (e.g., positive associations between education, screening, healthcare expenditure, and mortality) require stronger sensitivity analyses, lagged variable testing, and potential mediation modeling to avoid spurious correlations or reverse causality.Additionally, the study would bene t from addressing multicollinearity among governance and socioeconomic indicators more rigorously and providing clearer justi cation for variable operationalization, particularly composite gender equality proxies.The discussion should also adopt a more cautious interpretation of policy implications and acknowledge structural differences between cancer incidence and mortality drivers, Qeios qeios.com