Gordon Louisa, Scuffham Paul, Hayes Sandi, Newman Beth
Viertel Centre for Research in Cancer Control, Queensland Cancer Fund, Spring Hill, Brisbane, Australia.
Psychooncology. 2007 Dec;16(12):1130-9. doi: 10.1002/pon.1182.
The economic impact on individuals with breast cancer is not well understood. We sought to identify and describe the direct and indirect economic losses to breast cancer survivors in Australia. A longitudinal, population-based study of 287 women was used to explore economic outcomes (costs and lost income) for women with breast cancer 0-18 months post-diagnosis. Survey methods collected data on out-of-pocket costs, care-giving support, paid and unpaid work reductions, and perceptions from participants on these financial impacts. Bootstrapping was used to estimate 95% confidence intervals around means. Data were sub-grouped by cost type, age category and disease severity. Lost income, health service expenditures and lost unpaid work were the greatest sources of economic burden. Women with positive lymph nodes reported significantly higher costs than those with negative lymph nodes (US$6674 versus US$3533, p<0.001), and younger women (< or =50 years) with positive lymph nodes experienced costs 80% greater than older women (US$8880 versus US$4937, p<0.001). Economic costs related to breast cancer may continue to affect women 18 months post-diagnosis. Economic research adds an important dimension for understanding the impact of breast cancer, and findings may be used to help improve supportive care services for women and families confronted by this disease.
乳腺癌对个人的经济影响尚未得到充分了解。我们试图识别并描述澳大利亚乳腺癌幸存者的直接和间接经济损失。一项基于人群的纵向研究对287名女性进行了调查，以探讨乳腺癌确诊后0至18个月女性的经济状况（成本和收入损失）。调查方法收集了自付费用、护理支持、有偿和无偿工作减少情况以及参与者对这些经济影响的看法等数据。采用自抽样法来估计均值周围的95%置信区间。数据按成本类型、年龄类别和疾病严重程度进行了分组。收入损失、医疗服务支出和无偿工作损失是经济负担的最大来源。有阳性淋巴结的女性报告的成本显著高于有阴性淋巴结的女性（6674美元对3533美元，p<0.001），且有阳性淋巴结的年轻女性（≤50岁）的成本比老年女性高80%（8880美元对4937美元，p<0.001）。与乳腺癌相关的经济成本在确诊后18个月可能仍会影响女性。经济研究为理解乳腺癌的影响增添了一个重要层面，研究结果可用于帮助改善针对面临这种疾病的女性及其家庭的支持性护理服务。
