Lang Kathleen, Danchenko Natalya, Gondek Kathleen, Schwartz Brian, Thompson David
i3 Innovus, Medford, MA 02155, USA.
Urol Oncol. 2007 Sep-Oct;25(5):368-75. doi: 10.1016/j.urolonc.2007.02.014.
There were over 36,000 new cases of kidney cancer reported in the United States in 2004, the most common type being renal cell carcinoma (RCC). Available treatments for localized RCC frequently lead to cure; however RCC patients with advanced disease have limited treatment options and low survival rates. Data on the economic burden of RCC are limited.
A prevalence-based model was used to estimate the aggregate annual societal cost burden of RCC in the U.S., including costs of treatment and lost productivity. Key parameters in the model include: the annual number of patients treated for RCC by age group and cancer stage; utilization of cancer treatments; unit costs; work-days missed; and wage rates. Multiplying stratum-specific distributions of treatment by annual quantities of treatments and unit costs yields estimates of RCC-related health-care costs. Multiplying stratum-specific estimates of annual workdays missed by average wage rates yields estimates of RCC-related lost productivity.
The annual prevalence of RCC in the U.S. was estimated to be 109,500 cases. The associated annual burden (inflated to 2005 U.S.$) was approximately $4.4 billion ($40,176 per patient). Health-care costs and lost productivity accounted for 92.4% ($4.1 billion) and 7.6% ($334 million), respectively. Reflecting its higher prevalence, the total cost associated with localized RCC accounted for the greatest share (78.2%), followed by regional, distant, and unstaged RCC, at 18.3%, 2.8%, and 0.7%, respectively.
The economic burden of RCC in the U.S. is substantial. Interventions to reduce the prevalence of RCC have the potential to yield considerable economic benefits.
2004年美国报告了超过36000例肾癌新病例，最常见的类型是肾细胞癌（RCC）。局限性RCC的现有治疗方法常常能实现治愈；然而，晚期疾病的RCC患者治疗选择有限且生存率低。关于RCC经济负担的数据有限。
采用基于患病率的模型来估计美国RCC的年度社会总成本负担，包括治疗成本和生产力损失。该模型中的关键参数包括：按年龄组和癌症分期划分的每年接受RCC治疗的患者数量；癌症治疗的利用率；单位成本；缺勤工作日；以及工资率。将各层特定的治疗分布乘以每年的治疗量和单位成本，得出与RCC相关的医疗保健成本估计值。将各层特定的每年缺勤工作日估计值乘以平均工资率，得出与RCC相关的生产力损失估计值。
估计美国RCC的年患病率为109500例。相关的年度负担（折算为2005年美元）约为44亿美元（每位患者40176美元）。医疗保健成本和生产力损失分别占92.4%（41亿美元）和7.6%（3.34亿美元）。由于局限性RCC患病率较高，与之相关的总成本占比最大（78.2%），其次是区域性、远处转移性和分期不明的RCC，分别占18.3%、2.8%和0.7%。
美国RCC的经济负担巨大。降低RCC患病率的干预措施有可能带来可观的经济效益。
