Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia 30341, USA.
Am J Prev Med. 2012 Nov;43(5):537-45. doi: 10.1016/j.amepre.2012.07.031.
Melanoma is the most deadly form of skin cancer and an important public health concern. Given the substantial health burden associated with melanoma, it is important to examine the economic costs associated with its treatment. The purpose of the current study was to systematically review the literature on the direct medical care costs of melanoma.
A systematic review was performed using multiple databases including MEDLINE, Embase, CINAHL, and Econlit. Nineteen articles on the direct medical costs of melanoma were identified.
Detailed information on the study population, study country/setting, study perspective, costing approach, disease severity (stage), and key study results were abstracted. The overall costs of melanoma were examined as well as per-patient costs, costs by phase of care, stage of diagnosis, and setting/type of care. Among studies examining all stages of melanoma, annual treatment costs ranged from $44.9 million among Medicare patients with existing cases to $932.5 million among newly diagnosed cases across all age groups.
Melanoma leads to substantial direct medical care costs, with estimates varying widely because of the heterogeneity across studies in terms of the study setting, populations studied, costing approach, and study methods. Melanoma treatment costs varied by phase of care and stage at diagnoses; costs were highest among patients diagnosed with late-stage disease and in the initial and terminal phases of care. Aggregate treatment costs were generally highest in the outpatient/office-based setting; per-patient/per-case treatment costs were highest in the hospital inpatient setting. Given the substantial costs of treating melanoma, public health strategies should include efforts to enhance both primary prevention (reduction of ultraviolet light exposure) and secondary prevention (earlier detection) of melanoma.
黑色素瘤是最致命的皮肤癌形式，也是一个重要的公共卫生关注点。鉴于黑色素瘤相关的巨大健康负担，检查其治疗相关的经济成本非常重要。本研究的目的是系统地综述黑色素瘤直接医疗费用的文献。
使用多个数据库（包括 MEDLINE、Embase、CINAHL 和 Econlit）进行系统综述。确定了 19 篇关于黑色素瘤直接医疗费用的文章。
详细信息包括研究人群、研究国家/地区、研究视角、成本计算方法、疾病严重程度（分期）和主要研究结果。检查了黑色素瘤的总体费用以及每位患者的费用、按护理阶段、诊断阶段和护理地点/类型的费用。在检查所有黑色素瘤分期的研究中，年治疗费用范围从 Medicare 现有病例患者的 4490 万美元到所有年龄段新诊断病例的 9.325 亿美元不等。
黑色素瘤导致大量直接医疗费用，由于研究设置、研究人群、成本计算方法和研究方法的异质性，估计值差异很大。黑色素瘤治疗费用因护理阶段和诊断阶段而异；晚期诊断患者和初始和终末护理阶段的患者成本最高。总体治疗费用通常在门诊/基于办公室的环境中最高；每位患者/每个病例的治疗费用在医院住院患者中最高。鉴于治疗黑色素瘤的费用巨大，公共卫生策略应包括努力加强黑色素瘤的初级预防（减少紫外线暴露）和二级预防（早期发现）。
