丹麦肛门、阴茎、阴道和外阴癌的发病率和费用。
Incidence and cost of anal, penile, vaginal and vulvar cancer in Denmark.
机构信息
Centre for Applied Health Services Research and Technology Assessment (CAST), University of Southern Denmark, J, B, Winslows Vej 9B, 5000, Odense C, Denmark.
出版信息
BMC Public Health. 2012 Dec 17;12:1082. doi: 10.1186/1471-2458-12-1082.
BACKGROUND
Besides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV) contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. HPV types 16 & 18 in particular contribute to 74-93% of these cases. Overall the number of new cases of these four cancers may be relatively high implying notable health care cost to society. The aim of this study was to estimate the incidence and the health care sector costs of anal, penile, vaginal and vulvar cancer.
METHODS
New anogenital cancer patients were identified from the Danish National Cancer Register using ICD-10 diagnosis codes. Resource use in the health care sector was estimated for the year prior to diagnosis, and for the first, second and third years after diagnosis. Hospital resource use was defined in terms of registered hospital contacts, using DRG (Diagnosis Related Groups) and DAGS (Danish Outpatient Groups System) charges as cost estimates for inpatient and outpatient contacts, respectively. Health care consumption by cancer patients diagnosed in 2004-2007 was compared with that by an age- and sex-matched cohort without cancer. Hospital costs attributable to four anogenital cancers were estimated using regression analysis.
RESULTS
The annual incidence of anal cancer in Denmark is 1.9 per 100,000 persons. The corresponding incidence rates for penile, vaginal and vulvar cancer are 1.7, 0.9 and 3.6 per 100,000 males/females, respectively. The total number of new cases of these four cancers in Denmark is about 270 per year. In comparison, the total number of new cases cervical cancer is around 390 per year. The total cost of anogenital cancer to the hospital sector was estimated to be 7.6 million Euros per year. Costs associated with anal and vulvar cancer constituted the majority of the costs.
CONCLUSIONS
Anogenital cancer incurs considerable costs to the Danish hospital sector. It is expected that the current HPV vaccination program will markedly reduce this burden.
背景
人乳头瘤病毒（HPV）不仅是导致生殖器疣和宫颈癌的病原体，还会导致 40-85%的肛门癌、阴茎癌、阴道癌和外阴癌病例，以及癌前病变。特别是 HPV 类型 16 和 18 导致了 74-93%的这些病例。总体而言，这四种癌症的新发病例数量可能相对较高，这意味着对社会的医疗保健成本较高。本研究的目的是估计肛门癌、阴茎癌、阴道癌和外阴癌的发病率和医疗保健部门的成本。
方法
使用 ICD-10 诊断代码，从丹麦国家癌症登记处确定新的肛门生殖器癌症患者。在诊断前一年以及诊断后第一年、第二年和第三年，估计了卫生保健部门的资源利用情况。医院资源使用情况根据住院联系数进行定义，使用 DRG（诊断相关分组）和 DAGS（丹麦门诊组系统）收费分别作为住院和门诊联系的成本估算。使用回归分析比较了 2004-2007 年诊断的癌症患者与无癌症的年龄和性别匹配队列的医疗保健消费情况。使用回归分析估计归因于四种肛门生殖器癌症的医院费用。
结果
丹麦的肛门癌年发病率为每 10 万人 1.9 例。相应的阴茎癌、阴道癌和外阴癌的发病率分别为每 10 万男性/女性 1.7、0.9 和 3.6 例。丹麦每年新发生的这四种癌症的总病例数约为 270 例。相比之下，每年新发生宫颈癌的总病例数约为 390 例。医院部门治疗肛门生殖器癌症的总成本估计为每年 760 万欧元。与肛门癌和外阴癌相关的成本构成了大部分成本。
结论
肛门生殖器癌症给丹麦医院部门带来了相当大的负担。预计当前的 HPV 疫苗接种计划将显著降低这一负担。
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