Department of Social and Epidemiological Research, Centre for Addiction and Mental Health, 33 Russell Street, Room T414, Toronto, Ontario, M5S 2S1, Canada,
J Cancer Surviv. 2014 Mar;8(1):9-20. doi: 10.1007/s11764-013-0305-7. Epub 2013 Aug 23.
Time and out-of-pocket (OOP) costs can represent a substantial burden for cancer patients but have not been described for long-term cancer survivors. We estimated these costs, their predictors, and their relationship to financial income, among a cohort of long-term prostate cancer (PC) survivors.
A population-based, community-dwelling, geographically diverse sample of long-term (2-13 years) PC survivors in Ontario, Canada, was identified from the Ontario Cancer Registry and contacted through their referring physicians. We obtained data on demographics, health care resource use, and OOP costs through mailed questionnaires and conducted chart reviews to obtain clinical data. We compared mean annual time and OOP costs (2006 Canadian dollars) across clinical and sociodemographic characteristics and examined the association between costs and four groups of predictors (patient, disease, system, symptom) using two-part regression models.
Patients' (N = 585) mean age was 73 years; 77 % were retired, and 42 % reported total annual incomes less than $40,000. Overall, mean time costs were $838/year and mean OOP costs were $200/year. Although generally low, total costs represented approximately 10 % of income for lower income patients. No demographic variables were associated with costs. Radical prostatectomy, younger age, poor urinary function, current androgen deprivation therapy, and recent diagnosis were significantly associated with increased likelihood of incurring any costs, but only urinary function significantly affected total amount.
Time and OOP costs are modest for most long-term PC survivors but can represent a substantial burden for lower income patients. Even several years after diagnosis, PC-specific treatments and treatment-related dysfunction are associated with increased costs.
Time and out-of-pocket costs are generally manageable for long-term PC survivors but can be a significant burden mainly for lower income patients. The effects of PC-specific, treatment-related dysfunctions on quality of life can also represent sources of expense for patients.
时间和自付费用（OOP）对癌症患者来说可能是一个沉重的负担，但目前还没有针对长期癌症幸存者的描述。我们评估了加拿大安大略省的一个长期前列腺癌（PC）幸存者队列中这些成本、其预测因素以及与财务收入的关系。
通过安大略癌症登记处确定了一个基于人群、居住在社区、地理位置多样化的长期（2-13 年）PC 幸存者样本，并通过他们的转诊医生与他们联系。我们通过邮寄问卷获得了人口统计学、医疗资源使用和 OOP 成本数据，并进行了病历回顾以获取临床数据。我们比较了临床和社会人口统计学特征下的年度平均时间和 OOP 成本（2006 年加拿大元），并使用两部分回归模型检查了成本与四组预测因素（患者、疾病、系统、症状）之间的关联。
患者（N=585）的平均年龄为 73 岁；77%已退休，42%报告年收入低于 40,000 加元。总体而言，平均时间成本为每年 838 加元，OOP 成本为每年 200 加元。虽然总体较低，但对于低收入患者来说，总成本约占收入的 10%。没有人口统计学变量与成本相关。根治性前列腺切除术、年龄较小、尿功能较差、当前雄激素剥夺治疗和近期诊断与更高的费用发生率显著相关，但只有尿功能显著影响总费用。
对于大多数长期 PC 幸存者来说，时间和 OOP 成本适中，但对于低收入患者来说可能是一个沉重的负担。即使在诊断后几年，PC 特异性治疗和治疗相关的功能障碍仍与成本增加相关。
对于长期 PC 幸存者来说，时间和自付费用通常是可以控制的，但对于低收入患者来说，这些费用可能是一个重大负担。PC 特异性、治疗相关的功能障碍对生活质量的影响也可能是患者的费用来源。
