由于过早的癌症相关死亡导致的生产力损失的成本：癌症负担的经济衡量指标。
The cost of lost productivity due to premature cancer-related mortality: an economic measure of the cancer burden.
机构信息
National College of Ireland, Mayor Street, Dublin 1, Ireland.
出版信息
BMC Cancer. 2014 Mar 26;14:224. doi: 10.1186/1471-2407-14-224.
BACKGROUND
Most measures of the cancer burden take a public health perspective. Cancer also has a significant economic impact on society. To assess this economic burden, we estimated years of potential productive life lost (YPPLL) and costs of lost productivity due to premature cancer-related mortality in Ireland.
METHODS
All cancers combined and the 10 sites accounting for most deaths in men and in women were considered. To compute YPPLL, deaths in 5-year age-bands between 15 and 64 years were multiplied by average working-life expectancy. Valuation of costs, using the human capital approach, involved multiplying YPPLL by age-and-gender specific gross wages, and adjusting for unemployment and workforce participation. Sensitivity analyses were conducted around retirement age and wage growth, labour force participation, employment and discount rates, and to explore the impact of including household production and caring costs. Costs were expressed in €2009.
RESULTS
Total YPPLL was lower in men than women (men = 10,873; women = 12,119). Premature cancer-related mortality costs were higher in men (men: total cost = €332 million, cost/death = €290,172, cost/YPPLL = €30,558; women: total cost = €177 million, cost/death = €159,959, cost/YPPLL = €14,628). Lung cancer had the highest premature mortality cost (€84.0 million; 16.5% of total costs), followed by cancers of the colorectum (€49.6 million; 9.7%), breast (€49.4 million; 9.7%) and brain & CNS (€42.4 million: 8.3%). The total economic cost of premature cancer-related mortality in Ireland amounted to €509.5 million or 0.3% of gross domestic product. An increase of one year in the retirement age increased the total all-cancer premature mortality cost by 9.9% for men and 5.9% for women. The inclusion of household production and caring costs increased the total cost to €945.7 million.
CONCLUSION
Lost productivity costs due to cancer-related premature mortality are significant. The higher premature mortality cost in males than females reflects higher wages and rates of workforce participation. Productivity costs provide an alternative perspective on the cancer burden on society and may inform cancer control policy decisions.
背景
大多数癌症负担的衡量标准都从公共卫生角度出发。癌症对社会也有重大的经济影响。为了评估这种经济负担，我们估算了爱尔兰因癌症过早死亡而导致的潜在工作年限损失（YPPLL）和生产力损失成本。
方法
综合考虑所有癌症，以及在男性和女性中导致大多数死亡的 10 个部位。为了计算 YPPLL，我们将 15 至 64 岁之间每 5 岁一组的死亡人数乘以平均工作寿命预期。使用人力资本方法来评估成本，涉及将 YPPLL 乘以年龄和性别特定的总工资，并根据失业率和劳动力参与率进行调整。我们还围绕退休年龄和工资增长率、劳动力参与率、就业率和贴现率进行了敏感性分析，并探讨了包括家庭生产和护理成本的影响。成本以 2009 年的欧元表示。
结果
男性的总 YPPLL 低于女性（男性：10873；女性：12119）。男性因癌症过早死亡的相关成本更高（男性：总成本=3.32 亿欧元，每例死亡成本=290172 欧元，每 YPPLL 成本=30558 欧元；女性：总成本=1.77 亿欧元，每例死亡成本=159959 欧元，每 YPPLL 成本=14628 欧元）。肺癌导致的过早死亡成本最高（8400 万欧元；占总成本的 16.5%），其次是结直肠癌（4960 万欧元；占 9.7%）、乳腺癌（4940 万欧元；占 9.7%）和脑及中枢神经系统癌症（4240 万欧元；占 8.3%）。爱尔兰因癌症过早死亡导致的总经济成本为 5.095 亿欧元，占国内生产总值的 0.3%。男性和女性退休年龄每增加一年，所有癌症过早死亡的总成本将分别增加 9.9%和 5.9%。纳入家庭生产和护理成本将总成本增加到 9.457 亿欧元。
结论
因癌症过早死亡导致的生产力损失成本巨大。男性的过早死亡率成本高于女性，反映了更高的工资和劳动力参与率。生产力成本为社会癌症负担提供了另一个视角，可能为癌症控制政策决策提供信息。
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