Guy Gery P, Berkowitz Zahava, Ekwueme Donatus U, Rim Sun Hee, Yabroff K Robin
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and.
Pediatrics. 2016 Nov;138(Suppl 1):S15-S21. doi: 10.1542/peds.2015-4268D.
Although adult survivors of childhood cancers have poorer health and greater health limitations than other adults, substantial gaps remain in understanding the economic consequences of surviving childhood cancer. Therefore, we estimated the economic burden of productivity losses among adult survivors of childhood cancers.
We examined health status, functional limitations, and productivity loss among adult survivors of childhood cancers (n = 239) diagnosed at ≤14 years of age compared with adults without a history of cancer (n = 304 265) by using the 2004-2014 National Health Interview Survey. We estimated economic burden using the productivity loss from health-related unemployment, missed work days, missed household productivity, and multivariable regression models controlling for age, sex, race/ethnicity, education, comorbidities, and survey year.
Childhood cancer survivorship is associated with a substantial economic burden. Adult survivors of childhood cancers are more likely to be in poorer health, need assistance with personal care and routine needs, have work limitations, be unable to work because of health, miss more days of work, and have greater household productivity loss compared with adults without a history of cancer (all P < .05). The annual productivity loss for adult survivors of childhood cancer is $8169 per person compared with $3083 per person for individuals without a history of cancer.
These findings underscore the importance of efforts to reduce the health and economic burden among adult survivors of childhood cancer. In addition, this study highlights the potential productivity losses that could be avoided during adulthood from the prevention of childhood cancer in the United States.
尽管儿童癌症成年幸存者的健康状况比其他成年人更差，健康限制也更多，但在理解儿童癌症幸存的经济后果方面仍存在重大差距。因此，我们估算了儿童癌症成年幸存者生产力损失的经济负担。
我们通过使用2004 - 2014年国家健康访谈调查，研究了14岁及以下被诊断为儿童癌症的成年幸存者（n = 239）与无癌症病史的成年人（n = 304265）的健康状况、功能限制和生产力损失。我们使用与健康相关的失业、误工天数、家庭生产力损失以及控制年龄、性别、种族/族裔、教育程度、合并症和调查年份的多变量回归模型来估算经济负担。
儿童癌症幸存与巨大的经济负担相关。与无癌症病史的成年人相比，儿童癌症成年幸存者更有可能健康状况较差，在个人护理和日常需求方面需要帮助，存在工作限制，因健康原因无法工作，误工天数更多，家庭生产力损失更大（所有P <.05）。儿童癌症成年幸存者的年生产力损失为每人8169美元，而无癌症病史的个人为每人3083美元。
这些发现强调了努力减轻儿童癌症成年幸存者健康和经济负担的重要性。此外，本研究突出了在美国通过预防儿童癌症可避免成年期潜在生产力损失的可能性。
