Casamayor Montserrat, Morlock Robert, Maeda Hiroshi, Ajani Jaffer
IQVIA, C/Provença 392-3ª, 08025 Barcelona, Spain.
Astellas Pharma Global Development, Inc., 1 Astellas Way, Northbrook, IL 60062 USA.
Ecancermedicalscience. 2018 Nov 26;12:883. doi: 10.3332/ecancer.2018.883. eCollection 2018.
Gastric cancer (GC) and gastroesophageal junction cancers (GEJCs) are the third leading cause of cancer-related death worldwide. Although several studies have evaluated the epidemiology and management of GC and GEJC, to our knowledge, no global estimates of the economic burden of GC and GEJC have yet been reported. This targeted literature review was conducted to summarise the epidemiology and management of GC and GEJC and to estimate its global economic and humanistic burden. The incidence of GC and GEJC is highest in Eastern Asia, several South and Central American countries and Central and Eastern Europe and lowest in North America and Africa. Prognosis is generally poor; the global 5-year survival rate is 5%-10% in advanced stages. Patients with GC and GEJC have more severe symptoms compared with patients with other cancers, and health-related quality of life (HRQoL) worsens as the disease progresses. Given the rapid progression of GC and GEJC at advanced stages, chemotherapy, despite its toxicity, improves HRQoL compared with best supportive care. The costs of GC/GEJC are generally higher than for other cancers; in the US, the average annual cost per patient between 1998 and 2003 was 46,501 USD, compared with 29,609 USD and 35,672 USD for colorectal and lung cancer, respectively. Based on the 2012 incidence data and average costs per patient, estimates of the annual financial burden of GC and GEJC revealed great regional differences. Japan and Iran had the highest (8,492 million USD) and lowest (27 million USD) costs for 2017, respectively, while the estimate for the US was 3,171 million USD. The overall annual cost of GC and GEJC estimated for 2017 in a geographic area including Europe (France, Germany, Italy, Spain and the UK), Asia (Iran, Japan and China), North America (Canada and the US) and Australia was 20.6 billion USD.
胃癌（GC）和胃食管交界癌（GEJC）是全球癌症相关死亡的第三大主要原因。尽管有多项研究评估了GC和GEJC的流行病学及治疗情况，但据我们所知，尚未有关于GC和GEJC经济负担的全球估计报告。本次针对性文献综述旨在总结GC和GEJC的流行病学及治疗情况，并估计其全球经济和人文负担。GC和GEJC的发病率在东亚、几个南美和中美洲国家以及中东欧最高，在北美和非洲最低。预后通常较差；晚期的全球5年生存率为5%-10%。与其他癌症患者相比，GC和GEJC患者的症状更严重，且随着疾病进展，健康相关生活质量（HRQoL）会恶化。鉴于GC和GEJC在晚期进展迅速，化疗尽管有副作用，但与最佳支持治疗相比，可改善HRQoL。GC/GEJC的成本通常高于其他癌症；在美国，1998年至2003年间每位患者的年均成本为46,501美元，而结直肠癌和肺癌患者的年均成本分别为29,609美元和35,672美元。根据2012年的发病率数据和每位患者的平均成本，GC和GEJC年度财务负担的估计显示出巨大的地区差异。2017年，日本和伊朗的成本分别最高（8.492亿美元）和最低（2700万美元），而美国的估计成本为31.71亿美元。2017年，在一个包括欧洲（法国、德国、意大利、西班牙和英国）、亚洲（伊朗、日本和中国）、北美（加拿大和美国）和澳大利亚的地理区域内，GC和GEJC的总体年度成本估计为206亿美元。
