Department of Health Services Research, Management and Policy, University of Florida, FL, USA.
Department of Health Services Research, Management and Policy, University of Florida, FL, USA.
Value Health. 2019 Dec;22(12):1378-1386. doi: 10.1016/j.jval.2019.07.004. Epub 2019 Aug 20.
Obesity is a significant risk factor of several cancers that imposes a substantial economic burden on US healthcare that remains to be quantified. We estimated the excess costs and economic burden of obesity-related cancers in the United States.
From the Medical Expenditure Panel Survey (2008-2015) data, we identified 19 405 cancer survivors and 175 498 non-cancer individuals. We estimated annual health expenditures using generalized linear regression with log link and gamma distribution by cancer types (stratified by 11 obesity-related cancers and other cancer types), controlling for sociodemographic and clinical characteristics. All cost estimates were adjusted to 2015 USD value.
The average annual total health expenditures were $21 503 (95% CI, $20 946-$22 061) for those with obesity-related cancer and $13 120 (95% CI, $12 920-$13 319) for those with other cancer types. There was a positive association between body mass index and health expenditures among cancer survivors: for each additional 5-unit increase in body mass index, the average predicted expenditures increase by $1503 among those with obesity-related cancer and by $722 among those with other cancers. With adjustments for sociodemographic and clinical characteristics, the mean incremental expenditures of treating obesity-related cancer were 2.1 times higher than those of other cancers ($4492 vs $2139) and more considerable among the non-elderly cancer population. Obesity-related cancers accounted for nearly 43.5% of total direct cancer care expenditures, estimated at $35.9 billion in 2015.
The economic burden of obesity-related cancer in the United States is substantial. Our findings suggest a need for the inclusion of comprehensive obesity prevention and treatment in cancer care.
肥胖是多种癌症的一个重要危险因素,给美国的医疗保健带来了巨大的经济负担,但这一负担的具体数额尚未量化。我们评估了美国肥胖相关癌症的超额成本和经济负担。
我们从医疗支出调查(2008-2015 年)的数据中确定了 19405 名癌症幸存者和 175498 名非癌症个体。我们使用对数链接和伽马分布的广义线性回归,根据癌症类型(分为 11 种肥胖相关癌症和其他癌症类型)来估计每年的健康支出,同时控制社会人口统计学和临床特征。所有成本估计均按 2015 年美元价值进行调整。
肥胖相关癌症患者的平均年总健康支出为 21503 美元(95%CI:20946 美元-22061 美元),而其他癌症患者的平均年总健康支出为 13120 美元(95%CI:12920 美元-13319 美元)。对于癌症幸存者来说,体重指数与健康支出之间存在正相关关系:体重指数每增加 5 个单位,肥胖相关癌症患者的平均预测支出增加 1503 美元,而其他癌症患者的平均预测支出增加 722 美元。调整社会人口统计学和临床特征后,治疗肥胖相关癌症的平均增量支出是治疗其他癌症的 2.1 倍(4492 美元对 2139 美元),在非老年癌症患者中更为显著。肥胖相关癌症占 2015 年直接癌症护理总支出的近 43.5%,约为 359 亿美元。
美国肥胖相关癌症的经济负担巨大。我们的研究结果表明,需要将全面的肥胖预防和治疗纳入癌症护理中。