College of Pharmacy, Ewha Womans University, Seoul 03760, Korea.
Department of Statistics, Ewha Womans University, Seoul 03760, Korea.
Int J Environ Res Public Health. 2020 Aug 30;17(17):6308. doi: 10.3390/ijerph17176308.
This study used the Korean National Health Insurance (NHI) claims database from 2011 to 2017 to estimate the incidence and the incidence-based cost of cervical cancer and carcinoma in situ of cervix uteri (CIS) in Korea. The primary outcome was the direct medical cost per patient not diagnosed with cervical cancer (C53) or CIS (D06) 2 years prior to the index date in the first year after diagnosis. A regression analysis was conducted to adjust for relevant covariates. The incidence of cervical cancer tended to decrease from 2013 to 2016, while that of CIS increased. In particular, the incidence rate of CIS in women in their 20 s and 30 s increased by 56.8% and 28.4%, respectively, from 2013 to 2016. The incidence-based cost of cervical cancer and CIS was USD 13,058 and USD 2695 in 2016, respectively, which increased from 2013. Multivariate regression analysis suggested that age was the most influential variable of the cost in both patient groups, and the cost was highest in those aged over 60, i.e., the medical cost was significantly lower in younger women than their older counterparts. These findings suggest that targeting younger women in cervical cancer prevention is a reasonable option from both economic and public health perspectives.
本研究使用了 2011 年至 2017 年韩国国家健康保险(NHI)理赔数据库,以估计韩国宫颈癌和子宫颈原位癌(CIS)的发病率和基于发病率的成本。主要结局指标是在诊断后第一年,在索引日期前 2 年内未被诊断为宫颈癌(C53)或 CIS(D06)的每位患者的直接医疗费用。进行回归分析以调整相关协变量。宫颈癌的发病率从 2013 年到 2016 年呈下降趋势,而 CIS 的发病率则呈上升趋势。特别是,20 多岁和 30 多岁女性的 CIS 发病率分别增加了 56.8%和 28.4%。2016 年宫颈癌和 CIS 的发病率为 13058 美元和 2695 美元,高于 2013 年。多变量回归分析表明,年龄是两组患者费用的最主要影响因素,60 岁以上患者的费用最高,即年轻女性的医疗费用明显低于年长女性。这些发现表明,从经济和公共卫生的角度来看,针对宫颈癌年轻女性进行预防是一个合理的选择。