Canadian Partnership Against Cancer, Toronto, ON.
Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, U.S.A.
Curr Oncol. 2020 Dec;27(6):307-312. doi: 10.3747/co.27.5951. Epub 2020 Dec 1.
Smoking by cancer patients and survivors causes adverse cancer treatment outcomes, but little information is available about how smoking can affect cancer treatment costs.
We developed a model to estimate attributable cancer treatment failure because of continued smoking after a cancer diagnosis (af). Canadian health system data were used to determine the additional treatment cost for af for the most common cancers in Canada.
Of 206,000 patients diagnosed with cancer annually, an estimated 4789 experienced af. The annual incremental cost associated with treating patients experiencing af was estimated at between $198 million and $295 million (2017 Canadian dollars), reflecting an added incremental cost of $4,810-$7,162 per patient who continued to smoke. Analyses according to disease site demonstrated higher incremental costs where the smoking prevalence and the cost of individual second-line cancer treatment were highest. Of breast, prostate, colorectal, and lung cancers, lung cancer was associated with the highest incremental cost for treatment after af.
The costs associated with af in Canada after a cancer diagnosis are considerable. Populations in which the smoking prevalence and treatment costs are high are expected to benefit the most from efforts aimed at increasing smoking cessation capacity for patients newly diagnosed with cancer.
癌症患者和幸存者吸烟会导致癌症治疗结果不佳，但关于吸烟如何影响癌症治疗成本的信息却很少。
我们开发了一种模型来估计癌症诊断后继续吸烟导致的癌症治疗失败的可归因风险（af）。我们使用加拿大卫生系统的数据来确定加拿大最常见癌症的 af 患者的额外治疗成本。
每年有 206000 名癌症患者被诊断，估计有 4789 名患者经历了 af。治疗经历 af 的患者的年度增量成本估计在 1.98 亿至 2.95 亿加元（2017 年加元）之间，这反映了继续吸烟的患者每人增加的增量成本为 4810 至 7162 加元。根据疾病部位的分析表明，吸烟流行率和二线癌症治疗成本较高的地方增量成本更高。在乳腺癌、前列腺癌、结直肠癌和肺癌中，肺癌与 af 后治疗的最高增量成本相关。
加拿大癌症诊断后因 af 而产生的成本相当可观。预计那些吸烟流行率和治疗成本较高的人群将从旨在提高新诊断癌症患者戒烟能力的努力中获益最多。
