Brazilian National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, Brazil.
Institute for Health Technology Assessment, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
PLoS One. 2021 Mar 11;16(3):e0247983. doi: 10.1371/journal.pone.0247983. eCollection 2021.
The prevalence of excess body weight (EBW) has increased over the last decades in Brazil, where 55.4% of the adult population was overweight in 2019. EBW is a well-known risk factor for several types of cancer. We estimated the federal cost of EBW-related cancers in adults, considering the medical expenditures in the Brazilian Public Health System.
We calculated the costs related to 11 types of cancer considering the procedures performed in 2018 by all organizations that provide cancer care in the public health system. We obtained data from the Hospital and Ambulatory Information Systems of the Brazilian Public Health System. We calculated the fractions of cancer attributable to EBW using the relative risks from the literature and prevalence from a nationally representative survey. We converted the monetary values in Reais (R$) to international dollars (Int$), considering the purchasing power parity (PPP) of 2018.
In Brazil, the 2018 federal cost for all types of cancers combined was Int$ 1.73 billion, of which nearly Int$ 710 million was spent on EBW-related cancer care and Int$ 30 million was attributable to EBW. Outpatient and inpatient expenditures reached Int$ 20.41 million (of which 80% was for chemotherapy) and Int$ 10.06 million (of which 82% was for surgery), respectively. Approximately 80% of EBW-attributable costs were due to breast, endometrial and colorectal cancers.
A total of 1.76% of all federal cancer-related costs could be associated with EBW, representing a substantial economic burden for the public health system. We highlight the need for integrated policies for excess body weight control and cancer prevention.
过去几十年来,巴西超重人群(EBW)的比例不断增加,2019 年该国 55.4%的成年人超重。EBW 是多种癌症的已知危险因素。我们估算了巴西公共卫生系统中与 EBW 相关的癌症的联邦成本,考虑了医疗支出。
我们计算了 11 种癌症相关的成本,考虑了 2018 年所有公共卫生系统癌症治疗机构所执行的程序。我们从巴西公共卫生系统的医院和门诊信息系统获取数据。我们使用文献中的相对风险和全国代表性调查中的患病率来计算归因于 EBW 的癌症比例。我们将货币价值转换为国际美元(Int$),考虑了 2018 年的购买力平价(PPP)。
在巴西,2018 年所有癌症类型的联邦总成本为 17.3 亿美元,其中近 7.1 亿美元用于 EBW 相关癌症的治疗,3000 万美元归因于 EBW。门诊和住院支出分别达到 2041 万美元(其中 80%用于化疗)和 1006 万美元(其中 82%用于手术)。大约 80%的 EBW 归因成本归因于乳腺癌、子宫内膜癌和结直肠癌。
EBW 可能导致巴西联邦癌症相关费用的 1.76%,这对公共卫生系统构成了巨大的经济负担。我们强调需要采取综合政策来控制超重和预防癌症。