Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2021 Apr 15;16(4):e0250113. doi: 10.1371/journal.pone.0250113. eCollection 2021.
Cervical cancer imposes considerable economic burden on societies and individuals. There is lack of evidence regarding this from the developing world and particularly from sub-Saharan Africa. Therefore, the study aimed to estimate the societal costs of cervical cancer in Eswatini.
The cost of illness study (CoI) was applied using national specific clinical and registry data from hospitals, registries and reports to determine the prevalence of cervical intraepithelial neoplasia (CIN) and cervical cancer in Eswatini in 2018. Cost data included direct medical costs (health care utilization in inpatient and outpatient care), direct non-medical costs (patient costs for traveling) and indirect costs based on productivity loss due to morbidity (patient time during diagnosis and treatment) and premature mortality.
The estimated total annual cost for cervical cancer was $19 million (ranging between $14 million and $24 million estimated with lower and upper bounds). Direct cost represented the majority of the costs at 72% ($13.7 million) out of which total pre-cancerous treatment costs accounted for 0.7% ($94,161). The management of invasive cervical cancer was the main cost driver with costs attributable to treatment for FIGO III and FIGO IV representing $1.7 million and $8.7 million respectively. Indirect costs contributed 27% ($5.3 million) out of which productivity loss due to premature mortality represented the majority at 67% ($3.5 million).
The economic burden of cervical cancer in Eswatini is substantial. National public health prevention strategies with prophylactic HPV vaccine and screening for cervical lesions should therefore be prioritized to limit the extensive costs associated with cervical cancer.
宫颈癌给社会和个人带来了相当大的经济负担。发展中国家，特别是撒哈拉以南非洲地区，缺乏这方面的证据。因此，本研究旨在评估斯威士兰宫颈癌的社会成本。
本研究采用了疾病成本研究（CoI）方法，利用来自医院、登记处和报告的国家特定临床和登记数据，来确定 2018 年斯威士兰宫颈上皮内瘤变（CIN）和宫颈癌的患病率。成本数据包括直接医疗成本（住院和门诊护理的医疗保健利用）、直接非医疗成本（患者旅行费用）以及因发病和过早死亡导致的生产力损失而产生的间接成本。
宫颈癌的估计年总成本为 1900 万美元（估计范围为 1400 万美元至 2400 万美元，上下限）。直接成本占了总成本的大部分，为 72%（1370 万美元），其中癌前治疗总成本占 0.7%（94161 美元）。侵袭性宫颈癌的管理是主要的成本驱动因素，FIGO III 和 FIGO IV 治疗的成本分别为 170 万美元和 870 万美元。间接成本占 27%（5300 万美元），其中由于过早死亡导致的生产力损失占了大部分，为 67%（3500 万美元）。
斯威士兰宫颈癌的经济负担相当沉重。因此，应优先考虑国家公共卫生预防策略，包括预防性 HPV 疫苗接种和宫颈癌前病变筛查，以限制与宫颈癌相关的广泛成本。
