Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, T2S 3C3, Canada.
Statistics Canada, Ottawa, Ontario, Canada.
Can J Public Health. 2021 Dec;112(6):1083-1092. doi: 10.17269/s41997-021-00502-x. Epub 2021 May 25.
An estimated 33-37% of incident cancers in Canada are attributable to modifiable risk factors. Interventions targeting these risk factors would minimize the substantial health and economic burdens Canadians face due to cancer. We estimate the future health and economic burden of cancer in Canada by incorporating data from the Canadian Population Attributable Risk of Cancer (ComPARe) study into OncoSim, a web-based microsimulation tool.
Using the integrated OncoSim population attributable risk and population impact measures, we evaluated risk factor-targeted intervention scenarios implemented in 2020, assuming the targeted risk factor prevalence reduction would be achieved by 2032 with a 12-year latency period.
We estimate that smoking will be the largest contributor to cancer-related costs, with a cost of CAD $44.4 billion between 2032 and 2044. An estimated CAD $3.3 billion of the cost could be avoided with a 30% reduction in smoking prevalence by 2022. Following smoking, the next highest cancer management costs are associated with inadequate physical activity and excess body weight, accounting for CAD $10.7 billion ($2.7 billion avoidable) and CAD $9.8 billion ($3.2 billion avoidable), respectively. Avoidable costs for other risk factors range from CAD $90 million to CAD $2.5 billion.
Interventions targeting modifiable cancer risk factors could prevent a substantial number of incident cancer cases and billions of dollars in cancer management costs. With limited budgets and rising costs in cancer care in Canada, these simulation models and results are valuable for researchers and policymakers to inform decisions and prioritize and evaluate intervention programs.
加拿大约有 33-37%的新发癌症可归因于可改变的风险因素。针对这些风险因素的干预措施将最大限度地减少加拿大人因癌症而面临的巨大健康和经济负担。我们通过将加拿大癌症归因风险(ComPARe)研究的数据纳入基于网络的微型模拟工具 OncoSim 来估计加拿大未来的癌症健康和经济负担。
使用综合的 OncoSim 人群归因风险和人群影响衡量标准,我们评估了 2020 年实施的针对风险因素的干预方案,假设目标风险因素的流行率降低将在 12 年潜伏期后于 2032 年实现。
我们估计吸烟将是癌症相关成本的最大贡献者,在 2032 年至 2044 年期间,相关成本为 444 亿加元。如果到 2022 年吸烟流行率降低 30%,则可避免约 33 亿加元的成本。吸烟之后,下一个与癌症管理成本相关的最高风险因素是身体活动不足和体重超重,分别占 107 亿加元(可避免 27 亿加元)和 98 亿加元(可避免 32 亿加元)。其他风险因素的可避免成本范围从 9000 万加元到 25 亿加元。
针对可改变的癌症风险因素的干预措施可以预防大量的癌症新发病例和数十亿元的癌症管理成本。在加拿大癌症治疗的预算有限且成本不断上升的情况下,这些模拟模型和结果对于研究人员和决策者来说是有价值的,可以为他们提供决策依据,帮助他们确定优先事项和评估干预方案。