Evidinno Outcomes Research Inc., Vancouver, Canada.
GRAIL, Inc., Menlo Park, CA, USA.
Eur J Health Econ. 2021 Nov;22(8):1275-1288. doi: 10.1007/s10198-021-01335-8. Epub 2021 Jun 14.
OBJECTIVES: Cancer diagnoses at later stages are associated with a decrease in health-related quality of life (HRQOL). Health state utility values (HSUVs) reflect preference-based HRQOL and can vary based on cancer type, stage, treatment, and disease progression. Detecting and treating cancer at earlier stages may lead to improved HRQOL, which is important for value assessments. We describe published HSUVs by cancer type and stage. METHODS: A systematic review was conducted using Embase, MEDLINE, EconLit, and gray literature to identify studies published from January 1999 to September 2019 that reported HSUVs by cancer type and stage. Disutility values were calculated from differences in reported HSUVs across cancer stages. RESULTS: From 13,872 publications, 27 were eligible for evidence synthesis. The most frequent cancer types were breast (n = 9), lung (n = 5), colorectal (n = 4), and cervical cancer (n = 3). Mean HSUVs decreased with increased cancer stage, with consistently lower values seen in stage IV or later-stage cancer across studies (e.g., - 0.74, - 0.44, and - 0.51 for breast, colorectal, and cervical cancer, respectively). Disutility values were highest between later-stage (metastatic or stage IV) cancers compared to earlier-stage (localized or stage I-III) cancers. CONCLUSIONS: This study provides a summary of HSUVs across different cancer types and stages that can inform economic evaluations. Despite the large variation in HSUVs overall, a consistent decline in HSUVs can be seen in the later stages, including stage IV. These findings indicate substantial impairment on individuals' quality of life and suggest value in early detection and intervention.
目的:癌症晚期诊断与健康相关生活质量(HRQOL)下降有关。健康状态效用值(HSUVs)反映基于偏好的 HRQOL,可能因癌症类型、阶段、治疗和疾病进展而有所不同。更早阶段发现和治疗癌症可能会改善 HRQOL,这对于价值评估很重要。我们按癌症类型和阶段描述已发表的 HSUV。 方法:使用 Embase、MEDLINE、EconLit 和灰色文献进行系统评价,以确定从 1999 年 1 月至 2019 年 9 月发表的报告癌症类型和阶段 HSUV 的研究。通过跨癌症阶段报告的 HSUV 差异计算失能值。 结果:从 13872 篇文献中,有 27 篇符合证据综合标准。最常见的癌症类型为乳腺癌(n=9)、肺癌(n=5)、结直肠癌(n=4)和宫颈癌(n=3)。HSUV 随癌症阶段增加而降低,在大多数研究中,IV 期或更晚期癌症的 HSUV 值均较低(例如,乳腺癌、结直肠癌和宫颈癌的 HSUV 值分别为-0.74、-0.44 和-0.51)。与早期(局限性或 I-III 期)癌症相比,晚期(转移性或 IV 期)癌症之间的失能值更高。 结论:本研究提供了不同癌症类型和阶段 HSUV 的概述,可为经济评估提供信息。尽管 HSUV 总体差异较大,但在晚期,包括 IV 期,HSUV 呈持续下降趋势。这些发现表明个体生活质量严重受损,表明早期发现和干预具有价值。
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