Rezende Leandro F M, Ferrari Gerson, Bahia Luciana Ribeiro, Rosa Roger Dos Santos, da Rosa Michelle Quarti Machado, de Souza Romulo Cristovão, Lee Dong Hoon, Giovannucci Edward, Eluf-Neto José
Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Preventiva, Rua Botucatu, 740 -Vila Clementino, Sao Paulo, SP, 04023-062, Brazil.
Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, Chile.
BMC Public Health. 2021 Jun 22;21(1):1190. doi: 10.1186/s12889-021-11221-w.
The increasing number of cancer patients has an escalating economic impact to public health systems (approximately, International dollars- Int$ 60 billion annually in Brazil). Physical activity is widely recognized as one important modifiable risk factor for cancer. Herein, we estimated the economic costs of colon and post-menopausal breast cancers in the Brazilian Unified Health System (SUS) attributable to lack of physical activity.
Population attributable fractions were calculated using prevalence data from 57,962 adults who answered a physical activity questionnaire in the Brazilian National Health Survey, and relative risks of colon and breast cancer from a meta-analysis. Annual costs (1 Int$ = 2.1 reais) with hospitalization, chemotherapy and radiotherapy were obtained from the Hospital and Ambulatory Information Systems of the Brazilian SUS. Two counterfactual scenarios were considered: theoretical minimum risk exposure level (≥8000 MET-min/week) and physical activity guidelines (≥600 MET-min/week).
Annually, the Brazilian SUS expended Int$ 4.5 billion in direct costs related to cancer treatment, of which Int$ 553 million due to colon and breast cancers. Direct costs related to colon and breast cancers attributable to lack of physical activity were Int$ 23.4 million and Int$ 26.9 million, respectively. Achieving at least the physical activity guidelines would save Int$ 10.3 mi (colon, Int$ 6.4 mi; breast, Int$ 3.9 mi).
Lack of physical activity accounts for Int$ 50.3 million annually in direct costs related to colon and post-menopausal breast cancers. Population-wide interventions aiming to promote physical activity are needed to reduce the economic burden of cancer in Brazil.
癌症患者数量的不断增加对公共卫生系统造成了日益严重的经济影响（在巴西，每年约为600亿国际美元）。身体活动被广泛认为是癌症的一个重要可改变风险因素。在此，我们估计了巴西统一卫生系统（SUS）中因缺乏身体活动导致的结肠癌和绝经后乳腺癌的经济成本。
使用来自巴西全国健康调查中回答身体活动问卷的57962名成年人的患病率数据，以及一项荟萃分析得出的结肠癌和乳腺癌的相对风险，计算人群归因分数。住院、化疗和放疗的年度成本（1国际美元 = 2.1雷亚尔）来自巴西SUS的医院和门诊信息系统。考虑了两种反事实情景：理论最低风险暴露水平（≥8000梅脱-分钟/周）和身体活动指南（≥600梅脱-分钟/周）。
每年，巴西SUS在与癌症治疗相关的直接成本上支出45亿美元，其中5.53亿美元用于结肠癌和乳腺癌。因缺乏身体活动导致的与结肠癌和乳腺癌相关的直接成本分别为2340万美元和2690万美元。至少达到身体活动指南将节省1030万美元（结肠癌，640万美元；乳腺癌，390万美元）。
缺乏身体活动每年导致与结肠癌和绝经后乳腺癌相关的直接成本达5030万美元。需要在全人群中开展旨在促进身体活动的干预措施，以减轻巴西癌症的经济负担。
