State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, Macao SAR, China.
School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China.
Front Public Health. 2022 Apr 21;10:801981. doi: 10.3389/fpubh.2022.801981. eCollection 2022.
Hepatocellular carcinoma (HCC) accounts for more than 85%-90% of primary liver cancer globally, and approximately 45% of deaths from HCC occur in greater China. This disease poses a significant economic burden for patients, payers and society and significantly affects patients' quality of life (QoL). However, such impact of HCC in greater China has not been well characterized. This review was conducted to analyze the current evidence about the economic and humanistic impact of HCC in greater China for informing national disease management and identifying clinical gaps yet to be resolved.
A systematic search literature using seven databases (Web of Science, PubMed, Medline, Cochrane Central, China National Knowledge Infrastructure, Wanfang, and Weipu) was performed to identify interventional and observational studies that reported the impact of HCC on cost or QoL and published before April 6, 2021. The focus population included adult patients with HCC in greater China. This review excluded any studies that focused on any specific treatment. Study quality was assessed using the Effective Public Health Practice Project tool.
Of 39,930 studies retrieved, 27 were deemed eligible for inclusion. The methodologies, perspectives and data sources used in studies were heterogeneous. In greater China, while few studies reported the health expenditures of HCC patients and investigations about economic burden at national level was lacking, the significant economic impact of HCC on patients and their families had been reported. Health-related costs increased as the disease deteriorated. Additionally, HCC also has a negative impact on the QoL of patients, mostly in terms of physical, cognitive, social functioning and severe symptoms.
HCC has brought significant economic and QoL burden to patients in greater China. Both physical and psychological factors predicted QoL in patients with HCC in greater China. Future studies should explore the disease-related economic effects on Chinese patients and their families, the effects of physical and psychological factors on QoL and the relationships of physical and psychological factors in the region. www.crd.york.ac.uk/prospero/display_record.php?RecordID=278421, PROSPERO: CRD42021278421.
肝细胞癌（HCC）占全球原发性肝癌的 85%-90%以上，约 45%的 HCC 死亡病例发生在中国。这种疾病给患者、支付者和社会带来了巨大的经济负担，严重影响了患者的生活质量（QoL）。然而，在中国这一疾病的影响尚未得到充分描述。本综述旨在分析目前在中国关于 HCC 的经济和人文影响的证据，以为国家疾病管理提供信息，并确定尚未解决的临床差距。
使用七个数据库（Web of Science、PubMed、Medline、Cochrane Central、中国国家知识基础设施、万方和维普）系统地检索文献，以确定报告 HCC 对成本或 QoL 影响的干预性和观察性研究，并于 2021 年 4 月 6 日之前发表。重点人群包括中国的成年 HCC 患者。本综述排除了任何专门针对特定治疗的研究。使用有效公共卫生实践项目工具评估研究质量。
从 39930 项研究中检索到 27 项符合纳入标准的研究。研究采用的方法、视角和数据来源各不相同。在中国，虽然很少有研究报告 HCC 患者的健康支出，也缺乏国家层面的经济负担调查，但已报告 HCC 对患者及其家庭造成了重大的经济影响。随着疾病的恶化，健康相关成本也在增加。此外，HCC 还对患者的 QoL 产生负面影响，主要表现在身体、认知、社会功能和严重症状方面。
HCC 给中国患者带来了巨大的经济和 QoL 负担。身体和心理因素均预测了中国 HCC 患者的 QoL。未来的研究应探讨疾病对中国患者及其家庭的经济影响、身体和心理因素对 QoL 的影响以及该地区身体和心理因素的关系。www.crd.york.ac.uk/prospero/display_record.php?RecordID=278421, PROSPERO: CRD42021278421。
