非黑色素瘤皮肤癌和癌前病变的健康效用:一项系统综述。

Health utilities for non-melanoma skin cancers and pre-cancerous lesions: A systematic review.

作者信息

So C, Cust A E, Gordon L G, Morton R L, Canfell K, Ngo P, Dieng M, McLoughlin K, Watts C

机构信息

Sydney School of Public Health Faculty of Medicine and Health, The University of Sydney Sydney Australia.

The Daffodil Centre The University of Sydney, a joint venture with Cancer Council NSW Sydney Australia.

出版信息

Skin Health Dis. 2021 Jun 4;1(3):e51. doi: 10.1002/ski2.51. eCollection 2021 Sep.

Abstract

BACKGROUND

Non-melanoma skin cancers (NMSCs) are common and consume many healthcare resources. A health utility is a single preference-based value for assessing health-related quality of life, which can be used in economic evaluations. There are scarce data on health utilities for NMSCs.

OBJECTIVES

Using a systematic review approach, we synthesized the current data on NMSC-related health utilities.

METHODS

A systematic review of studies of NMSC-related health utilities was conducted in Medline, Embase, and Cochrane databases. Data were extracted based on the protocol and a quality assessment was performed for each study.

RESULTS

The protocol resulted in 16 studies, involving 121 621 participants. Mean utility values across the studies ranged from 0.56 to 1 for undifferentiated NMSC, 0.84 to 1 for actinic keratosis, 0.45 to 1 for squamous cell carcinoma, and 0.67 to 1 for basal cell carcinoma. There was considerable variability in utilities by type of cancer, stage of diagnosis, time to treatment, treatment modality, and quality of life instrument or method. Utility values were predominantly based on the EuroQol 5-dimension instrument and ranged from 0.45 to 0.96, while other measurement methods produced values ranging from 0.67 to 1. Lower utility values were observed for advanced cancers and for the time period during and immediately after treatment, after which values gradually returned to pre-treatment levels.

CONCLUSIONS

Most utility values clustered around relatively high values of 0.8 to 1, suggesting small decrements in quality of life associated with most NMSCs and their precursors. Variability in utilities indicates that careful characterization is required for measures to be used in economic evaluations.

摘要

背景

非黑色素瘤皮肤癌(NMSCs)很常见,消耗了大量医疗资源。健康效用是一种基于单一偏好的用于评估健康相关生活质量的值,可用于经济评估。关于NMSCs健康效用的数据很少。

目的

采用系统评价方法,综合当前与NMSC相关的健康效用数据。

方法

在Medline、Embase和Cochrane数据库中对与NMSC相关的健康效用研究进行系统评价。根据方案提取数据,并对每项研究进行质量评估。

结果

该方案检索到16项研究,涉及121621名参与者。各项研究中,未分化NMSC的平均效用值范围为0.56至1,光化性角化病为0.84至1,鳞状细胞癌为0.45至1,基底细胞癌为0.67至1。癌症类型、诊断阶段、治疗时间、治疗方式以及生活质量评估工具或方法导致效用存在很大差异。效用值主要基于欧洲五维健康量表,范围为0.45至0.96,而其他测量方法得出的值范围为0.67至1。晚期癌症以及治疗期间和治疗后即刻的效用值较低,之后逐渐恢复到治疗前水平。

结论

大多数效用值集中在相对较高的0.8至1之间,表明大多数NMSCs及其前驱病变对生活质量的影响较小。效用的差异表明,在经济评估中使用的测量方法需要仔细界定。

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