Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, Chile; Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile.
J Cancer Policy. 2022 Sep;33:100345. doi: 10.1016/j.jcpo.2022.100345. Epub 2022 Jun 18.
BACKGROUND: Alongside the rising prevalence of overweight and obesity in Brazil, there is expected to be increased direct healthcare costs of cancers. Herein, we estimated the economic costs of cancer attributable to overweight in the Brazilian Unified Health System (SUS), according to sex, type of cancer and geographic location (Federative Units). METHODS: The population attributable fraction (PAF) of fifteen types of cancer were estimated using body mass index (BMI) data of 85,715 adults (≥ 20 years) involved in the 2019 National Health Survey and relative risks of cancers from a meta-analysis. Inpatients and outpatient procedures and costs of cancer treatment were obtained from the SUS systems. RESULTS: Costs of cancers included in this study were Int$ 1 billion in 2019, of which 9 % or Int$ 95 million were attributable to overweight and obesity. PAFs were higher in men (11 %) than in women (8 %), while the attributable cancer costs were higher in women (Int$ 55 million) than in men (Int$ 40 million). Cancers with the highest PAFs were endometrial cancer (40 %) and esophageal cancer (26 %), whereas cancers with the highest attributable costs were colorectal cancer (Int$ 25 million) and breast cancer (Int$ 24 million). CONCLUSION: Overweight was responsible for approximately Int$ 95 million (9 %) cancer direct healthcare cost in Brazil. Public policies and programs aimed at encouraging healthy diets and physical activity may decrease the economic burden of cancer in Brazil.
背景:随着超重和肥胖在巴西的流行率不断上升,预计癌症的直接医疗保健成本将会增加。在此,我们根据性别、癌症类型和地理位置(联邦单位),估算了巴西全民健康系统(SUS)中与超重相关的癌症经济成本。
方法:使用 2019 年全国健康调查中 85715 名成年人(≥20 岁)的体重指数(BMI)数据和荟萃分析中癌症的相对风险,估算了 15 种癌症的人群归因分数(PAF)。从 SUS 系统中获得了癌症患者的住院和门诊程序以及治疗费用。
结果:本研究纳入的癌症成本为 2019 年 10 亿雷亚尔,其中 9%(9500 万雷亚尔)归因于超重和肥胖。男性的 PAF 高于女性(11%比 8%),而女性的归因癌症成本高于男性(5.5 亿雷亚尔比 4 亿雷亚尔)。PAF 最高的癌症是子宫内膜癌(40%)和食管癌(26%),而归因成本最高的癌症是结直肠癌(2.5 亿雷亚尔)和乳腺癌(2.4 亿雷亚尔)。
结论:超重导致巴西约 9500 万雷亚尔(9%)的癌症直接医疗保健成本。旨在鼓励健康饮食和体育活动的公共政策和计划可能会降低巴西癌症的经济负担。
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