Centre for Health Evaluation and Outcome Sciences, Providence Research, St. Paul's Hospital, 570-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada.
Curr Oncol. 2023 Mar 8;30(3):3176-3188. doi: 10.3390/curroncol30030240.
We aimed to estimate the total health care costs attributable to prostate cancer (PCa) during care phases by age, cancer stage, tumor grade, and primary treatment in the first year in British Columbia (BC), Canada. Using linked administrative health data, we followed a cohort of men aged ≥ 50 years at diagnosis with PCa between 2010 and 2017 (Cohort 1) from the diagnosis date until the date of death, the last date of observation, or 31 December 2019. Patients who died from PCa after 1 January 2010, were selected for Cohort 2. PCa attributable costs were estimated by comparing costs in patients to matched controls. Cohort 1 ( = 22,672) had a mean age of 69.9 years (SD = 8.9) and a median follow-up time of 5.2 years. Cohort 2 included 6942 patients. Mean PCa attributable costs were the highest during the first year after diagnosis ($14,307.9 [95% CI: $13,970.0, $14,645.8]) and the year before death ($9959.7 [$8738.8, $11,181.0]). Primary treatment with radiation therapy had significantly higher costs each year after diagnosis than a radical prostatectomy or other surgeries in advanced-stage PCa. Androgen deprivation therapy (and/or chemotherapy) had the highest cost for high-grade and early-stage cancer during the three years after diagnosis. No treatment group had the lowest cost. Updated cost estimates could inform economic evaluations and decision-making.
我们旨在估计加拿大不列颠哥伦比亚省(BC)前列腺癌(PCa)患者在诊断后的第一年中,按年龄、癌症分期、肿瘤分级和主要治疗方法计算的总医疗保健费用。使用链接的行政健康数据,我们对 2010 年至 2017 年期间诊断患有 PCa 的年龄≥50 岁的男性队列(队列 1)进行了随访,随访从诊断日期开始,直到患者死亡、最后观察日期或 2019 年 12 月 31 日。如果患者在 2010 年 1 月 1 日后死于 PCa,则将其纳入队列 2。通过比较患者与匹配对照者的成本来估计 PCa 的归因成本。队列 1(n=22672)的平均年龄为 69.9 岁(标准差=8.9),中位随访时间为 5.2 年。队列 2 包括 6942 名患者。诊断后第一年的平均 PCa 归因成本最高($14307.9 [95%CI: $13970.0, $14645.8]),其次是死亡前一年($9959.7 [$8738.8, $11181.0])。在晚期 PCa 中,与根治性前列腺切除术或其他手术相比,放射治疗的主要治疗方法每年的费用都要高得多。在诊断后的三年内,雄激素剥夺治疗(和/或化疗)对高级别和早期癌症的成本最高。无治疗组的成本最低。更新后的成本估计可以为经济评估和决策提供信息。