Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
Department of Surgery, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
Eur J Health Econ. 2024 Jul;25(5):775-785. doi: 10.1007/s10198-023-01624-4. Epub 2023 Aug 7.
How different subtypes and stages of lung cancer affect morbidity- and mortality-associated productivity have not been investigated. This study quantified the losses of lifetime employment duration and productivity among patients with various subtypes and stages of lung cancer.
We identified nationwide lung cancer patients diagnosed at the ages of 50-64 between 2011 and 2019. Monthly survival probabilities were weighted by monthly employed-to-population ratios and working salaries to estimate lifetime employment duration and productivity. We compared lifetime employment duration and productivity of patients with those of the age-, sex-, calendar year-matched general population for losses of lifetime employment duration and productivity, which were multiplied by pathology and stage shifts based on the first-round screening of Taiwan Lung Cancer Screening in Never Smoker Trial (TALENT) to calculate the savings of lifetime employment duration and productivity.
Lung cancer patients had shorter survival and employment duration than the referents. Patients with lung cancers other than adenocarcinoma experienced greater losses of lifetime employment duration and productivity as compared to adenocarcinoma patients. Applying the estimations of never-smoking patients to 100 lung cancer patients with pathology and stage shifts based on the TALENT, the savings of lifetime employment duration and productivity were 132.2 (95% prediction interval: 116.2-147.4) years and 3353 (95% prediction interval: 2914-3802) thousand US dollars, respectively.
Early diagnosis of lung cancer would save the losses of employment duration and lifetime productivity. Future evaluation of the cost-effectiveness of lung cancer screening could consider incorporating these societal impacts.
不同亚型和分期的肺癌如何影响与发病率和死亡率相关的生产力尚未得到研究。本研究量化了各种亚型和分期肺癌患者的终身就业时间和生产力损失。
我们确定了 2011 年至 2019 年间诊断为 50-64 岁的全国性肺癌患者。通过每月就业人口比例和工资加权每月生存率，以估计终身就业时间和生产力。我们比较了肺癌患者与年龄、性别、日历年份匹配的一般人群的终身就业时间和生产力，以计算终身就业时间和生产力的损失，该损失乘以基于台湾从不吸烟者肺癌筛查试验（TALENT）第一轮筛查的病理和分期变化，以计算终身就业时间和生产力的节省。
肺癌患者的生存率和就业时间短于参考人群。与腺癌患者相比，非腺癌肺癌患者的终身就业时间和生产力损失更大。将从不吸烟患者的估计值应用于 TALENT 基于病理和分期变化的 100 名肺癌患者，终身就业时间和生产力的节省分别为 132.2 年（95%预测区间：116.2-147.4）和 3353 千美元（95%预测区间：2914-3802）。
早期诊断肺癌可以节省就业时间和终身生产力的损失。未来对肺癌筛查的成本效益评估可以考虑纳入这些社会影响。
