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Darbà J, Ascanio M. Prostate cancer in Spain: A retrospective database analysis of hospital incidence and the direct medical costs. PLoS One 2024; 19:e0298764. [PMID: 38451968 PMCID: PMC10919697 DOI: 10.1371/journal.pone.0298764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION The goal of this study is to determine the medical costs, comorbidity profile, and health care resources use of patients diagnosed with prostate cancer who have been treated in Spanish hospitals. METHODS The admission records of the patients diagnosed with prostate cancer used in the study were registered between January 2016 and December 2020. These records have been collected from a Spanish hospital discharge database and have been evaluated in a retrospective multicenter analysis. RESULTS 8218 patients from the database met the criteria and were thus analyzed. The median aged of the diagnosed patients was 71.68 years. The median Charlson comorbidity index (CCI) score was 4, and the updated median CCI was 3. Hypertension was diagnosed in the 49.76% of the individuals, 37.03% had chronic obstructive pulmonary disease and 34.51% had hyperlipidaemia. The mortality rate was 9.30%. The most common medical procedure was prostate resection with percutaneous endoscopic approach (31.18%). The mean annual cost per admission was 5212.98€ €. CONCLUSIONS Technologies, such as the prostate-specific antigen (PSA) testing for screening has helped in the diagnosis in the past decades, enhancing a decrease in the mortality rate of the patients throughout the years.
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Affiliation(s)
- Josep Darbà
- Department of Economics, Universitat de Barcelona, Barcelona, Spain
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Serdà-Ferrer BC, Sanvisens A, Fuentes-Raspall R, Puigdemont M, Farré X, Vidal-Vila A, Rispau-Pagès M, Baltasar-Bagué A, Marcos-Gragera R. Significantly reduced incidence and improved survival from prostate cancer over 25 years. BMC Public Health 2023; 23:2552. [PMID: 38129873 PMCID: PMC10734155 DOI: 10.1186/s12889-023-17440-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Prostate cancer (PCa) was the second most frequent cancer and the fifth leading cause of cancer death among men in 2020. The aim of this study was to analyze trends in the incidence, mortality and survival of PCa in Girona, Spain, over 25 years. METHODS Population-based study of PCa collected in the Girona Cancer Registry, 1994-2018. Age-adjusted incidence and mortality rates were calculated per 100,000 men-year. Joinpoint regression models were used for trends, calculating the annual percentage changes (APC). Observed and net survival were analyzed using Kaplan-Meier and Pohar-Perme estimations, respectively. RESULTS A total of 9,846 cases of PCa were registered between 1994-2018. The age-adjusted incidence and mortality rates were 154.7 (95%CI: 151.7 157.8) and 38.9 (95%CI: 37.3 -40.6), respectively. An increased incidence of 6.2% was observed from 1994 to 2003 (95%CI: 4.4 -8.1), and a decrease of -2.7% (95%CI: -3.5 -;-1.9) between 2003 and 2018. Mortality APC was -2.6% (95%CI: -3.3 --2.0). Five-year observed and net survival were 72.8% (95%CI: 71.8 - 73.7) and 87.2% (95%CI: 85.9 - 88.4), respectively. Five-year net survival increased over time from 72.9% (1994-1998) to 91.3% (2014-2018). CONCLUSIONS The analyses show a clear reduction in PCa incidence rates from 2003 on, along with an increase in overall survival when comparing the earlier period with more recent years.
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Affiliation(s)
| | - Arantza Sanvisens
- Epidemiology Unit and Girona Cancer Registry, Institut Català d'Oncologia, Pla Director d'Oncologia, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), 17004, Girona, Spain
| | - Rafael Fuentes-Raspall
- Radiation Oncology Department, Institut Català d'Oncologia, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), 17007, Girona, Spain
| | - Montse Puigdemont
- Epidemiology Unit and Girona Cancer Registry, Institut Català d'Oncologia, Pla Director d'Oncologia, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), 17004, Girona, Spain
| | - Xavier Farré
- Department of Health, Agència de Salut Pública de Catalunya, 25006, Lleida, Spain
| | - Anna Vidal-Vila
- Epidemiology Unit and Girona Cancer Registry, Institut Català d'Oncologia, Pla Director d'Oncologia, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), 17004, Girona, Spain
| | - Martí Rispau-Pagès
- Registre de Tumors Hospitalari (RTH ICO-ICS), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), 17007, Girona, Spain
| | | | - Rafael Marcos-Gragera
- Department of Nursing, Universitat de Girona, 17003, Girona, Spain
- Epidemiology Unit and Girona Cancer Registry, Institut Català d'Oncologia, Pla Director d'Oncologia, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), 17004, Girona, Spain
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Prostate Cancer Survival by Risk and Other Prognostic Factors in Mallorca, Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111156. [PMID: 34769675 PMCID: PMC8583124 DOI: 10.3390/ijerph182111156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/08/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022]
Abstract
Studies about the survival of patients with prostate cancer by stage or risk of progression are scarce. The aims of this study were (1) to determine the cause-specific survival by risk in prostate cancer patients in Mallorca diagnosed in the period 2006-2011; (2) to identify the factors that explain and predict the likelihood of survival and the risk of dying from this type of cancer; and (3) to determine the distribution of prostate cancer by risk in the patients in Mallorca diagnosed in the period 2006-2011. Incident prostate cancer cases diagnosed between 2006 and 2011 were identified through the Mallorca Cancer Registry. We collected age; date and method of diagnosis; date of follow-up or death; T, N, M and stage according to the TNM 7th edition; Gleason score; prostate-specific antigen (PSA); histology according to the International Classification of Diseases for Oncology (ICD-O) 3rd edition, comorbidities and treatments. We calculated risk in four categories: low, medium, high and very high. The end point of follow-up was 31 December 2014. Multiple imputation (MI) was performed to estimate cases with unknown risk. We identified 2921 cases. Five years after diagnosis, survival after MI was 89% globally, and was 100% for low-risk cases, 96% for medium risk, 93% for high risk and 69% for very-high-risk cases. Cases with histology other than adenocarcinoma, with high (and especially very high) risk, as well as with systemic, mixed and observation/unspecified treatments had worse prognoses.
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Cayuela L, Lendínez-Cano G, Chávez-Conde M, Rodríguez-Domínguez S, Cayuela A. Recent trends in prostate cancer in Spain. Actas Urol Esp 2020; 44:483-488. [PMID: 32600879 DOI: 10.1016/j.acuro.2020.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/04/2020] [Accepted: 05/07/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To assess recent trends in prostate cancer incidence, survival and mortality in Spain using updated data. SUBJECTS AND METHOD Prostate cancer mortality data have been obtained from the National Institute of Statistics (INE). Incidence cases have been obtained from the databases Cancer Incidence in Five Continents (CI5) and European Cancer Information System. Joinpoint regression models were used for trend analysis. The results show the duration (years) of each trend, as well as the Annual Percent Change (APC) for each of them. The direction and magnitude of recent trends (last 5 years available) were evaluated using the percentages of Average Annual Percent Change (AAPC). RESULTS Incidence rates increased significantly from 16.4 in 1980 to 61.3 in 2014. The joinpoint analysis shows three periods: two initial periods of significant rise (1980-1990; 3.5% and 1990-2004; 8.4%) followed by a final one in which rates stabilize (2004-2014; -0.5%, non-significant). Mortality rates drop from 12.9 in 1980 to 7.9 in 2018, with an AAPC of -1.2% (p<0.05). However, the joinpoint analysis identified three time periods: an initial period of statistically significant rise (1980-1998; APC: 0.6%, p<0.05) and two periods of decreasing rates (1992-2008; APC: -3.3%, p<0.05 and 2008-2018; APC: -2.4%, p<0.05). CONCLUSION Recent trends (last 5 years) show that mortality rates have decreased and incidence rates have stabilized or even decreased in some age groups.
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Tang X, Li A, Xie C, Zhang Y, Liu X, Xie Y, Wu B, Zhou S, Huang X, Ma Y, Cao W, Xu R, Shen J, Huo Z, Cai S, Liang Y, Ma D. The PI3K/mTOR dual inhibitor BEZ235 nanoparticles improve radiosensitization of hepatoma cells through apoptosis and regulation DNA repair pathway. NANOSCALE RESEARCH LETTERS 2020; 15:63. [PMID: 32219609 PMCID: PMC7099126 DOI: 10.1186/s11671-020-3289-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/27/2020] [Indexed: 05/05/2023]
Abstract
Polymer materials encapsulating drugs have broad prospects for drug delivery. We evaluated the effectiveness of polyethylene glycol-poly (lactic-co-glycolic acid) (PLGA-PEG) encapsulation and release characteristics of PI3K/mTOR inhibitor NVP-BEZ235 (BEZ235). We proposed a strategy for targeting radiosensitization of liver cancer cells. The biocompatibility, cell interaction, and internalization of Glypican-3 (GPC3) antibody-modified, BEZ235-loaded PLGA-PEG nanoparticles (NP-BEZ235-Ab) in hepatoma cells in vitro were studied. Also, the cell killing effect of NP-BEZ235-Ab combined with γ-ray cell was evaluated. We used confocal microscopy to monitor nanoparticle-cell interactions and cellular uptake, conducted focus-formation experiments to analyze the synergistic biological effects of NP-BEZ235-Ab and priming, and studied synergy in liver cancer cells using molecular biological methods such as western blotting. We found that PLGA-PEG has good loading efficiency for BEZ235 and high selectivity to GPC3-positive HepG2 liver cancer cells, thus documenting that NP-BEZ235-Ab acts as a small-molecule drug delivery nanocarrier. At the nominal concentration, the NP-BEZ235-Ab nanoformulation synergistically kills liver cancer cells with significantly higher efficiency than does the free drug. Thus, NP-BEZ235-Ab is a potential radiosensitizer.
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Affiliation(s)
- Xiaolong Tang
- Huainan First People's Hospital and First Affiliated Hospital of Medical School, Anhui University of Science and Technology, Huainan, 232001, People's Republic of China
| | - Amin Li
- Huainan First People's Hospital and First Affiliated Hospital of Medical School, Anhui University of Science and Technology, Huainan, 232001, People's Republic of China
| | - Chunmei Xie
- Blood Transfusion Department, Guangzhou 8th People's Hospital, Guangzhou Medical University, Guangzhou, 510632, People's Republic of China
| | - Yinci Zhang
- Huainan First People's Hospital and First Affiliated Hospital of Medical School, Anhui University of Science and Technology, Huainan, 232001, People's Republic of China
| | - Xueke Liu
- Huainan First People's Hospital and First Affiliated Hospital of Medical School, Anhui University of Science and Technology, Huainan, 232001, People's Republic of China
| | - Yinghai Xie
- Huainan First People's Hospital and First Affiliated Hospital of Medical School, Anhui University of Science and Technology, Huainan, 232001, People's Republic of China
| | - Binquan Wu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, People's Republic of China
| | - Shuping Zhou
- Huainan First People's Hospital and First Affiliated Hospital of Medical School, Anhui University of Science and Technology, Huainan, 232001, People's Republic of China
| | - Xudong Huang
- Department of Interventional, Affiliated Oriental Hospital, Anhui University of Technology, Huainan, 232003, People's Republic of China
| | - Yongfang Ma
- Huainan First People's Hospital and First Affiliated Hospital of Medical School, Anhui University of Science and Technology, Huainan, 232001, People's Republic of China
| | - Weiya Cao
- Huainan First People's Hospital and First Affiliated Hospital of Medical School, Anhui University of Science and Technology, Huainan, 232001, People's Republic of China
| | - Ruyue Xu
- Huainan First People's Hospital and First Affiliated Hospital of Medical School, Anhui University of Science and Technology, Huainan, 232001, People's Republic of China
| | - Jing Shen
- Huainan First People's Hospital and First Affiliated Hospital of Medical School, Anhui University of Science and Technology, Huainan, 232001, People's Republic of China
| | - Zhen Huo
- Huainan First People's Hospital and First Affiliated Hospital of Medical School, Anhui University of Science and Technology, Huainan, 232001, People's Republic of China
| | - Shuyu Cai
- Huainan First People's Hospital and First Affiliated Hospital of Medical School, Anhui University of Science and Technology, Huainan, 232001, People's Republic of China
| | - Yong Liang
- Huai'an Hospital Affiliated of Xuzhou Medical College and Huai'an Second Hospital, Huai'an, 223002, People's Republic of China.
| | - Dong Ma
- Key Laboratory of Biomaterials of Guangdong Higher Education Institutes, Department of Biomedical Engineering, Jinan University, Guangzhou, 510632, People's Republic of China.
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Smith-Palmer J, Takizawa C, Valentine W. Literature review of the burden of prostate cancer in Germany, France, the United Kingdom and Canada. BMC Urol 2019; 19:19. [PMID: 30885200 PMCID: PMC6421711 DOI: 10.1186/s12894-019-0448-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 03/07/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Prostate cancer is the most frequently reported cancer in males in Europe, and is associated with substantial morbidity and mortality. The aim of the current review was to characterize the clinical, economic and humanistic burden of disease associated with prostate cancer in France, Germany, the UK and Canada. METHODS Literature searches were conducted using the PubMed, EMBASE and Cochrane Library databases to identify studies reporting incidence and/or mortality rates, costs and health state utilities associated with prostate cancer in the settings of interest. For inclusion, studies were required to be published in English in full-text form from 2006 onwards. RESULTS Incidence studies showed that in all settings the incidence of prostate cancer has increased substantially over the past two decades, driven in part by increased uptake of prostate specific antigen (PSA) screening leading to earlier identification of tumors, but which has also led to over-treatment, compounding the economic burden of disease. Mortality rates have declined over the same time frame, driven by earlier detection and improvements in treatment. Both prostate cancer itself, as well as treatment and treatment-related complications, are associated with reduced quality of life. CONCLUSIONS Prostate cancer is associated with a significant clinical and economic burden, whilst earlier detection and aggressive treatment is associated with improved survival, over-treatment of men with indolent tumors compounds the already significant burden of disease and treatment can lead to long-term side effects including impotence and impaired urinary and/or bowel function. There is currently an unmet clinical need for diagnostic and/or prognostic tools that facilitate personalized prostate cancer treatment, and potentially reduce the clinical, economic and humanistic burden of invasive cancer treatment.
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Affiliation(s)
- J. Smith-Palmer
- Ossian Health Economics and Communications GmbH, Bäumleingasse 20, 4051 Basel, Switzerland
| | - C. Takizawa
- Genomic Health International, Geneva, Switzerland
| | - W. Valentine
- Ossian Health Economics and Communications GmbH, Bäumleingasse 20, 4051 Basel, Switzerland
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Cancer survival in adult patients in Spain. Results from nine population-based cancer registries. Clin Transl Oncol 2017; 20:201-211. [PMID: 28718071 DOI: 10.1007/s12094-017-1710-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 06/20/2017] [Indexed: 01/24/2023]
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Inotai A, Abonyi-Tóth Z, Rokszin G, Vokó Z. Prognosis, Cost, and Occurrence of Colorectal, Lung, Breast, and Prostate Cancer in Hungary. Value Health Reg Issues 2015; 7:1-8. [PMID: 29698146 DOI: 10.1016/j.vhri.2015.03.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 02/26/2015] [Accepted: 03/30/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is an increasing social debate on expenditures on the care of patients with malignant diseases, especially in Central Eastern European countries with limited health resources. OBJECTIVES The aim of this research was to estimate the epidemiological and quality measures and resource use indicators in Hungary in four malignant conditions (breast, colorectal, lung, and prostate cancer) from the National Health Insurance Fund (NHIF) database. METHODS Survival and cost analyses were performed on the NHIF database. Patient records containing the International Classification of Diseases (ICD) codes C50 (breast cancer), C18-C20 (colorectal cancer), C33-C34 (lung cancer), and C61 (prostate cancer) were considered eligible. Inclusion criteria were at least two consecutive ICD codes between 2000 and 2012, with a minimum of 30-day difference, or one ICD code, followed by patient death within 60 days. A total of 428,860 social insurance numbers met inclusion criteria. RESULTS The number of new cases was 6381 for breast cancer, 8457 for colorectal cancer, 8902 for lung cancer, and 3419 for prostate cancer. The probability of 5-year overall survival from the first diagnosis was 75.2%, 41.3%, 17.1%, and 62.1%, respectively. Median time from first diagnosis to treatment initiation was less than 1 month in all conditions except for lung cancer. The annual cost of treatment was €2585, €3165, €4157, and €2834, respectively. Cost figures were compared with hemophilia as benchmark (€8284). CONCLUSIONS The results indicated that the database of the Hungarian NHIF is suitable for real-world data analysis in the field of oncology and can support long-term evidence-based policymaking.
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Affiliation(s)
| | - Zsolt Abonyi-Tóth
- RxTarget Statistical Agency, Szolnok, Hungary; Department of Biomathematics and Informatics, Szent István University, Budapest, Hungary
| | | | - Zoltán Vokó
- Syreon Research Institute, Budapest, Hungary; Faculty of Social Sciences, Department of Health Policy and Health Economics, Institute of Economics, Eötvös Loránd University (ELTE), Budapest, Hungary
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Jerez-Roig J, Souza DLB, Medeiros PFM, Barbosa IR, Curado MP, Costa ICC, Lima KC. Future burden of prostate cancer mortality in Brazil: a population-based study. CAD SAUDE PUBLICA 2014; 30:2451-2458. [DOI: 10.1590/0102-311x00007314] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 05/27/2014] [Indexed: 11/22/2022] Open
Abstract
Prostate cancer mortality projections at the nationwide and regional levels to the year 2025 are carried out in this ecological study that is based on an analysis of Brazilian trends between 1996 and 2010. The predictions were made for the period 2011-2025 utilizing the Nordpred program based on the period of 1996-2010, using the age-period-cohort model. A significant increase was observed in the Brazilian rates between 1996 and 2006, followed by a non-significant decrease. The projections indicate a decrease in rates at a national level as well as for the Central, South and Southeast regions. Increases are expected for the North and Northeast regions. In conclusion, a reduction in the mortality rates for prostate cancer in Brazil is expected to the year 2025, as well as for the Central, South and Southeast regions. However, an increase in the absolute number of deaths in all regions is expected due to the anticipated aging of the population.
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Affiliation(s)
- Javier Jerez-Roig
- Universidade Federal do Rio Grande do Norte, Brazil; Hospital Can Misses, España
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Serdà i Ferrer BC, Valle AD, Marcos-Gragera R. Prostate Cancer and Quality of Life: Analysis of Response Shift Using Triangulation Between Methods. J Gerontol Nurs 2014; 40:32-41. [DOI: 10.3928/00989134-20140211-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 12/05/2013] [Indexed: 11/20/2022]
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Berberine inhibits the expression of hypoxia induction factor-1alpha and increases the radiosensitivity of prostate cancer. Diagn Pathol 2014; 9:98. [PMID: 24886405 PMCID: PMC4051149 DOI: 10.1186/1746-1596-9-98] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 05/15/2014] [Indexed: 01/11/2023] Open
Abstract
Abstract Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1519827543125021.
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Rencz F, Brodszky V, Varga P, Gajdácsi J, Nyirády P, Gulácsi L. [The economic burden of prostate cancer. A systematic literature overview of registry-based studies]. Orv Hetil 2014; 155:509-20. [PMID: 24659744 DOI: 10.1556/oh.2014.29837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Prostate cancer, the most frequent malignant disease in males in Europe, accounts for a great proportion of health expenditures. AIM A systematic review of registry-based studies about the cost-of-illness and related factors of prostate cancer, published in the last 10 years. METHOD A MEDLINE-based literature review was carried out between January 1, 2003 and October 1, 2013. RESULTS Fifteen peer-reviewed articles met the criteria of interest. In developed countries radiotherapy, surgical treatment and hormone therapy account for the greatest per capita costs. In Europe early stage tumours (4-7000 €, 2006), while in the USA metastatic prostate cancer (19 900-25 500 $, 2004) was associated with highest per capita expenses. In Europe the greatest costs incurred within the initial treatment (6400 €/6 months, 2008), while in the USA within the end-of-life care (depending on age: 62 200-93 400 $, 2010). CONCLUSIONS Despite public health importance of prostate cancer, the cost-of-illness literature from Europe is relatively small.
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Affiliation(s)
- Fanni Rencz
- Budapesti Corvinus Egyetem Egészségügyi Közgazdaságtan Tanszék Budapest Fővám tér 8. 1093 Semmelweis Egyetem Klinikai Orvostudományok Doktori Iskola Budapest
| | | | - Péter Varga
- Országos Egészségbiztosítási Pénztár Elemzési, Orvosszakértői és Szakmai Ellenőrzési Főosztály Budapest
| | | | - Péter Nyirády
- Semmelweis Egyetem, Általános Orvostudományi Kar Urológiai Klinika és Uroonkológiai Centrum Budapest
| | - László Gulácsi
- Budapesti Corvinus Egyetem Egészségügyi Közgazdaságtan Tanszék Budapest Fővám tér 8. 1093
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