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Wang C, Shi L. Epidemiological trend of lung cancer burden caused by residential radon exposure in China from 1990 to 2019. Eur J Cancer Prev 2024; 33:232-240. [PMID: 37997905 DOI: 10.1097/cej.0000000000000855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
OBJECTIVE This study employed time series data to assess long-term changes in the burden of lung cancer (LC) caused by residential radon exposure, an important environmental risk factor, so as to develop evidence-based strategies for future public health management. METHODS Based on the open data from the Global Burden of Disease (GBD 2019) database, we conducted an analysis of the residential radon exposure-caused LC mortality, disability-adjusted life years (DALYs), and corresponding crude rates and age-standardized rates (ASRs) for various age groups. We employed the employed age-period-cohort (APC) model to investigate the age, period, and cohort effects of the data, allowing us to discern the trends in LC disease burden attributable to radon exposure in residential settings over time. RESULTS From 1990 to 2019, age-standardized mortality rates (ASMR) and age-standardized DALYs rates of LC caused by residential radon exposure in China demonstrated an overall increasing trend, with males higher than females. The CMR and crude DALYs rate for males were higher than those for females across all age groups. The APC analysis revealed that the local drift of LC death and DALYs rates in males and females showed a decreasing trend before 60 and an increasing trend after 60. CONCLUSION The persistent presence of residential radon exposure as a crucial risk factor for LC underscores the need for public health authorities and policymakers to take more proactive measures to reduce radon exposure. Particularly, attention should be paid on the elderly population and male patients.
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Affiliation(s)
- Chengzhi Wang
- Department of Oncology and Hematology, The People's Hospital of Tongliang District, Chongqing City, China
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Maul LV, Jamiolkowski D, Lapides RA, Mueller AM, Hauschild A, Garbe C, Lorigan P, Gershenwald JE, Ascierto PA, Long GV, Wang-Evers M, Scolyer RA, Saravi B, Augustin M, Navarini AA, Legge S, Németh IB, Jánosi ÁJ, Mocellin S, Feller A, Manstein D, Zink A, Maul JT, Buja A, Adhikari K, Roider E. Health Economic Consequences Associated With COVID-19-Related Delay in Melanoma Diagnosis in Europe. JAMA Netw Open 2024; 7:e2356479. [PMID: 38363565 PMCID: PMC10873772 DOI: 10.1001/jamanetworkopen.2023.56479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 12/26/2023] [Indexed: 02/17/2024] Open
Abstract
Importance The COVID-19 pandemic resulted in delayed access to medical care. Restrictions to health care specialists, staff shortages, and fear of SARS-CoV-2 infection led to interruptions in routine care, such as early melanoma detection; however, premature mortality and economic burden associated with this postponement have not been studied yet. Objective To determine the premature mortality and economic costs associated with suspended melanoma screenings during COVID-19 pandemic lockdowns by estimating the total burden of delayed melanoma diagnoses for Europe. Design, Setting, and Participants This multicenter economic evaluation used population-based data from patients aged at least 18 years with invasive primary cutaneous melanomas stages I to IV according to the American Joint Committee on Cancer (AJCC) seventh and eighth editions, including melanomas of unknown primary (T0). Data were collected from January 2017 to December 2021 in Switzerland and from January 2019 to December 2021 in Hungary. Data were used to develop an estimation of melanoma upstaging rates in AJCC stages, which was verified with peripandemic data. Years of life lost (YLL) were calculated and were, together with cost data, used for financial estimations. The total financial burden was assessed through direct and indirect treatment costs. Models were building using data from 50 072 patients aged 18 years and older with invasive primary cutaneous melanomas stages I to IV according to the AJCC seventh and eighth edition, including melanomas of unknown primary (T0) from 2 European tertiary centers. Data from European cancer registries included patient-based direct and indirect cost data, country-level economic indicators, melanoma incidence, and population rates per country. Data were analyzed from July 2021 to September 2022. Exposure COVID-19 lockdown-related delay of melanoma detection and consecutive public health and economic burden. As lockdown restrictions varied by country, lockdown scenario was defined as elimination of routine medical examinations and severely restricted access to follow-up examinations for at least 4 weeks. Main Outcomes and Measures Primary outcomes were the total burden of a delay in melanoma diagnosis during COVID-19 lockdown periods, measured using the direct (in US$) and indirect (calculated as YLL plus years lost due to disability [YLD] and disability-adjusted life-years [DALYs]) costs for Europe. Secondary outcomes included estimation of upstaging rate, estimated YLD, YLL, and DALY for each European country, absolute direct and indirect treatment costs per European country, proportion of the relative direct and indirect treatment costs for the countries, and European health expenditure. Results There were an estimated 111 464 (range, 52 454-295 051) YLL due to pandemic-associated delay in melanoma diagnosis in Europe, and estimated total additional costs were $7.65 (range, $3.60 to $20.25) billion. Indirect treatment costs were the main cost driver, accounting for 94.5% of total costs. Estimates for YLD in Europe resulted in 15 360 years for the 17% upstaging model, ranging from 7228 years (8% upstaging model) to 40 660 years (45% upstaging model). Together, YLL and YLD constitute the overall disease burden, ranging from 59 682 DALYs (8% upstaging model) to 335 711 DALYs (45% upstaging model), with 126 824 DALYs for the real-world 17% scenario. Conclusions and Relevance This economic analysis emphasizes the importance of continuing secondary skin cancer prevention measures during pandemics. Beyond the personal outcomes of a delayed melanoma diagnosis, the additional economic and public health consequences are underscored, emphasizing the need to include indirect economic costs in future decision-making processes. These estimates on DALYs and the associated financial losses complement previous studies highlighting the cost-effectiveness of screening for melanoma.
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Affiliation(s)
- Lara V. Maul
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Dagmar Jamiolkowski
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Division of Pediatric Dermatology, Children’s Hospital Auf der Bult, Hannover, Germany
| | - Rebecca A. Lapides
- Robert Larner, MD, College of Medicine at the University of Vermont, Burlington, Vermont
- Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Charlestown
| | - Alina M. Mueller
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Axel Hauschild
- Department of Dermatology, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Claus Garbe
- Center for Dermatooncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Paul Lorigan
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Jeffrey E. Gershenwald
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | | | - Georgina V. Long
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
- Royal North Shore Hospital, Sydney, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Michael Wang-Evers
- Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Charlestown
| | - Richard A. Scolyer
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
- Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Babak Saravi
- Department of Orthopedics and Trauma Surgery, Medical Center–University of Freiburg, Germany
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | | | | | - Stefan Legge
- Institute of Law and Economics, University of St Gallen, St Gallen, Switzerland
| | - István B. Németh
- Department of Dermatology and Allergology, University of Szeged, Szent-Györgyi Albert Medical School, Szeged, Hungary
| | - Ágnes J. Jánosi
- Department of Dermatology and Allergology, University of Szeged, Szent-Györgyi Albert Medical School, Szeged, Hungary
| | - Simone Mocellin
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Istituto Oncologico Veneto – IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Anita Feller
- National Agency for Cancer Registration, University of Zurich, Zurich, Switzerland
- Foundation National Institute for Cancer Epidemiology and Registration, University of Zurich, Zurich, Switzerland
| | - Dieter Manstein
- Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Charlestown
| | - Alexander Zink
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Julia-Tatjana Maul
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Alessandra Buja
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan, Padova, Italy
| | - Kaustubh Adhikari
- School of Mathematics and Statistics, Faculty of Science, Technology, Engineering and Mathematics, The Open University, Milton Keynes, United Kingdom
- Department of Genetics, Evolution and Environment, and UCL Genetics Institute, University College London, London, United Kingdom
| | - Elisabeth Roider
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Charlestown
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Crealey GE, Hackett C, Harkin K, Heckmann P, Kelleher F, Lyng Á, McCarthy T, McEnery M, Meaney C, Roche D, Tobin AM. Melanoma-related costs by disease stage and phase of management in Ireland. J Public Health (Oxf) 2023; 45:714-722. [PMID: 37169550 PMCID: PMC10470331 DOI: 10.1093/pubmed/fdac154] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/08/2022] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Management options for the treatment of melanoma have expanded in recent years. In an era of promising, but expensive novel pharmacological treatments, robust stage-specific melanoma-related cost estimates are necessary to support budgetary planning, evaluation of cost-effectiveness and to contribute to the investment case for prevention. METHODS A detailed decision model, describing the melanoma care pathway (by disease stage) from diagnosis, through treatment and follow-up was developed over a 5-year time frame from the perspective of the Irish healthcare system. The model was populated with real-world data from the National Cancer Registry Ireland. Uncertainty was explored using one-way and probabilistic sensitivity analysis. RESULTS The cost of managing a case of melanoma diagnosed at Stage IV (€122 985) was more than 25 times more expensive than managing a case diagnosed at Stage IA (€4269). Total costs were sensitive to the choice of immunotherapeutic and targeted drug, duration of treatment and proportion of patients receiving immunotherapy agents. CONCLUSIONS The rising incidence of melanoma and high cost of new novel therapies presents an immediate challenge to cancer control and public health globally. This study highlights the cost differential between early and late detection and the potential return on investment for prevention versus high-cost treatment.
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Affiliation(s)
| | | | - Katharine Harkin
- HSE National Cancer Control Programme (NCCP), King’s Inns House, 200 Parnell Street, Dublin 1 DO1 A3Y8, Ireland
| | - Patricia Heckmann
- HSE National Cancer Control Programme (NCCP), King’s Inns House, 200 Parnell Street, Dublin 1 DO1 A3Y8, Ireland
| | - Fergal Kelleher
- St. James and Tallaght University Hospitals, Department of Medicine, Trinity College Dublin, Dublin 2 D02 R590, Ireland
| | - Áine Lyng
- HSE National Cancer Control Programme (NCCP), King’s Inns House, 200 Parnell Street, Dublin 1 DO1 A3Y8, Ireland
| | - Triona McCarthy
- HSE National Cancer Control Programme (NCCP), King’s Inns House, 200 Parnell Street, Dublin 1 DO1 A3Y8, Ireland
| | - Maria McEnery
- HSE National Cancer Control Programme (NCCP), King’s Inns House, 200 Parnell Street, Dublin 1 DO1 A3Y8, Ireland
| | - Clare Meaney
- National Cancer Control Programme (NCCP), King’s Inn House, 200 Parnell Street, Dublin, D01 A3Y8, Ireland
| | | | - Anne-Marie Tobin
- Tallaght University Hospital, Tallaght, Dublin 24 D24 NR0A, Ireland
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4
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Young JN, Griffith‐Bauer K, Hill E, Latour E, Samatham R, Leachman S. The benefit of early-stage diagnosis: A registry-based survey evaluating the quality of life in patients with melanoma. SKIN HEALTH AND DISEASE 2023; 3:e237. [PMID: 37538330 PMCID: PMC10395626 DOI: 10.1002/ski2.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/29/2023] [Accepted: 04/06/2023] [Indexed: 08/05/2023]
Abstract
Background The morbidity associated with advanced stage melanoma is an important consideration in the dialog surrounding early detection and overdiagnosis. Few studies have stratified melanoma patient quality of life (QoL) by stage at diagnosis. Objective We sought to investigate if melanoma stage is independently associated with changes in QoL within a large, community-based melanoma registry. Secondarily, we investigated whether demographic factors such as age, geographic location or level of education are associated with changes in QoL in the same population. Methods 1108 melanoma patients were surveyed over a three-month period using the QoL in Adult Cancer Survivors Survey, consisting of 47 items on a 7-point frequency scale. Data were analysed using both descriptive statistical models and adjusted multivariate logistic regression. Results There were 677 respondents generating a 61% response rate. Overall, higher stage at diagnosis correlated with the largest decreases in QoL as it pertained to both general (p = 0.001) and Cancer-Specific stressors (p < 0.001). Education level (p = 0.020), age (p < 0.001), rural area code designation (p = 0.020) and family history of melanoma (p = 0.017) were also independently associated with changes in QoL. Conclusion Earlier stage at melanoma diagnosis is associated with better QoL and thus represents a crucial intervention in patient care. Given our findings and the growing body of evidence surrounding morbidity in late-stage melanoma, it is essential that QoL be included in assessing the benefits of early detection.
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Affiliation(s)
- Jade N. Young
- Department of DermatologyOregon Health and Science UniversityPortlandOregonUSA
| | - Kelly Griffith‐Bauer
- Department of DermatologyOregon Health and Science UniversityPortlandOregonUSA
- The PolyclinicSeattleWashingtonUSA
| | - Emma Hill
- Department of DermatologyOregon Health and Science UniversityPortlandOregonUSA
| | - Emile Latour
- Department of DermatologyOregon Health and Science UniversityPortlandOregonUSA
- Biostatistics Shared ResourceKnight Cancer InstituteOregon Health and Science UniversityPortlandOregonUSA
| | - Ravikant Samatham
- Department of DermatologyOregon Health and Science UniversityPortlandOregonUSA
| | - Sancy Leachman
- Department of DermatologyOregon Health and Science UniversityPortlandOregonUSA
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5
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Várnai M, Kiss Z, Gyulai R, Oláh J, Holló P, Emri G, Csejtei A, Kenessey I, Benedek A, Polányi Z, Nagy-Erdei Z, Dániel A, Knollmajer K, Rokszin G, Fábián I, Barcza Z, Polgár C, Nagy B, Liszkay G, Vokó Z. Improving Quality Indicator of Melanoma Management - Change of Melanoma Mortality-to-Incidence Rate Ratio Based on a Hungarian Nationwide Retrospective Study. Front Oncol 2021; 11:745550. [PMID: 34745967 PMCID: PMC8570304 DOI: 10.3389/fonc.2021.745550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/29/2021] [Indexed: 12/19/2022] Open
Abstract
Introduction The incidence of melanoma has been increasing in the last decades. A retrospective Hungarian epidemiological study provided real-world data on incidence and mortality rates. There have been changing trends in incidence in Hungary in the last decade and mortality decreased, shifting mortality-to-incidence rate ratios (MIR). MIR is an indicator of cancer management quality. Objectives Our aim is to show the changes of melanoma MIR in Hungary between 2011 and 2018 and to compare the real-world evidence-based results of our Hungarian nationwide retrospective study with other European countries. Methods MIR is calculated from the age-specific standardized incidence and mortality rates from our study. Annual MIR values are presented for the total population and for both sexes between 2011 and 2018, along with 95% confidence intervals. Comparison with European countries are shown for 2012 and 2018 based on the GLOBOCAN database and Eurostat health care expenditure per capita data. Results MIR decreased by 0.035 during the study years. The decrease was same in both sexes (0.031). Male had higher MIRs in all study years. In both 2012 and 2018, Hungarian MIR in both sexes was lower than the European Union average (males: 0.192 vs. 0.212 and 0.148 vs. 0.174 respectively, women: 0.107 vs. 0.129 and 0.083 vs. 0.107 respectively). Discussion Hungarian mortality-to-incidence ratio is the lowest in Central and Eastern Europe and is close to the level of Western and Northern European countries. The results are driven by the high number of new diagnosed melanoma cases.
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Affiliation(s)
- Máté Várnai
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary.,MSD Pharma Hungary Ltd., Budapest, Hungary
| | | | - Rolland Gyulai
- Department of Dermatology, Venerology and Oncodermatology, Medical School and Clinical Center, University of Pécs, Pécs, Hungary
| | - Judit Oláh
- Department of Oncotherapy, University of Szeged, Szeged, Hungary.,Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Péter Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Gabriella Emri
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - András Csejtei
- Department of Oncoradiology, Markusovszky University Teaching Hospital, Szombathely, Hungary
| | | | | | | | | | | | | | | | - Ibolya Fábián
- RxTarget Ltd., Szolnok, Hungary.,Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
| | - Zsófia Barcza
- Syntesia Medical Communications Ltd., Budapest, Hungary
| | - Csaba Polgár
- National Institute of Oncology, Budapest, Hungary.,Department of Oncology, Semmelweis University, Budapest, Hungary
| | - Balázs Nagy
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | | | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
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Ningrum DNA, Yuan SP, Kung WM, Wu CC, Tzeng IS, Huang CY, Li JYC, Wang YC. Deep Learning Classifier with Patient's Metadata of Dermoscopic Images in Malignant Melanoma Detection. J Multidiscip Healthc 2021; 14:877-885. [PMID: 33907414 PMCID: PMC8071207 DOI: 10.2147/jmdh.s306284] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 03/25/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Incidence of skin cancer is one of the global burdens of malignancies that increase each year, with melanoma being the deadliest one. Imaging-based automated skin cancer detection still remains challenging owing to variability in the skin lesions and limited standard dataset availability. Recent research indicates the potential of deep convolutional neural networks (CNN) in predicting outcomes from simple as well as highly complicated images. However, its implementation requires high-class computational facility, that is not feasible in low resource and remote areas of health care. There is potential in combining image and patient's metadata, but the study is still lacking. OBJECTIVE We want to develop malignant melanoma detection based on dermoscopic images and patient's metadata using an artificial intelligence (AI) model that will work on low-resource devices. METHODS We used an open-access dermatology repository of International Skin Imaging Collaboration (ISIC) Archive dataset consist of 23,801 biopsy-proven dermoscopic images. We tested performance for binary classification malignant melanomas vs nonmalignant melanomas. From 1200 sample images, we split the data for training (72%), validation (18%), and testing (10%). We compared CNN with image data only (CNN model) vs CNN for image data combined with an artificial neural network (ANN) for patient's metadata (CNN+ANN model). RESULTS The balanced accuracy for CNN+ANN model was higher (92.34%) than the CNN model (73.69%). Combination of the patient's metadata using ANN prevents the overfitting that occurs in the CNN model using dermoscopic images only. This small size (24 MB) of this model made it possible to run on a medium class computer without the need of cloud computing, suitable for deployment on devices with limited resources. CONCLUSION The CNN+ANN model can increase the accuracy of classification in malignant melanoma detection even with limited data and is promising for development as a screening device in remote and low resources health care.
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Affiliation(s)
- Dina Nur Anggraini Ningrum
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Public Health Department, Universitas Negeri Semarang, Semarang City, Indonesia
| | - Sheng-Po Yuan
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Department of Otorhinolaryngology, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Woon-Man Kung
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
| | - Chieh-Chen Wu
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
| | - I-Shiang Tzeng
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- Department of Statistics, National Taipei University, Taipei, Taiwan
| | - Chu-Ya Huang
- Taiwan College of Healthcare Executives, Taipei, Taiwan
| | - Jack Yu-Chuan Li
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Department Dermatology, Wan Fang Hospital, Taipei, Taiwan
- Taipei Medical University Research Center of Cancer Translational Medicine, Taipei, Taiwan
| | - Yao-Chin Wang
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Emergency Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan
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da Veiga CRP, da Veiga CP, Souza A, Wainstein AJA, de Melo AC, Drummond-Lage AP. Cutaneous melanoma: cost of illness under Brazilian health system perspectives. BMC Health Serv Res 2021; 21:284. [PMID: 33781270 PMCID: PMC8008665 DOI: 10.1186/s12913-021-06246-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The landscape of cutaneous melanoma (CM) diagnosis, staging, prognosis, and treatment has undergone fundamental changes in the past decade. While the benefits of new health resources are recognized, there is a distinct lack of accurate cost-of-illness information to aid healthcare decision makers. METHODS The cost-of-illness study for CM was conducted from the perspective of two health systems in Brazil: the public health system (Unified Health System, SUS) and the private health system (Health Management Organization, HMO). The study considered the direct medical cost in a bottom-up analysis, using melanoma incidence, knowledge of the disease's progression, and the overall survival rates. The executional costs for the complete healthcare delivery cycle were investigated considering different disease stages and possible clinical course variations. The structural cost was assessed qualitatively considering the health value chain in Brazil. RESULTS CM represents a critical financial burden in Brazil, and the cost of illness varied according to the health system and by stage at diagnosis. HMO patient costs are approximately 10-fold and 90-fold more than a SUS patient in the early-stage and advanced disease, respectively. Overall, spending on advanced disease patients can be up to 34-fold (SUS) or 270-fold (HMO) higher than that required for the early-stage disease. Given the massive amount of resources spent by the SUS and HMO, significant efforts must be made to improve the health value chain to deliver the right mix of medical care goods and services using available resources. CONCLUSION The cost-of-illness study for CM has the potential to inform policymakers and decision-makers regarding the economic burden that melanoma impose on a society in terms of the use of health care services, assisting them in making projections of future health care costs and resource allocation decisions. We believe that cost-of-illness analysis from a strategic perspective could be of help in assessing executional costs and be used to support the change in structural costs required for long-term strategies related to the health value chain.
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Affiliation(s)
- Cassia Rita Pereira da Veiga
- Departamento de Administração Geral e Aplicada (DAGA), Escola de Administração, Universidade Federal do Paraná (UFPR), Lothário Meissner 632, Jardim Botânico, Curitiba, PR, 80210-170, Brazil
| | - Claudimar Pereira da Veiga
- Departamento de Administração Geral e Aplicada (DAGA), Escola de Administração, Universidade Federal do Paraná (UFPR), Lothário Meissner 632, Jardim Botânico, Curitiba, PR, 80210-170, Brazil.
| | - Alceu Souza
- Pontifícia Universidade Católica do Paraná (PUCPR), Imaculada Conceição 1155, Curitiba, PR, 80215-901, Brazil
| | | | - Andreia Cristina de Melo
- Instituto Nacional de Câncer (INCA), Rio de Janeiro, Praça Cruz Vermelha 23, Rio de Janeiro, RJ, 20230-130, Brazil
| | - Ana Paula Drummond-Lage
- Faculdade de Ciências Médicas de Minas Gerais (FCMMG), Alameda Ezequiel Dias 275, Belo Horizonte, MG, 30130-110, Brazil
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Ng JJD, Upton Z, Leavesley D, Fan C. Investigating the Effects of Shikonin, Deoxyshikonin, and (β,β-Dimethylacryl)Shikonin on Melanoma Cell Lines. Nat Prod Commun 2020. [DOI: 10.1177/1934578x20922328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Melanoma is the most lethal form of various skin cancers and contributes to more than 79% of all skin cancer deaths. Although there are numerous therapies available for melanoma, the high rate of recurrence in melanoma post-therapy remains a challenging issue for both patients and clinicians. Apoptosis is one of the foundations for cancer treatment as deficient apoptosis is one of the most essential reasons for the formation of tumour tissues. Shikonin (SHI), an active component extracted from Lithospermum erythrorhizon, has been broadly demonstrated to possess antitumorigenic property due to its apoptosis-inducing ability in various cancer cell lines. The analogs of SHI, such as deoxyshikonin (DO-SHI) and (β,β-dimethylacryl)shikonin (β,β-SHI), have also been found to possess similar bioactivities. The apoptosis-inducing ability of SHI and its analogs enable them to be potential anticancer therapies. In this study reported herein, we investigated the effects of SHI, DO-SHI, and β,β-SHI on both human (A375) and mouse (B16-F0 and B16-F10) melanoma cell lines. Cell viability was measured using Alamar blue assay, while cell migration was detected using scratch assay. Cell apoptosis was captured using terminal deoxynucleotidyl dUTP nick end labeling and fluorescence activated cell sorting. Signaling pathway activation was detected using Western blotting. Our results revealed that SHI, DO-SHI, and β,β-SHI reduce cell viability, inhibit cell migration, and induce apoptosis in melanoma cell lines. These 3 molecules-induced apoptosis in A375 is regulated via mitogen-activated protein kinase/caspase 3 signaling pathway. In particular, DO-SHI and β,β-SHI induce higher apoptosis rate in A375 and B16-F0 compared to SHI. The data from this study demonstrate that DO-SHI and β,β-SHI offer potential new reagents for managing melanoma.
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Affiliation(s)
- Jin Jie Dillon Ng
- Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore
- School of Chemical and Life Sciences, Singapore Polytechnic, Singapore
| | - Zee Upton
- Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore
- Institute of Medical Biology, A*STAR, Singapore
| | - David Leavesley
- Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Chen Fan
- Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore
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Sen’kova AV, Savin IA, Kabilova TO, Zenkova MA, Chernolovskaya EL. Tumor-Suppressing, Immunostimulating, and Hepatotoxic Effects of Immunostimulatory RNA in Combination with Dacarbazine in a Murine Melanoma Model. Mol Biol 2020. [DOI: 10.1134/s0026893320020144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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10
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Melanoma diagnosis: predictive value of macroscopic changes observed by the patient. Melanoma Res 2018; 28:611-617. [DOI: 10.1097/cmr.0000000000000496] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Chicaiza-Ayala W, Henríquez-Trujillo AR, Ortiz-Prado E, Douce RW, Coral-Almeida M. The burden of acute respiratory infections in Ecuador 2011-2015. PLoS One 2018; 13:e0196650. [PMID: 29715314 PMCID: PMC5929540 DOI: 10.1371/journal.pone.0196650] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 04/17/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Burden of disease studies intend to improve public health decision-making and to measure social and economic impact in population. The objective of this study was to describe the burden of acute respiratory infections (ARI) in Ecuador between 2011 and 2015. METHODS Five-year period morbidity and mortality data available from national agencies of statistics was analyzed to estimate the burden of disease attributable to acute respiratory infections. Cases and deaths registered were grouped according to their ICD-10 code into three diagnostic groups: Acute upper respiratory infections (J00-J06), Influenza and pneumonia (J09-J18), and Bronchitis and other acute lower respiratory infections (J20-J22, J85, J86). Disability-adjusted life years stratified by diagnostic and age group were calculated using the "DALY" package for R. The productivity loss in monetary terms was estimated using the human capital method. RESULTS Over the 5-year period studied there were a total of 14.84 million cases of acute respiratory infections, with 17 757 deaths reported (0.12%). The yearly burden of disease ranged between 98 944 to 118 651 disability-adjusted life years, with an estimated average loss of productivity of US$152.16 million (±19.6) per year. Approximately 99% of the burden can be attributed to years life lost due to premature mortality in population under 5 years old and over 60 years-old. CONCLUSIONS The burden of acute respiratory infections remained steady during the analyzed period. Evidence-based prevention and control policies to tackle acute respiratory infections in Ecuador should focus on the population at extreme ages of life.
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Affiliation(s)
- Wilson Chicaiza-Ayala
- OneHealth Research Group, Faculty of Health Sciences, Universidad de Las Américas, Quito, Ecuador
| | | | - Esteban Ortiz-Prado
- OneHealth Research Group, Faculty of Health Sciences, Universidad de Las Américas, Quito, Ecuador
- Department of Medicine and Center for Global Health and Translational Science, State University of New York Upstate Medical University, Syracuse, New York, United States of America
| | - Richard W. Douce
- Department of Internal Medicine, Lakeland Health Care, St. Joseph, Michigan, United States of America
| | - Marco Coral-Almeida
- OneHealth Research Group, Faculty of Health Sciences, Universidad de Las Américas, Quito, Ecuador
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12
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Bell K, Cust A. Beyond country-specific incidence and mortality: the global burden of melanoma. Br J Dermatol 2018; 178:315-316. [DOI: 10.1111/bjd.15688] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- K.J.L. Bell
- School of Public Health; The University of Sydney; Rm 333, Edward Ford Building A27 Sydney NSW 2006 Australia
| | - A.E. Cust
- School of Public Health; The University of Sydney; Rm 333, Edward Ford Building A27 Sydney NSW 2006 Australia
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13
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Maertens de Noordhout C, Devleesschauwer B, Haagsma JA, Havelaar AH, Bertrand S, Vandenberg O, Quoilin S, Brandt PT, Speybroeck N. Burden of salmonellosis, campylobacteriosis and listeriosis: a time series analysis, Belgium, 2012 to 2020. Euro Surveill 2017; 22:30615. [PMID: 28935025 PMCID: PMC5709949 DOI: 10.2807/1560-7917.es.2017.22.38.30615] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 05/09/2017] [Indexed: 01/06/2023] Open
Abstract
Salmonellosis, campylobacteriosis and listeriosis are food-borne diseases. We estimated and forecasted the number of cases of these three diseases in Belgium from 2012 to 2020, and calculated the corresponding number of disability-adjusted life years (DALYs). The salmonellosis time series was fitted with a Bai and Perron two-breakpoint model, while a dynamic linear model was used for campylobacteriosis and a Poisson autoregressive model for listeriosis. The average monthly number of cases of salmonellosis was 264 (standard deviation (SD): 86) in 2012 and predicted to be 212 (SD: 87) in 2020; campylobacteriosis case numbers were 633 (SD: 81) and 1,081 (SD: 311); listeriosis case numbers were 5 (SD: 2) in 2012 and 6 (SD: 3) in 2014. After applying correction factors, the estimated DALYs for salmonellosis were 102 (95% uncertainty interval (UI): 8-376) in 2012 and predicted to be 82 (95% UI: 6-310) in 2020; campylobacteriosis DALYs were 1,019 (95% UI: 137-3,181) and 1,736 (95% UI: 178-5,874); listeriosis DALYs were 208 (95% UI: 192-226) in 2012 and 252 (95% UI: 200-307) in 2014. New actions are needed to reduce the risk of food-borne infection with Campylobacter spp. because campylobacteriosis incidence may almost double through 2020.
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Affiliation(s)
| | - Brecht Devleesschauwer
- Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium
| | | | - Arie H Havelaar
- Utrecht University, Utrecht, the Netherlands
- University of Florida, Gainesville, Florida, United States
| | - Sophie Bertrand
- Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium
| | | | - Sophie Quoilin
- Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium
| | | | - Niko Speybroeck
- Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
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14
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Karimkhani C, Green AC, Nijsten T, Weinstock MA, Dellavalle RP, Naghavi M, Fitzmaurice C. The global burden of melanoma: results from the Global Burden of Disease Study 2015. Br J Dermatol 2017; 177:134-140. [PMID: 28369739 PMCID: PMC5575560 DOI: 10.1111/bjd.15510] [Citation(s) in RCA: 261] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Despite recent improvements in prevention, diagnosis and treatment, vast differences in melanoma burden still exist between populations. Comparative data can highlight these differences and lead to focused efforts to reduce the burden of melanoma. OBJECTIVES To assess global, regional and national melanoma incidence, mortality and disability-adjusted life year (DALY) estimates from the Global Burden of Disease Study 2015. METHODS Vital registration system and cancer registry data were used for melanoma mortality modelling. Incidence and prevalence were estimated using separately modelled mortality-to-incidence ratios. Total prevalence was divided into four disease phases and multiplied by disability weights to generate years lived with disability (YLDs). Deaths in each age group were multiplied by the reference life expectancy to generate years of life lost (YLLs). YLDs and YLLs were added to estimate DALYs. RESULTS The five world regions with the greatest melanoma incidence, DALY and mortality rates were Australasia, North America, Eastern Europe, Western Europe and Central Europe. With the exception of regions in sub-Saharan Africa, DALY and mortality rates were greater in men than in women. DALY rate by age was highest in those aged 75-79 years, 70-74 years and ≥ 80 years. CONCLUSIONS The greatest burden from melanoma falls on Australasian, North American, European, elderly and male populations, which is consistent with previous investigations. These substantial disparities in melanoma burden worldwide highlight the need for aggressive prevention efforts. The Global Burden of Disease Study results can help shape melanoma research and public policy.
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Affiliation(s)
- C Karimkhani
- Department of Dermatology, University of Colorado, Aurora, CO, U.S.A
| | - A C Green
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.,CRUK Manchester Institute, University of Manchester, Manchester, U.K
| | - T Nijsten
- Erasmus MC Cancer Institute, Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - M A Weinstock
- Center for Dermatoepidemiology, Department of Veterans Affairs Medical Center, Providence, RI, U.S.A.,Department of Dermatology and Epidemiology, Brown University, Providence, RI, U.S.A
| | - R P Dellavalle
- Department of Dermatology, University of Colorado, Aurora, CO, U.S.A.,Dermatology of Epidemiology, Colorado School of Public Health, Aurora, CO, U.S.A.,Dermatology Service, U.S. Department of Veterans Affairs, Eastern Colorado Health System, Denver, CO, U.S.A
| | - M Naghavi
- Institute for Health Metrics and Evaluation, Seattle, WA, U.S.A
| | - C Fitzmaurice
- Institute for Health Metrics and Evaluation, Seattle, WA, U.S.A.,Department of Medicine, Division of Hematology, University of Washington, Seattle, WA, U.S.A
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15
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Cost-effectiveness analysis in melanoma detection: A transition model applied to dermoscopy. Eur J Cancer 2016; 67:38-45. [PMID: 27592070 DOI: 10.1016/j.ejca.2016.07.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 07/18/2016] [Indexed: 11/20/2022]
Abstract
AIM The main aim of this study is to demonstrate how our melanoma disease model (MDM) can be used for cost-effectiveness analyses (CEAs) in the melanoma detection field. In particular, we used the data of two cohorts of Belgian melanoma patients to investigate the cost-effectiveness of dermoscopy. METHODS A MDM, previously constructed to calculate the melanoma burden, was slightly modified to be suitable for CEAs. Two cohorts of patients entered into the model to calculate morbidity, mortality and costs. These cohorts were constituted by melanoma patients diagnosed by dermatologists adequately, or not adequately, trained in dermoscopy. Effectiveness and costs were calculated for each cohort and compared. Effectiveness was expressed in quality-adjusted life years (QALYs), a composite measure depending on melanoma-related morbidity and mortality. Costs included costs of treatment and follow-up as well as costs of detection in non-melanoma patients and costs of excision and pathology of benign lesions excised to rule out melanoma. RESULTS The result of our analysis concluded that melanoma diagnosis by dermatologists adequately trained in dermoscopy resulted in both a gain of QALYs (less morbidity and/or mortality) and a reduction in costs. CONCLUSION This study demonstrates how our MDM can be used in CEAs in the melanoma detection field. The model and the methodology suggested in this paper were applied to two cohorts of Belgian melanoma patients. Their analysis concluded that adequate dermoscopy training is cost-effective. The results should be confirmed by a large-scale randomised study.
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