Epidemiology and Health

Original Articles

Disease burden of prostate cancer from 2014 to 2019 in the United States: estimation from the Global Burden of Disease Study 2019 and Medical Expenditure Panel Survey: Shen Lin, Dong Lin, Yiyuan Li, Lixian Zhong, Wei Zhou, Yajing Wu, Chen Xie, Shaohong Luo, Xiaoting Huang, Xiongwei Xu, Xiuhua Weng; Epidemiol Health. 2023;45:e2023038. Published online March 21, 2023; DOI: https://doi.org/10.4178/epih.e2023038

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Abstract

OBJECTIVES
The aim of this study was to evaluate the disease burden of prostate cancer (PC) and assess key influencing factors associated with the disease expenditures of PC in the United States.

METHODS

The total deaths, incidence, prevalence, and disability-adjusted life-years of PC were obtained from the Global Burden of Disease Study 2019. The Medical Expenditure Panel Survey was used to estimate healthcare expenditures and productivity loss and to investigate patterns of payment and use of healthcare resources in the United States. A multivariable logistic regression model was conducted to identify key factors influencing expenditures.

RESULTS

For patients aged 50 and older, the burden for all age groups showed a modest increase over the 6-year period. Annual medical expenditures were estimated to range from US$24.8 billion to US$39.2 billion from 2014 to 2019. The annual loss in productivity for patients was approximately US$1,200. The top 3 major components of medical costs were hospital inpatient stays, prescription medicines, and office-based visits. Medicare was the largest source of payments for survivors. In terms of drug consumption, genitourinary tract agents (57.0%) and antineoplastics (18.6%) were the main therapeutic drugs. High medical expenditures were positively associated with age (p=0.005), having private health insurance (p=0.016), more comorbidities, not currently smoking (p=0.001), and patient self-perception of fair/poor health status (p<0.001).

CONCLUSIONS

From 2014 to 2019, the national real-world data of PC revealed that the disease burden in the United States continued to increase, which was partly related to patient characteristics.

Summary

Key Message
This study quantified the disease burden of prostate cancer and showed that the burden is still substantial in the US from 2014-2019. This study explored the patients’ payment sources for healthcare expenditures and identified the top types of healthcare service expenditure for PC survivors. Moreover, this study also assessed key influencing factors for the high healthcare expenditures, which were associated with some demographic characteristics, such as age, having private health insurance, more comorbidities, smoking situation, and patients’ self-perceived health status.

Citations

Citations to this article as recorded by

Identification of circadian clock-related immunological prognostic index and molecular subtypes in prostate cancer
Lu Che, Dengxiong Li, Jie Wang, Zhouting Tuo, Koo Han Yoo, Dechao Feng, Yun Ou, Ruicheng Wu, Wuran Wei
Discover Oncology.2024;[Epub] CrossRef

The associations of tobacco use, sexually transmitted infections, HPV vaccination, and screening with the global incidence of cervical cancer: an ecological time series modeling study: Luyan Zheng, Yushi Lin, Jie Wu, Min Zheng; Epidemiol Health. 2023;45:e2023005. Published online December 13, 2022; DOI: https://doi.org/10.4178/epih.e2023005

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We aimed to quantify the temporal associations between cervical cancer incidence and cervical cancer-related factors and to predict the number of new cervical cancer cases averted under counterfactual scenarios compared to the status quo scenario.

METHODS

We described temporal trends in cervical cancer and associated factors globally from 1990 to 2019. We then used generalized linear mixed models to explore the impact of tobacco use, sexually transmitted infections (STIs), human papillomavirus (HPV) vaccination, and cervical screening on cervical cancer incidence. A counterfactual analysis was performed to simulate the most effective scenario for reducing cervical cancer incidence.

RESULTS

The worldwide incidence of cervical cancer showed a downward trend over the past 3 decades (estimated annual percentage change, -0.72%), although the incidence remained high (>30 cases per 100,000 persons) in sub-Saharan Africa, Latin America, and the Caribbean. Higher smoking and STI prevalence showed significant direct associations with the incidence of cervical cancer, whereas HPV vaccination and screening coverage showed significant inverse associations. If the strategic goals for accelerating the elimination of cervical cancer and tobacco control programs had been achieved in 2019, the largest decrease in the number of new cervical cancer cases would have been observed, with 54,169 fewer new cases of cervical cancer in 2019.

CONCLUSIONS

Our counterfactual analysis found that a comprehensive intervention program emphasizing scaled-up cervical screening coverage (70%), HPV vaccination coverage (90%), and tobacco control (30% relative reduction) would be the most effective program for reducing cervical cancer incidence.

Summary

Key Message
A comprehensive intervention program emphasizing scaled-up cervical screening coverage (70%), HPV vaccination coverage (90%), and tobacco control (30% relative reduction) would be the most effective program for reducing cervical cancer incidence in our counterfactual analysis.

Citations

Citations to this article as recorded by

Analysis of urinary tobacco-specific nitrosamine 4- (methylnitrosamino)1-(3-pyridyl)-1- butanol (NNAL) and HPV infection in American women: National health and nutrition examination survey
Daiwen Liang, Qi Zhang, Wenyu Li, Youkun Lin, Ashis K. Basu
PLOS ONE.2024; 19(5): e0304499. CrossRef

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