Estimates and Projections of Value of Life Lost From Cancer Deaths in the United States
Estimates and Projections of Value of Life Lost From Cancer Deaths in the United States
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DOI：
10.1093/jnci/djn383
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发表时间：
2008-12-17
期刊：
影响因子：
--
通讯作者：
Feuer, Eric J.
中科院分区：
文献类型：
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作者：
Yabroff, K. Robin;Bradley, Cathy J.;Feuer, Eric J.
生命价值方法越来越多地用于疾病经济负担的政策分析。本研究的目的是估计和预测美国癌症死亡的生命损失价值，我们估计和预测了2000-2020年美国所有癌症和16种男性癌症和18种女性癌症的年龄别死亡率，并将其应用于美国人口预测，以估计每年的死亡人数。队列寿命表用于计算在没有癌症死亡的情况下的剩余预期寿命-025 EF人-年寿命损失（PYLL）。我们使用了一种支付意愿的方法，其中由于癌症死亡而损失的生命价值是通过PYLL乘以1年生命价值（15万美元）的估计值来计算的。我们对女性乳腺癌、结直肠癌、肺癌和前列腺癌进行了敏感性分析，使用了到2020年的未来癌症死亡率的不同假设。2000年所有癌症死亡造成的生命损失价值为9606亿美元，仅肺癌就占该价值的25%以上。根据目前的癌症死亡率预测，到2020年，生命损失的总价值将增加53%（14725亿美元）。预计癌症死亡率每年下降2%，到2020年，乳腺癌的预期生命损失价值从1210亿美元降至807亿美元，结肠直肠癌从1401亿美元降至935亿美元，肺癌从4334亿美元降至2894亿美元，在美国，由于癌症死亡而导致的生命损失的估计值是巨大的，并且由于预期的人口变化，即使死亡率保持不变，预期也会急剧增加。这些估计和预测可能有助于将癌症控制战略的投资针对可能造成最大疾病负担的肿瘤部位和最具成本效益的干预措施。
Value-of-life methods are increasingly used in policy analyses of the economic burden of disease. The purpose of this study was to estimate and project the value of life lost from cancer deaths in the United States.We estimated and projected US age-specific mortality rates for all cancers and for 16 types of cancer in men and 18 cancers in women in the years 2000-2020 and applied them to US population projections to estimate the number of deaths in each year. Cohort life tables were used to calculate the remaining life expectancy in the absence of cancer deaths-025EFthe person-years of life lost (PYLL). We used a willingness-to-pay approach in which the value of life lost due to cancer death was calculated by multiplying PYLL by an estimate of the value of 1 year of life ($150 000). We performed sensitivity analyses for female breast, colorectal, lung, and prostate cancers using varying assumptions about future cancer mortality rates through the year 2020.The value of life lost from all cancer deaths in the year 2000 was $960.6 billion; lung cancer alone represented more than 25% of this value. Projections for the year 2020 with current cancer mortality rates showed a 53% increase in the total value of life lost ($1472.5 billion). Projected annual decreases of cancer mortality rates of 2% reduced the expected value of life lost in the year 2020 from $121.0 billion to $80.7 billion for breast cancer, $140.1 billion to $93.5 billion for colorectal cancer, from $433.4 billion to $289.4 billion for lung cancer, and from $58.4 billion to $39.0 billion for prostate cancer.Estimated value of life lost due to cancer deaths in the United States is substantial and expected to increase dramatically, even if mortality rates remain constant, because of expected population changes. These estimates and projections may help target investments in cancer control strategies to tumor sites that are likely to result in the greatest burden of disease and to interventions that are the most cost-effective.