Article Text
Abstract
Objectives To quantify the life years gained and financial savings by preventing a case of occupational cancer.
Methods The authors retrieved data from the Taiwan Cancer Registry and linked them with the National Mortality Registry to estimate the survival functions for major occupational cancers: lung, pleural mesothelioma, urinary bladder and leukaemia. Assuming a constant excess hazard for each type of cancer, the authors extrapolated lifetime survival functions by the Monte Carlo method. For each patient with cancer, the authors simulated an age- and gender-matched person without cancer based on vital statistics of Taiwan to estimate life expectancy and expected years of life lost (EYLL). By using the reimbursement data from the National Health Insurance Research Database, the authors calculated the average monthly healthcare expenditures, which were summed to estimate the lifetime healthcare expenditures after adjusting for the corresponding monthly survival probability.
Results A total of 51 408, 136, 12 891 and 5285 new cases of lung, pleural mesothelioma, bladder and leukaemia cancers, respectively, were identified during 1997–2005 and followed until the end of 2007. The EYLL was predicted to be 13.7±0.1, 18.9±0.7, 4.7±0.3 and 19.4±0.5 years for these cancers, respectively, and the lifetime healthcare expenditures with a 3% annual discount were predicted to be US$22 359, US$14 900, US$51 987 and US$59 741, respectively.
Conclusions The burden of these occupational cancers, in terms of EYLL and lifetime healthcare expenditures, was substantial. Such estimates may provide useful empirical evidence for comparative risk assessment that can be applied in health policy-making and clinical decision-making.
- Expected years of life lost (EYLL)
- life expectancy
- lifetime healthcare expenditure
- public health
- cancer
- mesothelioma
- preventive medicine
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Footnotes
Funding This study was supported by the National Health Research Institutes (NHRI) intramural project EO-100-EO-PP04, and the Institute of Occupational Health and Safety (IOSH-100-M303). The funder helps in acquisition of data from the National Health Insurance Research Database. The authors have worked on the research independently. The interpretation and conclusions contained herein do not represent those of the National Health Research Institutes.
Competing interests None declared.
Ethics approval Ethics approval was provided by the Institutional Review Board of the National Taiwan University Hospital.
Provenance and peer review Not commissioned; externally peer reviewed.