PDF(Pubmed)
Abstract：
Each year, malignant melanoma accounts for 57 000 deaths globally. If current rates continue, there will be an estimated 510 000 new cases annually and 96 000 deaths by 2040. Melanoma and keratinocyte cancers (KCs) incur a large societal burden. Using a mathematical population model, we performed an economic evaluation of the SunSmart program in the state of Western Australia (WA), a primary prevention program to reduce the incidence of skin cancer, versus no program. A societal perspective was taken combining costs to the health system, patients and lost productivity. The model combined data from pragmatic trial evidence of sun protection, epidemiological studies and national cost reports. The main outcomes modelled were societal and government costs, skin cancer counts, melanoma deaths, life years and quality-adjusted life years. Over the next 20 years, the model predicted that implementing the WA SunSmart program would prevent 13 728 KCs, 636 melanomas and 46 melanoma deaths per 100 000 population. Furthermore, 251 life years would be saved, 358 quality-adjusted life years gained and AU$2.95 million in cost savings to society per 100 000 population would be achieved. Key drivers of the model were the rate reduction of benign lesions from sunscreen use, the costs of purchasing sunscreen and the effectiveness of reducing KCs in sunscreen users. The likelihood of WA SunSmart being cost-effective was 90.1%. For the WA Government, the estimated return on investment was $8.70 gained for every $1 invested. Primary prevention of skin cancer is a cost-effective strategy for preventing skin cancers.
摘要：
每一年,全球恶性黑色素瘤死亡人数为57000人。如果当前利率继续，到2040年，估计每年将有510,000例新病例和96,000例死亡。黑色素瘤和角质形成细胞癌（KC）造成了巨大的社会负担。使用数学人口模型，我们对西澳大利亚州（WA）的SunSmart计划进行了经济评估，降低皮肤癌发病率的一级预防计划，而不是没有程序。从社会角度出发，将卫生系统的成本结合起来，患者和生产力的损失。该模型结合了实用的防晒试验证据数据，流行病学研究和国家成本报告。建模的主要结果是社会和政府成本，皮肤癌计数，黑色素瘤死亡,生命年和质量调整生命年。在接下来的20年里,该模型预测，实施WASunSmart计划将防止13728KC，每10万人口中有636例黑色素瘤和46例黑色素瘤死亡。此外，将挽救251年的生命，将获得358个质量调整生命年，并为每10万人口节省295万澳元的社会成本。该模型的主要驱动因素是使用防晒霜导致良性病变的发生率降低，购买防晒霜的成本和减少防晒霜使用者KC的有效性。WASunSmart具有成本效益的可能性为90.1%。对于西澳政府来说，估计每投资1美元，投资回报率为8.70美元。皮肤癌的一级预防是预防皮肤癌的一种经济有效的策略。
