Article

The health burden and economic costs of cutaneous melanoma mortality by race/ethnicity–United States, 2000 to 2006

Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Journal of the American Academy of Dermatology (Impact Factor: 4.45). 11/2011; 65(5 Suppl 1):S133-43. DOI: 10.1016/j.jaad.2011.04.036
Source: PubMed

ABSTRACT

Cutaneous melanoma is the most deadly form of skin cancer with more than 8000 deaths per year in the United States. The health burden and economic costs associated with melanoma mortality by race/ethnicity have not been appropriately addressed.
We sought to quantify the health burden and economic costs associated with melanoma mortality among racial/ethnic groups in the United States.
We used 2000 to 2006 national mortality data and US life tables to estimate the number of deaths, and years of potential life lost (YPLL). Further, we estimated the economic costs of melanoma mortality in terms of productivity losses. All the estimates were stratified by race/ethnicity and sex.
From 2000 to 2006, we estimated an increase of 13,349 (8.7%) YPLL because of melanoma mortality compared with a 2.8% increase among all malignant cancers across all race/ethnicity. On average, an individual in the United States loses 20.4 years of potential life during their lifetime as a result of melanoma mortality compared with 16.6 years for all malignant cancers. The estimated annual productivity loss attributed to melanoma mortality was $3.5 billion. Our estimates suggest that an individual who died from melanoma in 2000 through 2006 would lose an average of $413,370 in forgone lifetime earnings. YPLL rates and total productivity losses are much higher among non-Hispanic whites as compared with non-Hispanic blacks and Hispanics.
The estimated economic costs did not include treatment, morbidity, and intangible costs.
We estimated substantial YPLL and productivity losses as a result of melanoma mortality during an individual's lifetime. By examining the burden by race/ethnicity, this study provides useful information to assist policy-makers in making informed resource allocation decisions regarding cutaneous melanoma mortality.

Download full-text

Full-text

Available from: Pratibha Nayak
  • Source
    • "This discrepancy is reported to be related to overdiagnosis [2e4] and/or to the fact that most melanoma deaths are due to fast-growing melanomas, the incidence of the latter being stable because rarely identified during screenings [5] [6]. Due to its relatively low mean age at diagnosis, melanoma ranks among the most devastating adult cancers in terms of years of life lost (YLL) per death [7] [8]. Nevertheless, the emergence of new, yet expensive treatments for metastatic melanoma kindles hope for a decreased mortality in the coming decades, despite being associated with longer disease durations. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: The total burden of melanoma has already been studied but little is known about the distribution of this burden amongst localised, node metastatic and distant metastatic stages. Methods: Disability-adjusted life years (DALY) assesses disease burden, being the sum of years of life with disability (YLD) and years of life lost (YLL). A melanoma disease model was developed in order to predict the evolution of patients from diagnosis until death. The model was applied to a large cohort of 8016 melanoma patients recorded by the Belgian Cancer Registry for incidence years 2009-2011. DALYs were calculated for each American Joint Committee on Cancer stage, considering stage at diagnosis on the one hand and time spent in localised, node metastatic and visceral metastatic stages on the other. Probabilistic sensitivity analyses and scenario analyses were performed to explore uncertainty. Findings: Our analyses resulted in 3.67 DALYs per melanoma, 90.81 per 100,000 inhabitants, or 32.67 per death due to melanoma. The total YLL accounted for 80.4% of the total DALY. Stages I, II, III and IV patients at diagnosis generated, respectively, 27.8%, 32.7%, 26.2% and 13.3% of the total YLL. For the time spent in each stage, localised melanomas, node metastatic melanomas, and distant metastatic accounted, respectively, for 34.8%, 52.6% and 12.6% of the total YLD. Parametric uncertainty was very limited, but the influence of using pre-2010 Global Burden of Disease approaches was substantial. Interpretation: The total DALY for melanoma was consistent with the previous studies. Our results in terms of proportions of DALY/YLL/YLD per stage could be extrapolated to other high-income countries. YLDs generated by localised melanoma which will never metastasize were inferior to YLLs resulting from stage IA melanomas. This result supports the hypothesis that efforts for an earlier diagnosis of melanoma are important. Funding: None.
    Full-text · Article · Jan 2016 · European journal of cancer (Oxford, England: 1990)
  • Source
    • "In fact, it is the most common form of cancer in young adults ages 25 to 29 years old, and the second most common cancer in those ages 15 to 24 years old. [1] Melanoma has a further predilection for higher socioeconomic groups and has an estimated annual productivity loss due to mortality of $3.5 billion [2]. Most of the melanoma cases diagnosed are in early stages of disease and have an excellent prognosis with 86-95% 10 year survival with appropriate therapy. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Neoadjuvant therapy is an under-utilized regimen for the treatment of metastatic melanoma. The use of this approach has been increasing in other tumor types. Neoadjuvant therapy may reduce occult circulating tumor cell burden in the face of bulky disease and afford a real time evaluation of treatment effectiveness. Neoadjuvant approach can also provide preoperative histologic and molecular analysis of treated tissue that may guide the postoperative treatment planning in patients with resectable metastatic melanoma lesions. The putative benefits of better margin control and clearance of occult systemic disease would theoretically improve surgical outcome. With the advent of effective agents against metastatic melanoma, this common approach to the treatment of rectal cancer, metastatic colon cancer, and breast cancer should also be evaluated as a viable treatment strategy for advanced stage melanoma.
    Full-text · Article · Nov 2013
  • Source
    • "Therefore, information material designed to educate on Public (Skin) Health issues serve as important communication tools of decision-making in doctors-patients relationship and preventive medicine [7]. Preventive efforts reduce mid- and long-term costs for public medical care of all types of UV radiation-related skin diseases [8,9]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Unprotected leisure time exposure to ultraviolet radiation from the sun or artificial tanning beds is the most important environmental risk factor for melanoma, a malignant skin cancer with increasing incidences over the past decades. The aim of the present study was to assess the impact of skin health information provided by several sources and different publishing issues on knowledge, risk perception, and sun protective behavior of sunbathers. A cross-sectional questionnaire survey was conducted among Austrian residents (n=563) spending leisure time outdoors in August 2010. Print media, television, and family were perceived as the most relevant sources of information on skin health, whereas the source physician was only ranked as fourth important source. Compared to other sources, information provided by doctors positively influenced participants' knowledge on skin risk and sun protective behavior resulting in higher scores in the knowledge test (p=0.009), higher risk perception (p<0.001), and more sun protection (p<0.001). Regarding gender differences, internet was more often used by males as health information source, whereas females were more familiar with printed information material in general. The results of this survey put emphasis on the demand for information provided by medical professionals in order to attain effective, long-lasting promotion of photoprotective habits.
    Full-text · Article · Mar 2013
Show more