Epidemiology and Hospitalization Cost of Bladder Cancer in Kerman Province, Southeastern Iran
Background: Bladder cancer is the fifth most common cancer in Iran. In this study, we aimed to assess the epidemiological status and calculate the hospitalization cost of bladder cancer patients in the southeastern part of Iran.
Methods: This retrospective study reviewed the medical records of 243 patients admitted to a referral center for the treatment of bladder cancer patients in the southeastern part of Iran during the years 2014–2015 and extracted their pathologic and hospitalization cost data. Using Kruskal-Wallis and Mann-Witney tests, we investigated the association between hospitalization cost and other variables including sex, age, cancer grade, cancer histology, type of treatment and time from diagnosis.
Results: About 53% of patients were in grade III or IV. More than half of them were non- muscle invasive (65%). The mean and median hospitalization costs per month were US$101 and US$72, respectively. The annual hospitalization cost for the first, second, and third year after diagnosis was estimated US$1608, US$840, and US$468 respectively. About 70% of patients were hospitalized only during the first year after diagnosis. In muscle-invasive bladder cancer, patients the average monthly hospitalization cost were about 2.1 times more than for non-muscle invasive patients (US$156 vs. US$76).
Conclusion: Bladder cancer is a costly disease and its cost significantly varies with disease stage at diagnosis. Developing effective strategies for early detection of bladder cancer as well as careful surveillance programs for early diagnosis of recurrence could reduce the cost of this cancer.
Ferlay J, Soerjomataram I, Dikshit R et al (2015). Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 136(5):E359-86.
Ploeg M, Aben KK, Kiemeney LA (2009). The present and future burden of urinary bladder cancer in the world. World J Urol, 27(3): 289–293.
Kim MJ, Shin DH, Song MJ, Song HY, Seo M (2013). Paleoparasitological surveys for detection of helminth eggs in archaeological sites of Jeolla-do and Jeju-do. Korean J Parasitol, 51(4): 489–492.
Aldousari S, Kassouf W (2010). Update on the management of non-muscle invasive bladder cancer. Can Urol Assoc J,4(1): 56–64.
James AC, Gore JL (2013). The costs of non-muscle invasive bladder cancer. Urol Clin North Am, 40(2):261-9.
van der Heijden AG, Witjes JA (2009). Recurrence, progression, and follow-up in non–muscle-invasive bladder cancer. Eur Urol Suppl, 8:556-562.
Yazbek-Hanna M, Whelan P, Jain S (2016). Bladder cancer. Medicine, 44:52-55.
Mossanen M, Gore JL (2014). The burden of bladder cancer care: direct and indirect costs. Curr Opin Urol, 24(5):487-91.
Yeung C, Dinh T, Lee J (2014). The health economics of bladder cancer: an updated review of the published literature. Pharmacoeconomics, 32(11):1093-104.
Leal J, Luengo-Fernandez R, Sullivan R, Witjes JA (2016). Economic burden of bladder cancer across the European Union. Eur Urol, 69(3):438-47.
Sleeper J., Lotan Y. (2011) Economics of Bladder Cancer Diagnosis and Surveillance. In: Lokeshwar V., Merseburger A., Hautmann S. (eds) Bladder Tumors: Cancer Drug Discovery and Development. Humana Press, pp. 121-137.
Moradi-Lakeh M, Vosoogh-Moghaddam A (2015). Health sector evolution plan in Iran; equity and sustainability concerns. Int J Health Policy Manag, 4(10): 637–640.
The Central Bank of Islamic Republic of Iran (CBI), Exchange Rate. http://www.cbi.ir/ExRates/rates_fa.aspx
Schinkel JK, Shao S, Zahm SH et al (2016). Overall and recurrence-free survival among black and white bladder cancer patients in an equal-access health system. Cancer Epidemiol, 42:154-8.
Fernandez-Gomez J, Madero R, Solsona E et al (2009). Predicting nonmuscle invasive bladder cancer recurrence and progression in patients treated with bacillus Calmette-Guerin: the CUETO scoring model. J Urol, 182(5):2195-203.
Yavari P, Sadrolhefazi B, Mohagheghi M, Mehrazin R (2009). A descriptive retrospective study of bladder cancer at a hospital in Iran (1973-2003). Asian Pac J Cancer Prev, 10(4):681-4.
Salehi A, Khezri A-a, Malekmakan L, Aminsharifi A (2011). Epidemiologic status of bladder cancer in Shiraz, southern Iran. Asian Pac J Cancer Prev, 12(5):1323-7.
Han M, Schoenberg MP(2000). The use of molecular diagnostics in bladder cancer. Urol Oncol, 5(3):87-92.
Avritscher EB, Cooksley CD, Grossman HB et al (2006). Clinical model of lifetime cost of treating bladder cancer and associated complications. Urology, 68(3):549-53.
Cooksley CD, Avritscher EB, Grossman HB et al (2008). Clinical model of cost of bladder cancer in the elderly. Urology, 71(3):519-525.
Svatek RS, Hollenbeck BK, Holmäng S et al (2014). The economics of bladder cancer: costs and considerations of caring for this disease. Eur Urol, 66(2):253-62.
Babjuk M, Böhle A, Burger M et al (2017). EAU Guidelines on Non–Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Urol, 71(3):447-461.
Spiess PE, Agarwal N, Bangs R et al (2017). Bladder Cancer, Version 5.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 15(10):1240-1267.
Han H, Hyun SS (2015). Customer retention in the medical tourism industry: Impact of quality, satisfaction, trust, and price reasonableness. Tour Manag, 46:20-29.
Madeb R, Golijanin D, Noyes K et al (2009). Treatment of nonmuscle invading bladder cancer: do physicians in the United States practice evidence based medicine? Cancer, 115(12):2660-70.
Hall MC, Chang SS, Dalbagni G et al (2007). Guideline for the management of nonmuscle invasive bladder cancer (stages Ta, T1, and Tis): 2007 update. J Urol, 178(6):2314-30.
Sievert KD, Amend B, Nagele U et al (2009). Economic aspects of bladder cancer: what are the benefits and costs? World J Urol, 27(3): 295–300.
Uchida A, Yonou H, Hayashi E et al (2007). Intravesical instillation of bacille Calmette-Guerin for superficial bladder cancer: cost-effectiveness analysis. Urology, 69(2):275-279.
Kilbridge K, Kantoff P, Loughlin K (1997). Is bacillus calmette-guerin (BCG) immunotherapy cost-effective in recurrent high grade transitional cell cancer (TCC). J Urol, (4) (Suppl):214. Abstract
van Rhijn BW, Burger M, Lotan Y et al (2009). Recurrence and progression of disease in non–muscle-invasive bladder cancer: from epidemiology to treatment strategy. Eur Urol, 56(3):430-42.
The National Institute for Health and Care Excellence (NICE), Bladder cancer: diagnosis and management of bladder cancer (2015) NICE guideline 2, https://www.nice.org.uk/guidance/NG2
Drug Deputy of Iran Food and Drug Organization. The Drug Price List in 2015. Tehran, Iran: Ministry of Health and Medical Education; 2015. http://www.fda.gov.ir/item/463
Grossman HB, Natale RB, Tangen CM et al (2003). Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med, 349(9):859-66.
Collaboration ABCM-a (2005). Adjuvant chemotherapy in invasive bladder cancer: a systematic review and meta-analysis of individual patient data Advanced Bladder Cancer (ABC) Meta-analysis Collaboration. Eur Urol, 48(2):189-199.
Leow JJ, Martin-Doyle W, Rajagopal PS et al (2014). Adjuvant chemotherapy for invasive bladder cancer: a 2013 updated systematic review and meta-analysis of randomized trials. Eur Urol, 66(1):42-54.
Shamsnia SJ, Khezri AA, Tabbatabaei HR, Mehrabani D (2013). Survival from Bladder Cancer in Shiraz, Southern Iran: A Hospital-Based Study. Middle East J Sci Res, 18(4):425-431.
Reardon ZD, Patel SG, Zaid HB et al (2015). Trends in the use of perioperative chemotherapy for localized and locally advanced muscle-invasive bladder cancer: a sign of changing tides. Eur Urol, 67(1):165-170.
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|Bladder cancer Hospitalization cost Iran|
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