Economic burden of colorectal and breast cancers attributable to lack of physical activity in Brazil

Abstract

Background The increasing number of cancer patients has an escalating economic impact to public health systems (approximately, International dollars- Int$ 60 billion annually in Brazil). Physical activity is widely recognized as one important modifiable risk factor for cancer. Herein, we estimated the economic costs of colon and post-menopausal breast cancers in the Brazilian Unified Health System (SUS) attributable to lack of physical activity. Methods Population attributable fractions were calculated using prevalence data from 57,962 adults who answered a physical activity questionnaire in the Brazilian National Health Survey, and relative risks of colon and breast cancer from a meta-analysis. Annual costs (1 Int$ = 2.1 reais) with hospitalization, chemotherapy and radiotherapy were obtained from the Hospital and Ambulatory Information Systems of the Brazilian SUS. Two counterfactual scenarios were considered: theoretical minimum risk exposure level (≥8000 MET-min/week) and physical activity guidelines (≥600 MET-min/week). Results Annually, the Brazilian SUS expended Int$ 4.5 billion in direct costs related to cancer treatment, of which Int$ 553 million due to colon and breast cancers. Direct costs related to colon and breast cancers attributable to lack of physical activity were Int$ 23.4 million and Int$ 26.9 million, respectively. Achieving at least the physical activity guidelines would save Int$ 10.3 mi (colon, Int$ 6.4 mi; breast, Int$ 3.9 mi). Conclusions Lack of physical activity accounts for Int$ 50.3 million annually in direct costs related to colon and post-menopausal breast cancers. Population-wide interventions aiming to promote physical activity are needed to reduce the economic burden of cancer in Brazil.

The association between health costs and physical inactivity; analysis from the Physical Activity at Work study in Thailand

“…The result aligned with previous research in other countries (38,39) that being physically active was associated with a lower health cost. Using mean annual health expenditure as the outcome variable, Carlson et al found 30% higher health expenditure in physically inactive US adults compared to active adults, and Brown (40,41). However, comparing findings between studies is challenging because of the different methods of assessment and estimation of the association between cost outcomes and physical inactivity, including the general context of study settings (15,40).…”

“…Using mean annual health expenditure as the outcome variable, Carlson et al found 30% higher health expenditure in physically inactive US adults compared to active adults, and Brown (40,41). However, comparing findings between studies is challenging because of the different methods of assessment and estimation of the association between cost outcomes and physical inactivity, including the general context of study settings (15,40). Most studies reported health expenditures that included the payer's perspective and neglected direct non-medical and indirect costs (15,(42)(43)(44).…”

“…Reverse causality is a potential issue in this study because the primary analyses used cross-sectional data where both PA and health costs data were collected at the same time (baseline), unlike some studies, which incorporated a lag of cost data collection succeeding the PA data extraction (40). Nevertheless, the PAW study inclusion criteria addressed the issue by recruiting participants without physical mobility limitations (24).…”

“…Most studies reported health expenditures that included the payer's perspective and neglected direct non-medical and indirect costs ( 15 , 42 – 44 ). While it is true that these studies extracted extensive variables from linked databases, the challenge remained to extrapolate societal cost.…”

Multidisciplinary Prehabilitation and Postoperative Rehabilitation for Avoiding Complications in Patients Undergoing Resection of Colon Cancer: Rationale, Design, and Methodology of the ONCOFIT Study

“…It has been reported that physical inactivity, dietary unhealthy habits, alcohol or tobacco consumption, and bad sleep patterns, are related not only to a higher incidence of colon cancer, but also to a greater risk of presenting surgical-derived complications [ 6 ]. Indeed, Rezende et al [ 125 ] have recently highlighted that the direct costs of colon cancer in Brazil attributable to the lack of physical activity is USD ~23.4 millions/year. Therefore, it seems evident the necessity of lifestyle interventions including physical, dietary and psychological programs to enhance the prognosis of these surgical interventions and to decrease their derived health-related costs [ 5 , 12 , 19 ].…”