Lifetime risks, expected years of life lost, and cost-per-life year of esophageal cancer in Taiwan

Abstract

Besides lifetime risks, we estimated life expectancy (Le), expected years of life lost (eYLL), lifetime costs, and cost-per-LY (life-year) stratified by different stages of esophageal cancer (EC). From theTaiwan Cancer Registry, we collected 14,420 EC to estimate the incidence rates during 2008-2014. They were followed to 2015 to obtain the survival function, which was extrapolated to lifetime by a semiparametric method. We abstracted the monthly healthcare expenditures from the reimbursement database of National Health Insurance, which were multiplied with the corresponding survival probabilities to quantify lifetime cost and cost-per-LY after adjustments. About 93.7% of patients were male; 90.8% had squamous cell carcinoma. Most patients were diagnosed at advanced stages, with 44.6% and 28.3% at stages III and IV. The lifetime risk of EC in males increased in Taiwan with a cumulative incidence rate (CIR 30-84 ) of 0.0146% (2008~2010) to 0.0165% (2013-2014). The EYLL for stages I-IV were 15.8, 17.5, 20.5, and 22.5, while the average of cost-per-LY for stages I-IV were US$ 6,987, $8,776, $12,153, and $22,426. EC in Taiwan appears to have shifted into younger ages groups and incidence is still increasing. Strategies for prevention, early diagnosis and treatment are warranted to improve the cost-effectiveness and control of this cancer. ResultsThe mean age at diagnosis was younger for males than females (58.0 v.s. 65.2). Esophageal cancer in Taiwan is still more predominant in male (93.7%), and 90.8% are squamous cell carcinoma (Table 1).The incidence of squamous esophageal cancer in males increased gradually in Taiwan with a CIR 30-84 (‰) of 0.146 (2008~2010) to 0.165 (2013)(2014) (Tables 1 and 2). A shift in the highest IR to a younger age-group from 60-69 y

Low cardiac dose and neutrophil-to-lymphocyte ratio predict overall survival in inoperable esophageal squamous cell cancer patients after chemoradiotherapy

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The association between mortality and use of Chinese herbal medicine among incident stage IV esophageal cancer patients: A retrospective cohort study with core herbs exploration

“…For stage IV unresectable advanced or metastatic EC, treatment options are often limited and depend on each patient’s condition ( Cheng et al, 2018 ; Kato et al, 2019 ; Kitagawa et al, 2019 ). Unfortunately, most patients in Taiwan were diagnosed at advanced stages (44.6% at stage III and 28.3% at stage IV) ( Lai et al, 2020 ). Fluoropyrimidine plus platinum compounds are used as first-line therapy and taxanes as second-line therapy in stage IV EC patients.…”

Higher pre-treatment skin sympathetic nerve activity and elevated resting heart rate after chemoradiotherapy predict worse esophageal cancer outcomes

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