Distribution Of Malignant Tumors And Its Disease Economic Burden In Shaoxing Residents

With the development of society,change of lifestyle and aging of population, disease pattern in the world was changed from the infectious diseases to non-communicable diseases as the main disease burden.Chronic non-communicable diseases such as malignant tumors had become the major diseases to seriously threaten people's lives and health.In our country,malignant tumors had become the NO.1&2 death causes in both urban and rural residents.Longer course of disease and higher medical costs brought a heavy economic burden to the individuals,concerned families and our society.1 ObjectiveTo analyze death distribution and life loss induced by malignant tumors in Shaoxing residents,and to investigate the disease economic burden of malignant tumors.2 Methods2.1 Death investigation of malignant tumorsThe death data of malignant tumors from January 1^st2008 to December 31^th2008 in Yuecheng district,Shangyu and Xinchang counties of Shaoxing were investigated. The death causes were classified by ICD-10.The Statistical indexes such as mortality rate,standardized mortality rate,average life expectancy,removal of malignant tumors death in life expectancy,potential years of life lost(PYLL),PYLL rate,average potential years of life lost(AYLL),working potential years of life lost(WPYLL), WPYLL rate,average working potential years of life lost(AWYLL)were calculated and used to evaluate the disease burden of malignant tumors.2.2 The economic burden investigation of malignant tumors deathsThe economic costs due to malignant tumors were surveyed in about half of randomized dead patients in 2008.These patients were died of six kinds of main malignant tumors including lung,stomach,liver,esophageal,intestinal and breast cancer.The patient's family numbers,relatives and friends were interviewed and the Questionnaire of the Medical Treatment and Expenses on Shaoxing Death Residents was used to collect the various cost information.The average economic burden of each malignant tumors were calculated.3 Results3.1 The mortality rate of malignant tumors was 174.78/100000 for Shaoxing residents in 2008.According to standard population compositions of China in 2000,standardized mortality rate was 126.17/100000.The male deaths of malignant tumors were higher than the female deaths.Standardized mortality rate with sexual ratio was 2.00:1.3.2 Malignant tumors was on the top of all death causes.And the top 10 order of death causes of Malignant tumors were lung cancer,gastric carcinoma,liver cancer, esophageal carcinoma,intestine cancer,leukemia,breast cancer,nasopharyngeal cancer, carcinoma of bladder and cervix carcinoma.3.3 Mortality rate of malignant tumors increased with age.To above 80 years old group,its mortality rate reached a peak.And death occurred mainly in people over the age of 45.3.4 For children and adolescents aged 0-19,constituent ratio of death of leukemia ranked top of all malignant tumors.Constituent ratio of death of youngsters and middle aged 20-59 of liver cancer ranked top of all malignant tumors.In the above 60 years old group,constituent ratio of death of lung cancer ranked top of all malignant tumors.3.5 Malignant tumors caused 36172.00 person years of PYLL on Shaoxing residents in 2008.It was on the top of PYLL of all death.AYLL of malignant tumors was 11.16 years.PYLL rate of malignant tumors was 19.51‰.WPYLL of malignant tumors was 16607.50 people year.AWYLL of malignant tumors was 5.13 years.WPYLL rate of malignant tumors was 8.96‰.PYLL,PYLL rate,WPYLL and WPYLL rate of malignant tumors in males were all higher than those in females.But the females' AYLL and AWYLL were higher than males'.3.6 Constituent ratio of average potential years of lost of leukemia,cervical cancer, breast cancer and nasopharyngeal cancer was significantly higher than constituent ratio of death causes.3.7 The average life expectancy of Shaoxing residents in 2008 was 77.66 years. Removal of malignant tumors death in life expectancy was 80.83 years,which is 3.17 years longer than the average life expectancy.Without death induced by malignant tumors,average life expectancy for males and females increased by 3.89 years and 2.22 years,and the increase in males was higher than that in females.3.8 The average economic burden of each malignant tumors deaths on Shaoxing residents in 2008 was 52106 yuan,including direct economic burden 39618 yuan and indirect economic burden 12488 yuan.The economic burden of malignant tumors deaths on urban residents was higher than that on rural residents.3.9 The average direct economic loss 54997 yuan and 33823 yuan,which was 2.50 times and 3.48 times of per capita annual income on urban and rural residents in 2007.3.10 The average treatment costs of each malignant tumors deaths on urban and rural residents was respectively 52337 yuan and 31448 yuan,which was 64.31 times 61.21 times of per capita health care costs on urban and rural residents in 2007.4 ConclusionMalignant tumors were the main causes to effect health of Shaoxing residents. Malignant tumors led to a heavy economic burden on not only the patient families but also the whole society.Effective measures on community based integrated prevention and control work should be taken.