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BACKGROUND: Cancer is a critical public health issue that imposes a considerable economic burden, especially in low-resource countries. In Bangladesh, there has been a noticeable lack of research focusing on the economic burden associated with cancer. AIMS: This study aimed to examine the economic burden of cancer care and the contributing factors. METHODS: This cross-sectional study included 623 cancer patients. Data were collected between January and May 2022. The magnitude of the economic burden (no burden to extreme burden) was the outcome variable. A logistic regression model was performed to determine the associated factors of the economic burden of cancer. RESULTS: Overall, 34% of cancer survivors experienced extreme economic burden due to treatment costs. Patients with prostate (relative risk ratio, RRR = 23.24; 95% confidence interval, CI: 1.97, 273.70), bone (RRR = 5.85; 95% CI: 1.10, 31.04), and liver cancer (RRR = 4.94; 95% CI: 1.29, 18.9) reported significantly higher extreme economic burden compared to patients with other cancers. The economic burden was significantly higher for patients diagnosed with Stage III (RRR = 38.69; 95% CI: 6.17, 242.72) and Stage IV (RRR = 24.74; 95% CI: 3.22, 190.11) compared to Stage 0. Patients from low-income households suffered from nine times more extreme burden (RRR = 8.85; 95% CI: 4.05, 19.36) compared with those from high-income households. CONCLUSION: Our study found a disproportionately high economic burden among patients with cancer, across disease sites, stages, and income quintiles. The burden was significantly higher among patients with prostate, bone, and liver cancer, and those diagnosed with advanced stage. The findings underscore the importance of early cancer detection before metastasis which may lead to more efficient treatment, avoid disease progression, lower disease management costs, and better health outcomes. Patients from low-income households experience an extreme economic burden due to cancer, highlighting the need for affordable healthcare services, financial support, and healthcare subsidies.
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Supervivientes de Cáncer , Costo de Enfermedad , Neoplasias , Humanos , Supervivientes de Cáncer/estadística & datos numéricos , Masculino , Bangladesh/epidemiología , Estudios Transversales , Femenino , Persona de Mediana Edad , Neoplasias/economía , Neoplasias/terapia , Neoplasias/epidemiología , Adulto , Costos de la Atención en Salud/estadística & datos numéricos , Anciano , Adulto JovenRESUMEN
Objective: To investigate the trends and patterns of the cancer burden among the elderly in different regions of India at a subnational level. Methods: Data were extracted from the Global Burden of Disease (GBD) Studies India Compare 2019. Prevalence rate, disability-adjusted life years (DALY), and annual percentage change techniques were used to analyze data. Results: The three age groups with the highest prevalence of cancer were those aged 60-64 years, 65-69 years, and 70-74 years. In 2019, The prevalence of cancer among the elderly ranged from 7048.815 in Karnataka to 5743.040 in Jharkhand. Kerala has the most significant annual percentage change in the cancer prevalence rate of 0.291 between 1990 and 2019. The highest DALY rate was observed among individuals aged 80-84 years in 2019. That year, the DALY rate among the elderly was 8112.283 in India. The top five cancers with higher DALY rates among the elderly in India in 2019 were tracheal, bronchus, and lung cancer (908.473), colon and rectum cancer (752.961), stomach cancer (707.464), breast cancer (597.881), and lip and oral cavity cancer (557.637). Conclusion: Elderly individuals demonstrated a higher vulnerable to cancer compared to other age groups. There is a need for state-specific government intervention to minimize the risk of cancer among the elderly due to the heterogeneity in the burden of cancer across Indian states.
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BACKGROUND: The monoclonal antibody durvalumab, an immune-checkpoint inhibitor (ICI) antiprogrammed death ligand 1 (PD-L1), is available for unresectable stage III NSCLC patients as consolidation therapy following induction chemoradiotherapy, with very promising overall survival (OS) and progression-free survial (PFS) results in registration trials. The purpose of this study was to provide policymakers with an estimate of the cost-effectiveness of durvalumab in the treatment of non-small cell lung cancer (NSCLC). METHODS: The study developed a Markov model covering a 5-year period to compare costs and outcomes of treating PD-L1 positive patients with or without durvalumab. We conducted a series of sensitivity analyses (Tornado analysis and Monte Carlo simulation) by varying some parameters to assess the robustness of our model and identify the parameters with the greatest impact on cost-effectiveness. RESULTS: Prior to the release of durvalumab, the management of NSCLC over a 5-year period cost 33 317 per patient, with an average life expectancy of 2.01 years. After the introduction of the drug, this increased to 37 317 per patient, with an average life expectancy of 2.13 years. Treatment with durvalumab led to an incremental cost-effectiveness ratio (ICER) of 35 526 per year. OS is the variable that contributes the most to the variability of the ICER. CONCLUSIONS: The study observed that durvalumab is a cost-effective treatment option for patients with unresectable stage III NSCLC.
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Antineoplásicos Inmunológicos , Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Anticuerpos Monoclonales/uso terapéutico , Antineoplásicos Inmunológicos/efectos adversos , Antígeno B7-H1/uso terapéutico , Quimioradioterapia/efectos adversos , Análisis Costo-Beneficio , Humanos , Inhibidores de Puntos de Control InmunológicoRESUMEN
BACKGROUND: With ageing populations and rising cancer incidence, more people are becoming informal caregivers. Informal caregivers are less likely to work than non-caregivers, yet little is known about how their employment changes over time. This study aimed to examine the association between decline in cancer patient's health (termed health shock) and caregiver's employment. A secondary aim was to assess characteristics of caregivers who stayed employed despite the health shock and the burden of caring for advanced stage cancer patients. METHOD: This study used data from 270 dyads of advanced cancer patients and their caregivers who participated in the Cost of Medical Care of Patients with Advanced Serious Illness in Singapore study. The dyads were interviewed every 3 months for 2 years. Fixed-effects regression was used to analyse the association between patient health shock and two caregiver employment outcomes (i.e., employment status and work disruptions). RESULTS: Ninety-seven% of caregivers whose patient experienced a health shock reported work disruptions. About 13% of caregivers whose patient experienced at least one health shock left employment, compared to 5% of those whose patient did not experience any health shock. Following a patient health shock, caregivers were significantly less likely to be employed (ß: -0.03; 95% CI, -0.05 to -0.001) and more likely to experience work disruptions (ß: 0.06; 95% confidence interval [CI], -0.01 to 0.12). Caregivers who were young, educated, unmarried, not spousal caregivers, and not living with their patients were more likely to stay employed despite patient health shock (p < 0.01 for all). CONCLUSION: Findings show that caregivers' employment is affected by their patients' health through the caregiving trajectory. Continuous support for caregivers catered to specific vulnerable subgroups may be important to keeping caregivers in the workforce.
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Cuidadores , Neoplasias , Costo de Enfermedad , Empleo , Humanos , SingapurRESUMEN
Several infectious agents are ascertained causes of cancer, but the burden of cancer mortality attributable to carcinogenic infections in Italy is still unknown. To tackle this issue, we calculated the rate and regional distribution of cancer deaths due to infections sustained by seven pathogens ranked as group 1 carcinogenic agents in humans by the International Agency for Research on Cancer. Population attributable fractions related to these agents were applied to annual statistics of cancer deaths coded according to the 10th International Classification of Diseases. The estimated burden of cancer mortality attributable to carcinogenic infections in Italy during the period 2011-2015 was 8.7% of all cancer deaths registered yearly, on average. Approximately 60% of deaths occurred in men, and almost the whole burden was due to four infectious agents (Helicobacter pylori, hepatitis C virus, high-risk human papillomavirus, and hepatitis B virus). The analysis of regional distribution showed a higher number of infection-related cancer deaths in the northern regions, where the estimates reached 30 (Liguria) and 28 (Friuli Venezia Giulia) deaths per 100,000 inhabitants in 2015. Since one-twelfth of cancer deaths were attributable to these modifiable risk factors, the implementation of appropriate prevention and treatment interventions may help to reduce the impact of these infections on cancer mortality.
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Infecciones por Virus ADN , Infecciones por Helicobacter , Neoplasias , Infecciones por Virus ADN/complicaciones , Infecciones por Virus ADN/epidemiología , Infecciones por Virus ADN/mortalidad , Femenino , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/mortalidad , Helicobacter pylori , Hepatitis B/complicaciones , Hepatitis B/epidemiología , Hepatitis B/mortalidad , Hepatitis C/complicaciones , Hepatitis C/epidemiología , Hepatitis C/mortalidad , Humanos , Italia/epidemiología , Masculino , Neoplasias/complicaciones , Neoplasias/microbiología , Neoplasias/mortalidad , Neoplasias/virología , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/mortalidadRESUMEN
Cancer is the first or second leading cause of premature death (i.e., at ages 30-69 years) in 134 of 183 countries, and it ranks third or fourth in an additional 45 countries. An estimated 18.1 million new cancer cases and 9.6 million cancer-related deaths occurred worldwide in 2018. The incidence of cancer globally is expected to exceed 27 million new cancer cases per year by 2040 in part due to the aging of the population and greater susceptibility to aging-related diseases such as cancer. This estimated increase in cancer incidence will occur in all countries, but the predicted increase will be proportionately greatest in low and medium countries. Cancer is also a disease associated with significant morbidity. It is estimated that the total annual economic cost of cancer in 2010 was US$1.16 trillion per year.
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Neoplasias , Enfermería Oncológica , Adulto , Anciano , Salud Global , Humanos , Persona de Mediana Edad , Neoplasias/epidemiologíaRESUMEN
PURPOSE: China has a heavy cancer burden. We aimed to quantitatively estimate the secular trend of cancer mortality and incidence in China. METHODS: We extracted numbers, age-specific and age-standardized rates of 29 cancer groups (from 1990 to 2017) from the Global Burden of Disease (GBD) study in 2017. We estimated rates of major cancer types for annual percent change by Joinpoint regression, and for age, period, and cohort effect by an age-period-cohort model. RESULTS: In 2017, breast cancer had the highest incidence rate in females. Lung cancer had the highest mortality and incidence rates in males. Although the age-standardized incidence rate of prostate cancer ranked second highest in males, it increased by 112% from 1990 to 2017. Individuals aged over 50 years were at high risk of developing cancer, and the number of deaths at this age accounted for over 89% of all cancers in all age groups. When compared with the global average level, the age-standardized mortality and incidence rates of both liver and esophageal cancers were 2.1 times higher in China, and stomach, lung and nasopharyngeal cancers in China also had high levels (more than 1.5 times higher). During 1990-2017, most of the 29 cancers exhibited an increasing incidence trend, and Joinpoint regression demonstrated increasing mortality of some major cancers. The period effect indicated that the risk of mortality and incidence due to the main cancers generally increased during 1992-2017. CONCLUSION: Trend analysis provided information on the effects of prevention strategies and targeted interventions on the occurrence of different cancers. Etiological studies need to be conducted on some major cancers in the Chinese population.
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BACKGROUND: Quantifying the potential cancer cases associated with environmental carcinogen exposure can help inform efforts to improve population health. This study developed an approach to estimate the environmental burden of cancer and applied it to Ontario, Canada. The purpose was to identify environmental carcinogens with the greatest impact on cancer burden to support evidence-based decision making. METHODS: We conducted a probabilistic assessment of the environmental burden of cancer in Ontario. We selected 23 carcinogens that we defined as "environmental" (e.g., pollutants) and were relevant to the province, based on select classifications provided by the International Agency for Research on Cancer. We evaluated population exposure to the carcinogens through inhalation of indoor/outdoor air; ingestion of food, water, and dust; and exposure to radiation. We obtained or calculated concentration-response functions relating carcinogen exposure and the risk of developing cancer. Using both human health risk assessment and population attributable fraction models in a Monte Carlo simulation, we estimated the annual cancer cases associated with each environmental carcinogen, reporting the simulation summary (e.g., mean and percentiles). RESULTS: We estimated between 3540 and 6510 annual cancer cases attributable to exposure to 23 environmental carcinogens in Ontario. Three carcinogens were responsible for over 90% of the environmental burden of cancer: solar ultraviolet (UV) radiation, radon in homes, and fine particulate matter (PM2.5) in outdoor air. Eight other carcinogens had an estimated mean burden of at least 10 annual cancer cases: acrylamide, arsenic, asbestos, chromium, diesel engine exhaust particulate matter, dioxins, formaldehyde, and second-hand smoke. The remaining 12 carcinogens had an estimated mean burden of less than 10 annual cancer cases in Ontario. CONCLUSIONS: We found the environmental burden of cancer in Ontario to fall between previously estimated burdens of alcohol and tobacco use. These results allow for a comparative assessment across carcinogens and offer insights into strategies to reduce the environmental burden of cancer. Our analysis could be adopted by other jurisdictions and repeated in the future for Ontario to track progress in reducing cancer burden, assess newly classified environmental carcinogens, and identify top burden contributors.
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Carcinógenos Ambientales/administración & dosificación , Costo de Enfermedad , Exposición a Riesgos Ambientales/efectos adversos , Monitoreo del Ambiente/estadística & datos numéricos , Neoplasias/inducido químicamente , Amianto/efectos adversos , Carcinógenos , Carcinógenos Ambientales/análisis , Exposición a Riesgos Ambientales/estadística & datos numéricos , Humanos , Neoplasias/epidemiología , Ontario , Material Particulado/análisis , Medición de Riesgo , Factores de RiesgoRESUMEN
Head and neck cancer is increasing globally owing to rising rates of tobacco use and human papillomavirus infection. Today, cancer is the leading cause of death and disabilities in developed countries and the second leading cause of death in countries with developing economies. Understanding the global landscape of head and neck cancer will empower oral and maxillofacial surgeons to play a critical role among patients and societal education regarding the importance of addressing modifiable risk factors and continuing to play an important role in the diagnosis and management of head and neck cancer.
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Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello/terapia , Infecciones por Papillomavirus , Humanos , Factores de RiesgoRESUMEN
BACKGROUND: The purpose of this study was to estimate the proportion of Chinese cancer survivors experiencing financial hardship and then examine the relationship between material and behavioral financial hardship. METHODS: This study surveyed 964 cancer survivors who were 30 to 64 years old and 644 survivors who were 65 years old or older during 2015-2016 (1608 survivors in all). Material financial hardship was measured by whether they had borrowed money because of cancer, its treatment, or the lasting effects of treatment, and behavioral financial hardship was measured by whether they had forgone some cancer-related medical care because of cost. Multivariable logistic regression models were used to examine factors associated with material financial hardship by age group. RESULTS: Approximately 44% of the cancer survivors who were 65 years old or older borrowed money or went into debt because of cancer, and 54% of younger patients (P < .01) reported cancer-related debts. Among these survivors with cancer care debt, survivors aged 65 years old or older had a lower proportion of borrowing more than 50,000 Chinese yuan (CNY; approximately US $7700) than survivors aged 30 to 64 years (14% vs 20%). In both age groups, approximately 10% of cancer survivors reported that they had experienced behavioral financial hardship. After adjustments for covariates, cancer survivors who reported material financial problems were more likely to report behavioral financial hardship (odds ratio [OR] for those aged 30-64 years, 3.72; 95% confidence interval [CI], 2.13-6.50; OR for those aged 65 years or older, 5.48; 95% CI, 2.69-11.15). CONCLUSIONS: Older cancer survivors in China experience significant material financial hardship, but it is not as noticeable as younger patients' hardship. The results highlight the importance of identifying cancer survivors who are more likely to experience financial hardship and improving the affordability of cancer care in China.
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Supervivientes de Cáncer , Estrés Financiero/economía , Estrés Financiero/epidemiología , Neoplasias/economía , Sistema de Registros , Adulto , Anciano , Supervivientes de Cáncer/psicología , China/epidemiología , Costo de Enfermedad , Estudios Transversales , Bases de Datos Factuales , Femenino , Estrés Financiero/psicología , Gastos en Salud , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Neoplasias/psicología , Oportunidad Relativa , Prevalencia , Encuestas y CuestionariosRESUMEN
INTRODUCTION: The impact of carcinogenic infections on cancer-related mortality is unknown. METHODS: The mortality due to cancers attributable to carcinogenic infections was estimated. The attributable fraction for the infectious agents classified as group 1 carcinogenic in human beings was applied to yearly data on causes of cancer mortality over the period 2013-2017 in Spain according to the International Classification of Diseases (ICD-10). RESULTS: It was estimated that 9115 deaths (over 110,287 cancer-related deaths, 8.3%) were attributable to infections caused by carcinogenic agents. The estimated number of deaths in men was 5434 (59.6%). The estimated mortality attributable to Helicobacter pylori infection accounted for 48.3% and four agents (H. pylori, HCV, HPV, and HBV) accounted for 96.8% of all cancer deaths attributable to carcinogenic infections. The burden of cancer-related mortality attributable to carcinogenic infections in Spain during the period 2013-2017 was approximately 8%. CONCLUSIONS: In Spain, one-twelfth of cancer deaths are attributable to carcinogenic infections. Public health measures aiming to reduce the impact of carcinogenic infections are essential.
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Infecciones por Helicobacter , Helicobacter pylori , Neoplasias , Carcinógenos , Humanos , Masculino , Neoplasias/etiología , España/epidemiologíaRESUMEN
BACKGROUND: Obesity is a significant risk factor of several cancers that imposes a substantial economic burden on US healthcare that remains to be quantified. We estimated the excess costs and economic burden of obesity-related cancers in the United States. METHODS: From the Medical Expenditure Panel Survey (2008-2015) data, we identified 19 405 cancer survivors and 175 498 non-cancer individuals. We estimated annual health expenditures using generalized linear regression with log link and gamma distribution by cancer types (stratified by 11 obesity-related cancers and other cancer types), controlling for sociodemographic and clinical characteristics. All cost estimates were adjusted to 2015 USD value. RESULTS: The average annual total health expenditures were $21 503 (95% CI, $20 946-$22 061) for those with obesity-related cancer and $13 120 (95% CI, $12 920-$13 319) for those with other cancer types. There was a positive association between body mass index and health expenditures among cancer survivors: for each additional 5-unit increase in body mass index, the average predicted expenditures increase by $1503 among those with obesity-related cancer and by $722 among those with other cancers. With adjustments for sociodemographic and clinical characteristics, the mean incremental expenditures of treating obesity-related cancer were 2.1 times higher than those of other cancers ($4492 vs $2139) and more considerable among the non-elderly cancer population. Obesity-related cancers accounted for nearly 43.5% of total direct cancer care expenditures, estimated at $35.9 billion in 2015. CONCLUSION: The economic burden of obesity-related cancer in the United States is substantial. Our findings suggest a need for the inclusion of comprehensive obesity prevention and treatment in cancer care.
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Supervivientes de Cáncer/estadística & datos numéricos , Costo de Enfermedad , Gastos en Salud/estadística & datos numéricos , Neoplasias/economía , Obesidad/complicaciones , Adolescente , Adulto , Anciano , Índice de Masa Corporal , Estudios de Casos y Controles , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/epidemiología , Neoplasias/etiología , Obesidad/clasificación , Obesidad/epidemiología , Estados Unidos , Adulto JovenRESUMEN
PURPOSE: To examine whether the implementation of Affordable Care Act (ACA) reduced the financial burden associated with cancer care among non-elderly cancer survivors. METHODS: Using data from the MEPS-Experiences with Cancer Survivorship Survey, we examined whether there was a difference in financial burden associated with cancer care between 2011 (pre-ACA) and 2016 (post-ACA). Two aspects of financial burden were considered: (1) self-reported financial burden, whether having financial difficulties associated with cancer care and (2) high-burden spending, whether total out-of-pocket (OOP) spending incurred in excess of 10% or 20% of family income. Generalized linear regression models were estimated to adjust the OOP expenditures (reported in 2016 US dollar). RESULTS: Our sample included adults aged 18-64 with a confirmed diagnosis of any cancer in 2011 (n = 655) and in 2016 (n = 490). There was no apparent difference in the prevalence of cancer survivors reporting any financial hardship or being with high-burden spending between 2011 and 2016. The mean OOP decreased by $268 (95% CI, - 384 to - 152) after the ACA. However, we found that the mean premium payments increased by $421 (95% CI, 149 to 692) in the same period. CONCLUSIONS: The ACA was associated with reduced OOP for health services but increased premium contributions, resulting in no significant impact on perceived financial burden among non-elderly cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: The financial hardship of cancer survivorship points to the need for the development of provisions that help cancer patients reduce both perceived and materialized burden of cancer care under ongoing health reform.
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Costo de Enfermedad , Gastos en Salud/estadística & datos numéricos , Neoplasias/economía , Neoplasias/terapia , Patient Protection and Affordable Care Act , Supervivencia , Adolescente , Adulto , Supervivientes de Cáncer/estadística & datos numéricos , Femenino , Reforma de la Atención de Salud/economía , Reforma de la Atención de Salud/estadística & datos numéricos , Implementación de Plan de Salud/economía , Implementación de Plan de Salud/normas , Implementación de Plan de Salud/estadística & datos numéricos , Humanos , Seguro de Salud/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , Patient Protection and Affordable Care Act/economía , Patient Protection and Affordable Care Act/normas , Autoinforme , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Adulto JovenRESUMEN
Oncology is currently a sector of medical science with accelerated progress due to rapid technological development, the advancement in molecular biology, and the invention of many innovative therapies. Immunotherapy partially accounts for this advance, since it is increasingly playing an important role in the treatment of cancer patients, bringing on a sense of hope and optimism through a series of clinical studies and cases with spectacular results. Immunotherapy, after the initial successes it experienced in the early 20th century, was forgotten after chemotherapy and radiotherapy prevailed and developed slowly in the background. Today, it is the new hope for cancer treatment, despite the unorthodox path it has followed. In this article, we study the course and key points of the discovery of immune-oncology from the oncologist's point of view. We also record the questions that have been posed about immunotherapy that sometimes lead to confusion or stalemate.
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Neoplasias/inmunología , Neoplasias/terapia , Humanos , Inmunoterapia/métodos , Oncología Médica/métodosRESUMEN
BACKGROUND: Comparative evidence on the burden, trend, and risk factors of cancer is limited. Using data from the Global Burden of Disease (GBD) study, we aimed to assess cancer burden - incidence, prevalence, mortality, disability-adjusted life years (DALYs) - and attributable risk factors for Australia between 1990 and 2015, and to compare them with those of 34 members of the Organisation for Economic Co-operation and Development (OECD). METHODS: The general GBD cancer estimation methods were used with data input from vital registration systems and cancer registries. A comparative risk assessment approach was used to estimate the population-attributable fractions due to risk factors. RESULTS: In 2015 there were 198,880 (95% uncertainty interval [UI]: 183,908-217,365) estimated incident cancer cases and 47,562 (95% UI: 46,061-49,004) cancer deaths in Australia. Twenty-nine percent (95% UI: 28.2-29.8) of total deaths and 17.0% (95% UI: 15.0-19.1) of DALYs were caused by cancer in Australia in 2015. Cancers of the trachea, bronchus and lung, colon and rectum, and prostate were the most common causes of cancer deaths. Thirty-six percent (95% UI: 33.1-37.9) of all cancer deaths were attributable to behavioral risks. The age-standardized cancer incidence rate (ASIR) increased between 1990 and 2015, while the age-standardized cancer death rate (ASDR) decreased over the same period. In 2015, compared to 34 other OECD countries Australia ranked first (highest) and 24th based on ASIR and ASDR, respectively. CONCLUSION: The incidence of cancer has increased over 25 years, and behavioral risks are responsible for a large proportion of cancer deaths. Scaling up of prevention (using strategies targeting cancer risk factors), early detection, and treatment of cancer is required to effectively address this growing health challenge.
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Personas con Discapacidad/estadística & datos numéricos , Carga Global de Enfermedades/tendencias , Mortalidad/tendencias , Neoplasias/epidemiología , Neoplasias/mortalidad , Organización para la Cooperación y el Desarrollo Económico , Años de Vida Ajustados por Calidad de Vida , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Salud Global , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Neoplasias/terapia , Prevalencia , Pronóstico , Factores de Riesgo , Factores Sexuales , Tasa de Supervivencia , Factores de Tiempo , Adulto JovenRESUMEN
The global burden of cancer is increasing. By 2020, the global cancer burden is expected to rise by 50% owing to the increasingly elderly population. The delivery of cancer care is likely to increase the need for perioperative physicians for both operative procedures and pain management, offering new professional challenges. Specifically, these challenges will include volume and financial management, as well coordination of cancer treatment and pain management. Coordinated, team-based cancer care will be essential to ensure value-based care. Short and long-term outcome measurement is an integral part of the process.