Economic burden of lung cancer in mainland China,1996-2014:a systematic review

Objective To explore the status quo of economic burden of lung cancer in China from 1996 to 2014 and to provide references for further studies and policy making in relation to lung cancer prevention and control.Methods Based on two Chinese publication databases (China National Knowledge InfrastructureCNKI and Wangfang database) and PubMed,literatures focusing on economic burden of lung cancer and published between January 1,1996 and December 31,2 014 were retrieved with the searching words including ‘cancer’,‘economic burden’,‘cost of illness’,‘expenditure’ and so on.Then the information were abstracted from the included literatures through a strict inclusion and exclusion process.All the expenditure data were discounted to year of 2013 using China's health care consumer price index (CPI) and an average growth rate per annum (AAGR) was calculated.Results A total of 32 studies were included.The majority of the studies were individual-based (n=30) and only two population-based studies were confirmed.The numbers of studies involving ‘direct expenditure’,‘indirect expenditure’,and ‘direct and indirect expenditure’ were 26,1 and 5,respectively.The available data suggested that between 1996 and 2011,the direct expenditure per lung cancer patient ranged from 10 415-27 595 Chinese Yuan (CNY) and the overall AAGR was 2.2%(the AAGR of expenditure on inspection,medicine and laboratory testing were 3.5%,-3.2% and 2.2%,respectively).The direct expenditure per clinical visit between year 1997 and 2010 ranged from 9 463 to 38 209 CNY;the AAGR of overall,inspection,medicine and laboratory testing were -1.7%,16.9%,-2.2%,and 17.3%,respectively.The estimated expenditure per diem between year 1996 and 2009 ranged from 426 to 1 036 CNY,and the AAGR was 6.3%.Time trend of direct non-medical expenditure and indirect medical expenditure could not be clearly described due to the low comparability among the studies.Conclusion Based on the limited information from the included studies,the methodologies and results of economic burden of lung cancer in mainland China over the past 20 years were less comparable.Although substantial growth was not observed in expenditure per lung cancer patient and per clinic visit over time,the expenditure for some of the detailed breakdown items increased to different extents.