Lai Ling Hui, Emily Liao, Jin Xiao Lian, Ching So, Ting Ting Wu, Carlos K H Wong, Tharani Loganathan, Edmund Anthony S Nelson
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引用次数: 0
Abstract
Background: Breastfeeding protects mothers against breast cancer. Our study aimed to estimate the healthcare cost-savings resulting from a reduction in breast cancer attributed to an increase in the breastfeeding rate in Hong Kong.
Methods: This is an economic evaluation. We constructed an individual-based Monte Carlo method to simulate with probabilistic sensitivity analysis the development of breast cancer over a woman's lifetime in a hypothetical birth cohort aged 20 years in 2018 (n = 33500) using best available data mainly from government statistics. We predicted the cases of, and deaths due to breast cancer in the base case (with the actual breastfeeding rate in 2018) and two hypothetical optimal scenarios (90% exclusive breastfeeding for six months or cumulative exclusive/partial breastfeeding for at least 12 months). The healthcare cost-savings, the number of deaths averted and the increase in disability-adjusted life years (DALYs) due to the prevention of breast cancer attributed to a higher breastfeeding rate were then deduced, assuming an annual discount rate of 3%.
Results: Increasing the proportion of parous women breastfeeding exclusively for six months from 26 to 90% averted 266 (95% CI 259, 273) or ~ 10% of all-stage breast cancer cases, 18 deaths (95% CI 17, 19) and 399 DALYs (95% CI 381, 416), over the lifetime of each annual cohort of women in Hong Kong. The lifetime medical costs that could be saved would be ~ USD3 million using 2018 prices. However cost-savings were 5-times less in another scenario where the cumulative partial/exclusive breastfeeding for 12 months in parous women is increased to 90% due to its weaker protection against breast cancer compared to exclusive breastfeeding.
Conclusions: Promoting and protecting breastfeeding could lead to cost-savings for treating breast cancer in Hong Kong. Our analysis can inform the annual healthcare budget that could be allocated to promote exclusive breastfeeding for six months.
背景：母乳喂养可以保护母亲免受乳腺癌的侵害。我们的研究旨在估计香港母乳喂养率的提高，可减少乳癌的发病率，从而节省医疗费用。方法：进行经济评价。我们构建了一种基于个体的蒙特卡罗方法，利用主要来自政府统计数据的最佳可用数据，对2018年一个假设的20岁出生队列（n = 33500）中女性一生中乳腺癌的发展进行概率敏感性分析。我们预测了基本情况（2018年的实际母乳喂养率）和两种假设的最佳情况（90%纯母乳喂养6个月或累计纯母乳喂养/部分母乳喂养至少12个月）下乳腺癌的病例和死亡人数。然后，在假定年折扣率为3%的情况下，推断出由于母乳喂养率较高而预防乳腺癌所节省的医疗费用、避免的死亡人数和残疾调整生命年（DALYs）的增加。结果：将全母乳喂养6个月的产妇比例从26%提高到90%，避免了266例（95% CI 259, 273）或约10%的全期乳腺癌病例，18例死亡（95% CI 17, 19）和399例DALYs (95% CI 381, 416)，在香港每年的妇女队列中。按2018年的价格计算，可以节省的终身医疗费用约为300万美元。然而，在另一种情况下，由于与纯母乳喂养相比，部分/纯母乳喂养对乳腺癌的保护作用较弱，已产妇女12个月的累计部分/纯母乳喂养增加到90%，节省的费用少5倍。结论：在香港，提倡和保护母乳喂养可以节省治疗乳腺癌的费用。我们的分析可以为年度卫生保健预算提供信息，这些预算可以用于促进6个月的纯母乳喂养。
期刊介绍：
Breastfeeding is recognized as an important public health issue with enormous social and economic implications. Infants who do not receive breast milk are likely to experience poorer health outcomes than breastfed infants; mothers who do not breastfeed increase their own health risks.
Publications on the topic of breastfeeding are wide ranging. Articles about breastfeeding are currently published journals focused on nursing, midwifery, paediatric, obstetric, family medicine, public health, immunology, physiology, sociology and many other topics. In addition, electronic publishing allows fast publication time for authors and Open Access ensures the journal is easily accessible to readers.
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