ABSTRACT
The exponential rise in cancer costs in South Africa (SA) was illustrated in a recent Sunday Times article entitled 'The cost of cancer can be a debt sentence'. Our Minister of Health talks of a 'war' against the high costs of cancer drugs, and epidemiologists project a sharply rising incidence. Eminent international medical journals, such as The Lancet, underline the fact that cancer cost is a growing international problem that confronts even the richest countries. If richer countries in the world are battling to cover the costs of cancer, what is the prognosis for SA?
Subject(s)
Cost of Illness , Disease Management , Health Care Rationing , Neoplasms , Patient Care Team , Health Care Rationing/methods , Health Care Rationing/organization & administration , Humans , Incidence , Neoplasms/economics , Neoplasms/epidemiology , Neoplasms/therapy , Patient Care Team/economics , Patient Care Team/organization & administration , South Africa/epidemiologyABSTRACT
PURPOSE: The problems of screening costs, as well as poor data, potentially lead to the underestimation of the incidence of hepatocellular carcinoma (HCC). In particular, this is problematic in developing countries with limited resources and poor data. The study develops a model to inform policy makers of the true incidence and potential extra cost of HCC in a developing country context. METHODS: Using Globocan 2012 data, we employed an ecological correlation design at country level to associate HCC incidence data with relevant determinant data like HBV-HCV and other exposure factors. A Poisson regression model was used to estimate potentially missed incident cases of HCC by country and region based on the country risk factor covariate values. RESULTS: The results indicated that HBV and HCV prevalence were significantly associated with HCC incidence (p<0.001) and potentially accounted for 94%% of incident HCC in 2012. We estimated a total of 120,772 potentially missed incident HCC cases in 2012. These cases are largely predicted for South Asia (>21,000), North Asia (>15,000), Western Africa (14,500) and Eastern Africa (12,500). CONCLUSIONS: Developing countries, with poorer quality data and a high historical burden of hepatitis, were predicted to have the majority of missed HCC cases in 2012 based on our model. These countries are, therefore, less able to detect, budget for or manage HCC. The high cost of HCC treatment, as well as its economic implications, poses a challenge in resource poor settings.
Subject(s)
Carcinoma, Hepatocellular/epidemiology , Global Health/statistics & numerical data , Liver Neoplasms/epidemiology , Humans , Incidence , Prevalence , Risk FactorsABSTRACT
Non-Hodgkins lymphoma of the ovary is a rare disease and there is only one previously documented case arising in a patient with human immunodeficiency virus (HIV). In this report, the authors discuss the management of a case of non-Hodgkins Lymphoma of the ovary occurring in a patient with HIV and demonstrate that treatment regimens may be successfully implemented in this immunocompromised population without an increase in adverse effects.
