Impact of smoking habit on medical care use and its costs: a prospective observation of National Health Insurance beneficiaries in Japan

Izumi, Yasukatsu; Tsuji, Ichiro; Ohkubo, Takayoshi; Kuwahara, Aya; Nishino, Yoshikazu; Hisamichi, Shigeru

doi:10.1093/ije/30.3.616

Cited by 68 publications

(79 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As all of the analyses showed consistent trends (Supplementary Materials), we chose the commonly accepted threshold PY20 in the further analyses. (23) Multivariate analysis including EGFR, sex, and smoking status showed that only drug-sensitive EGFR mutations were significantly associated with longer OS and PFS (OS: hazard ratio = 0.48, 95% CI = 0.36 -0.63, P < 0.001) (PFS: hazard ratio = 0.29, 95% CI = 0.22-0.37, P < 0.001) ( Table 2). Next, we separated the impact of EGFR, sex, and smoking status on survival of patients treated with gefitinib to further understanding of these factors.…”

Section: Resultsmentioning

confidence: 99%

“…Ever-smokers were classified into two categories based on the degree of cumulative smoking dose: 40 patients with light-to moderate-smoking status (0 < pack-years [PY] < 20), and 152 patients with heavy-smoking status (20 ≤ PY). (23) The details of the patient characteristics are shown in Table 1 Detection of EGFR mutations. The direct sequence with genomic DNA was used for all specimens analyzed in Okayama University Hospital and 66 specimens in National Cancer Center Hospital.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Epidermal growth factor receptor mutation, but not sex and smoking, is independently associated with favorable prognosis of gefitinib‐treated patients with lung adenocarcinoma

Toyooka¹,

Takano

Kosaka³

et al. 2008

Cancer Science

View full text Add to dashboard Cite

Epidermal growth factor receptor (EGFR) mutations have been reported as a predictive factor for favorable prognosis of gefitinibtreated patients with lung adenocarcinoma. However, its confounding with sex and smoking makes it unclear whether the EGFR mutation is independently associated with prolonged patient survival. In this study, we analyzed a large-scale database to discriminate the survival impact of EGFR mutations against those of sex and smoking after gefitinib therapy. EGFR mutations in exon19 and exon21 named drug-sensitive EGFR mutations were examined to investigate the impact of EGFR mutation, sex, and smoking status on survival of 362 gefitinib-treated patients with lung adenocarcinoma. Drugsensitive EGFR mutations were detected in 169 patients (46.7%). The multivariate analysis including EGFR, sex, and smoking status showed that drug-sensitive EGFR mutations were significantly related to longer overall survival (OS) (P < 0.001) and progressionfree survival (PFS) (P < 0.001). In addition, we investigated the impact of sex and smoking status according to EGFR mutation status, and the impact of EGFR mutation status according to sex and smoking status on survival. Sex and smoking status were not significantly associated with longer OS and PFS according to EGFR mutation status. Drug-sensitive EGFR mutations were significantly associated with longer OS and PFS according to sex or smoking status. Our results indicated that drug-sensitive EGFR mutations were the only independent factor for longer survival of patients treated with gefitinib, suggesting that patient selection based on EGFR mutation status for gefitinib therapy will lead to a better outcome for patients with lung adenocarcinoma. (Cancer Sci 2008; 99: 303-308) E pidermal growth factor receptor (EGFR) is a receptor tyrosine kinase that is highly expressed in cancer cells.(1) Gefitinib and erlotinib are reversible EGFR tyrosine kinase inhibitors (EGFR-TKI) used for the treatment of non-small-cell lung cancer (NSCLC) patients.(2) Previous studies have focused on identifying factors that are useful indicators when selecting candidate patients for gefitinib treatment. An adenocarcinoma histology, female sex, a never-smoking status, and an East Asian ethnicity are clinicopathological factors that are associated with sensitivity to gefitinib and these factors can be indicators for gefitinib therapy. (2,3) Mutations in EGFR have been reported, particularly in NSCLC.(1,4,5) EGFR mutations are frequently located in exon19 and exon21 of the EGFR tyrosine kinase domain and play an oncogenic role in adenocarcinoma.(6) Previous studies have shown that a positive EGFR mutation status is significantly related to adenocarcinoma histology, female sex, a never-smoking status, and an East Asian ethnicity.(4,5,7-10) Of clinical interest, approximately 80% of patients with the EGFR mutation, especially exon19 deletions and the L858R mutation at exon21, are associated with sensitivity to reversible EGFR-TKIs. Positive EGFR mutation status is considered to predict a ...

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Epidermal growth factor receptor mutation, but not sex and smoking, is independently associated with favorable prognosis of gefitinib‐treated patients with lung adenocarcinoma

Toyooka¹,

Takano

Kosaka³

et al. 2008

Cancer Science

View full text Add to dashboard Cite

show abstract

“…Em estudo conduzido por Izumi et al (2001) no Japão, observou-se que cerca de 92% dos indivíduos adultos utilizam, em média, 2 a 2,5 consultas médicas/mês. Na Califórnia, entre os participantes adultos, maiores de 40 anos de idade, em um estudo de intervenção, Lorig et al (2001) relatam cerca de 5,86 visitas ao médico ou a um serviço de emergência nos últimos 6 meses.…”

Section: Utilização De Serviços De Saúde Pelos Portadores De Problemaunclassified

Prevalência de doenças crônicas auto-referidas e utilização de serviços de saúde, PNAD/1998, Brasil

Almeida

Barata²,

Montero

et al. 2002

Ciênc. saúde coletiva

View full text Add to dashboard Cite

Com o envelhecimento da população brasileira torna-se cada vez mais importante conhecer a prevalência das doenças crônicas. Essas doenças constituem-se em forte demanda aos serviços de saúde. Foram utilizados os dados da amostra da PNAD/98. Analisou-se o conjunto de doenças crônicas auto-referidas, empregou-se a razão de prevalência e razão de odds ratios com intervalo de confiança de 95% para verificar a presença de associações. Comprovou-se o aumento da prevalência das doenças crônicas com o aumento da idade; padronizando-se a idade identificou-se um gradiente de redução da prevalência com aumento da escolaridade e da renda. Observou-se maior prevalência entre mulheres e entre os que não possuíam plano de saúde. A presença de doença crônica estava associada à má avaliação do estado de saúde e de restrição de atividade. A utilização dos serviços de saúde foi de 1,8 vezes entre os portadores de doenças crônicas; com um consumo significativamente maior do número médio de consultas. Não se verificou diferença significante do número médio de consultas médicas por estrato de renda. Entre os portadores de doença crônica não houve diferença significativa do número médio de consultas entre usuários do SUS e de planos privados de saúde.

show abstract

“…If two or more articles were published on the same study, the most recent article was selected and the earlier article(s) not used. Eleven articles [19][20][21][22][23][24][25][26][27][28][29] were selected for calculating the ratio of mean medical expenditure between smokers and nonsmokers. We did not find many articles in which medical expenditures of female smokers were described.…”

Section: Articles and Information Collectedmentioning

confidence: 99%

Comparing medical expenditures of smokers and nonsmokers in studies using direct methodology in Japan

Shimada

Miyakawa

Tatemichi³

et al. 2007

Keio J. Med.

View full text Add to dashboard Cite

Abstract. Numerous epidemiologic studies have revealed that smoking is a significant risk factor of many diseases. Some studies reported increase in medical expenditure by smoking using odds or hazard ratios between smoking and diseases in epidemiologic studies. The purpose of the present study is to investigate the ratios of mean medical expenditures between smokers and nonsmokers from studies conducted observing medical expenditure directly in Japan. We collected 11 published articles of studies conducted observing medical expenditures of smokers and nonsmokers directly in Japan. The weighted geometric mean of ratios between age-adjusted mean medical expenditures for smokers and nonsmokers of National Health Insurance and Government-Managed Health Insurance beneficiaries which included many elderly individuals was somewhat greater than 1.0, while the value of Society-Managed Health Insurance that included a small number of elderly people was less than 1.0. Smoking and smokers' indifference to health increase the medical expenditure of the smokers, especially elderly smokers. It was not determined, however, whether the mean medical expenditure of smokers is actually greater than that of nonsmokers. (Keio J Med 56 (2) : 53 -60, June 2007)

show abstract

Impact of smoking habit on medical care use and its costs: a prospective observation of National Health Insurance beneficiaries in Japan

Abstract: Smokers consume excess medical care. Among the population aged 45 years and over, about 4% of total medical costs were attributable to smoking. To pursue both better health and lower medical costs for the nation, a comprehensive programme to reduce tobacco use is needed.

Cited by 68 publications

References 14 publications

Epidermal growth factor receptor mutation, but not sex and smoking, is independently associated with favorable prognosis of gefitinib‐treated patients with lung adenocarcinoma

Epidermal growth factor receptor mutation, but not sex and smoking, is independently associated with favorable prognosis of gefitinib‐treated patients with lung adenocarcinoma

Prevalência de doenças crônicas auto-referidas e utilização de serviços de saúde, PNAD/1998, Brasil

Comparing medical expenditures of smokers and nonsmokers in studies using direct methodology in Japan

Contact Info

Product

Resources

About