Cost of treating patients with smoking history in a specialized cancer hospital.

Objective: To describe the costs of treating lung, laryngeal and esophageal cancer among patients with histories of smoking.

Methods: A longitudinal non-concurrent study on three cohorts with histories of smoking at a specialized hospital was carried out in the city of Rio de Janeiro, Southeastern Brazil, between 2000 and 2006. The sample was composed of 127 cases of lung cancer, 80 of laryngeal cancer and 35 of esophageal cancer. These cancers were selected through analyzing the frequencies and monetary values of the hospital admissions, weighted according to the fraction attributable to smoking among the population. Data were gathered from the medical files. Patients were classified according to their smoking profile, primary diagnosis, stage and comorbidities. The statistical analysis included the log-normal distribution to adjust for cost values and the Spearman correlation.

Results: The patients were heavy smokers and were diagnosed at advanced stages. The burden from smoking was high, and 92%, 72% and 94% of lung, laryngeal and esophageal cancer patients, respectively, were diagnosed at advanced stages. The most frequent comorbidities were heart diseases and respiratory diseases. The mean costs of lung, laryngeal and esophageal cancers were R$ 28,901, R$ 37,529 and R$ 33,164, respectively. The main cost drivers were radiotherapy and hospitalization. There was an association between advanced stage and lower cost for lung and esophageal cancer.

Conclusions: Since radiotherapy and hospitalization were the main total cost drivers, patients at more severe stages presented lower costs, probably because of the reduction in the number of therapeutic options.