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首页> 外文期刊>Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer >Vulvovaginal atrophy (VVA) in breast cancer survivors (BCS) is still an unmet medical need: results of an Italian Delphi Panel
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Vulvovaginal atrophy (VVA) in breast cancer survivors (BCS) is still an unmet medical need: results of an Italian Delphi Panel

机译：乳腺癌幸存者（BCS）的外阴阴压萎缩（VVA）仍然是一个未满足的医疗需求：意大利德尔福小组的结果

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Purpose VVA is a common disease, with approximately 50% of all postmenopausal women having related symptoms. VVA has a significant impact on the personal and sexual lives and on many aspects of women's self-esteem and emotional well-being. It is particularly frequent and severe in patients treated for BC, where it originates significant economic and social costs. Given the lack of published evidence on this subject, a Delphi Panel was carried out to evaluate: The epidemiology of VVA and of its risk-factors/comorbidities in Italy The present standard of care and unmet medical needs The comparison between recent US epidemiological data and the Italian situation The health resources used in VVA BC The burden of illnessDespite the considerable negative impact on quality of life, a disparity between the high prevalence of this condition and the infrequent clinical diagnosis is documented in medical practice and in surveys. This inaccuracy is thought to be primarily a consequence of patients' unwillingness and/or reluctance to report symptoms in the clinical setting and of health-care professional's difficulty in approaching this sensitive topic during routine consultations. Methods A Delphi Panel methodology was used: a first round of written questionnaires, followed by a plenary meeting with a facilitator and by two additional rounds of telephone interviews. Results The prevalence of the condition in Italy can be estimated in 115,000 cases out of 380,000 BC survivors. The Panel confirmed that the epidemiological findings of a recent pharmacoeconomic analysis of a US claims database can be applied to Italian patient population. The Panel confirmed also an estimate of 4.25 additional cases/100/yr of UTI (urinary tract infection) in VVA BC patients (vs. a non-VVA-matched population), of 3.68 additional cases of vulvovaginitis, of 6.97 cases of climacteric symptoms, and of 3.64 cases of bone and joint disorders. As far as the resource use is concerned, in the VVA BC populations, 33.4 additional gynecological visits/100/year can be expected, along with 22.8 additional cancer screenings, 7.07 additional outpatient visits and 5.04 screenings for HPV. Conclusions Even in Italy, a diagnosis of VVA, especially in a BC population, is associated with a relevant increase in the burden of illness and social costs, compared to a control population matched for age without VVA. This is due essentially to an increase in comorbidities and resource utilization with the consequence that an adequate treatment could reduce the impact of the condition.
机译：目的VVA是一种常见的疾病，约有50％的绝经后患有相关症状。 VVA对个人和性生活产生了重大影响，以及妇女自尊和情感福祉的许多方面。对于BC治疗的患者特别频繁和严重，其中它起源于显着的经济和社会成本。鉴于缺乏关于这一主题的公布证据，进行了德尔福小组进行评估：VVA的流行病学和意大利的风险因素/可核心的危险性/未满足的医疗标准需要最近的美国流行病学数据的比较和意大利人民境内使用的健康资源在VVA BC疾病的负担对生活质量的相当负面影响，在医疗实践和调查中记录了这种情况的高患病率和不经常的临床诊断之间的差异。这种不准确性被认为主要是患者不愿意和/或不愿意在临床环境中报告症状和卫生保健专业人员在常规磋商期间接近这种敏感话题的症状的结果。方法使用Delphi面板方法：第一轮书面问卷，其次是与促进者的全体会议以及另外两轮电话访谈。结果意大利病症的患病率可以估计115,000例BC幸存者的115,000例。该小组证实，美国索赔数据库最近药物经济分析的流行病学发现可以应用于意大利患者人口。该小组还证实了4.25次估计的4.25株/ 100 /年在VVA BC患者（非VVA匹配群体中的尿路感染），3.68例外阴症患者的患者，6.97例的更年性症状3.64例骨关节障碍。就资源使用而言，在VVA BC群体中，33.4额外的妇科访问/ 100 /年可以预期，以及22.8次额外的癌症筛查，7.07份额外的门诊访问和HPV的5.04筛选。结论即使在意大利也是在意大利的诊断，特别是在BC人群中，与没有VVA的年龄相匹配的控制人群相比，与疾病和社会成本的负担相关的相关性。这基本上由于合并和资源利用的增加，因此充分处理可以降低病情的影响。

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