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Assessing Human and Economic Benefits of Cancer Prevention

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Fundamentals of Cancer Prevention

Abstract

It is important to quantify the human and economic value of cancer prevention to illustrate the wisdom of executing behaviors and implementing policies that help avoid the many consequences of a cancer diagnosis. The impact of cancer and its treatment can include significant burdens on patients, their families, the health-care system, and society as a whole. For the patient, cancer can lead to decreases in both the length and quality of life. It was estimated that each person who died of cancer in 2008 in the USA lost, on average, 15.5 years of life. For cancer survivors, there is increased risk for poorer physical health-related quality of life, psychological distress, higher out-of-pocket medical expenditures, employment challenges, and personal bankruptcy. However, to justify investments in cancer prevention, it is essential to have data about the relative costs and outcomes of prevention activities. Resources should be used for programs that produce the greatest benefit for the greatest number of people. Comparative effectiveness research is emerging as a promising means of generating the type of evidence that will inform health-care decisions that are important to patients and their families.

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References

  • American Cancer Society (2012) Cancer facts & figures 2012. Atlanta, American Cancer Society. Available at: http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-031941.pdf

  • Aaronson NK, Ahmedzai S et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376

    Article  PubMed  CAS  Google Scholar 

  • Agency for Healthcare Research and Quality (2012) What is comparative effectiveness research? Available at: http://effectivehealthcare.ahrq.gov/index.cfm/what-is-comparative-effectiveness-research1/. Accessed 28 Dec 2012

  • Basch E, Abernethy AP et al (2012) Recommendations for incorporating patient-reported outcomes into clinical comparative effectiveness research in adult oncology. J Clin Oncol 30(34):4249–4255

    Article  PubMed  Google Scholar 

  • Badia X, Herdman M (2001) The importance of health-related quality of life data in determining the value of drug therapy. Clin Ther 23(1):168–175

    Article  PubMed  CAS  Google Scholar 

  • Bennetts A, Irwig L et al (1995) PEAPS-Q: a questionnaire to measure the psychosocial effects of having an abnormal Pap smear. J Clin Epidemiol 48(10):1235–1243

    Article  PubMed  CAS  Google Scholar 

  • Bowling A (1997) Measuring health: a review of quality of life measurement scales. Open University Press, Philadelphia

    Google Scholar 

  • Bowling A (2001) Measuring disease: a review of disease-specific quality of life measurement scales. Open University Press, Philadelphia

    Google Scholar 

  • Brazier J, Roberts J et al (2002) The estimation of a preference-based measure of health from the SF-36. J Health Econ 21(2):271–292

    Article  PubMed  Google Scholar 

  • Brettschneider C, Lühmann D, Raspe H (2011) Informative value of patient reported outcomes (PRO) in health technology assessment (HTA). GMS Health Technol Assess 7:Doc01. Available at: http://www.egms.de/static/pdf/journals/hta/2011-7/hta000092.pdf

  • Broderson J, Thorsen H et al (2007) Validation of a condition-specific measure for women having an abnormal screening mammography. Value Health 10(4):294–304

    Article  Google Scholar 

  • Brown AD, Garber AM (1999) Cost-effectiveness of 3 methods to enhance the sensitivity of Papanicolaou testing. JAMA 281(4):347–353

    Article  PubMed  CAS  Google Scholar 

  • Brown ML, Lipscomb J et al (2001) The burden of illness of cancer: economic cost and quality of life. Annu Rev Public Health 22:91–113

    Article  PubMed  CAS  Google Scholar 

  • Bruner DW, Movsas B et al (2004) Outcomes research in cancer clinical trial cooperative groups: the RTOG model. Qual Life Res 13(6):1025–1041

    Article  PubMed  CAS  Google Scholar 

  • Campbell CMP, Menezes LJ, Paskett ED, Giuliano AR (2012) Prevention of invasive cervical cancer in the United States: past, present, and future. Cancer Epidemiol Biomarkers Prev 21(9):1402–1408

    Article  Google Scholar 

  • Cella DF, Tulsky DS et al (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11(3):570–579

    PubMed  CAS  Google Scholar 

  • Centers for Disease Control (2012) Possible side effects from vaccines. Available at: http://www.cdc.gov/vaccines/vac-gen/side-effects.html

  • Centers for Medicare and Medicaid Services (2012) National health expenditures 2010 highlights. Available at: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/highlights.pdf

  • Cullen J, Schwartz MD et al (2004) Short-term impact of cancer prevention and screening activities on quality of life. J Clin Oncol 22(5):943–952

    Article  PubMed  Google Scholar 

  • Donaldson MS (2004) Taking stock of health-related quality-of-life measurement in oncology practice in the United States. J Natl Cancer Inst Monogr 33:155–167

    Article  PubMed  Google Scholar 

  • Eddy DM (1990) Screening for cervical cancer. Ann Intern Med 113(3):214–226

    Article  PubMed  CAS  Google Scholar 

  • Elbasha EH, Dasbach EJ, Insinga RP (2007) Model for assessing human papillomavirus vaccination strategies. Emerg Infect Dis 13:28–41

    Article  PubMed  Google Scholar 

  • Einstein MH, Baron M et al (2009) Comparison of the immunogenicity and safety of Cervarix and Gardasil human papillomavirus (HPV) cervical cancer vaccines in healthy women aged 18–45 years. Hum Vaccin 5(10):705–719

    Article  PubMed  CAS  Google Scholar 

  • Esser M, Brunner H (2003) Economic evaluations of granulocyte colony-stimulating factor: in the prevention and treatment of chemotherapy-induced neutropenia. Pharmacoeconomics 21(18):1295–1313

    Article  PubMed  Google Scholar 

  • European Medicines Agency (2005) Reflection paper on the regulatory guidance for the use of health-related quality of life (HRQL) measures in the evaluation of medicinal products. Available at: http://www.emea.eu.int/pdfs/human/ewp/13939104en.pdf. Accessed 27 July 2005

  • Ferrans CE (2005) Definitions and conceptual models of quality of life. In: Lipscomb J, Gotay CC, Snyder C (eds) Outcomes assessment in cancer: measures, methods, and applications. Cambridge University Press, Cambridge, pp 14–30

    Google Scholar 

  • Frost MH, Reeve BB et al (2007) What is sufficient evidence for the reliability and validity of patient-reported outcome measures? Value Health 10(suppl 2):S94–S105

    Article  PubMed  Google Scholar 

  • Fryback DG, Craig BM (2004) Measuring economic outcomes of cancer. J Natl Cancer Inst Monogr 33:134–141

    Article  PubMed  Google Scholar 

  • Gelber RD, Goldhirsch A et al (1993) Evaluation of effectiveness: Q-TWiST. The International Breast Cancer Study Group. Cancer Treat Rev 19(Suppl A):73–84

    Article  PubMed  Google Scholar 

  • Gold MR, Stevenson D, Fryback DG (2002) HALYs and QALYs and DALYs, oh my: similarities and differences in summary measures of population health. Annu Rev Public Health 23:115–134

    Article  PubMed  Google Scholar 

  • Goldie SJ, Kohli M et al (2004) Projected clinical benefits and cost-effectiveness of a human papillomavirus 16/18 vaccine. J Natl Cancer Inst 96(8):604–615

    Article  PubMed  Google Scholar 

  • Goldie SJ, Weinstein MC et al (1999) The costs, clinical benefits, and cost-effectiveness of screening for cervical cancer in HIV-infected women. Ann Intern Med 130(2):97–107

    Article  PubMed  CAS  Google Scholar 

  • Grant M, Ferrell B et al (2004) Revision and psychometric testing of the City of Hope Quality of Life – Ostomy Questionnaire. Qual Life Res 13:1445–1458

    Article  PubMed  Google Scholar 

  • Guyatt GH, Feeny DH et al (1993) Measuring health-related quality of life. Ann Intern Med 118(8):622–629

    Article  PubMed  CAS  Google Scholar 

  • Hoffman KE, McCarthy EP, Recklitis CJ, Ng AK (2009) Psychological distress in long-term survivors of adult-onset cancer: results from a national survey. Arch Intern Med 169(14):1274–1281

    Article  PubMed  Google Scholar 

  • Houts PS, Lipton A et al (1984) Nonmedical costs to patients and their families associated with outpatient chemotherapy. Cancer 53(11):2388–2392

    Article  PubMed  CAS  Google Scholar 

  • Johnson E, Dominici F, Griswold M, Zeger SL (2003) Disease cases and their medical costs attributable to smoking: an analysis of the national medical expenditure survey. J Economet 112(1):135–151

    Article  Google Scholar 

  • Karnofsky D, Burchenal J (1949) The clinical evaluation of chemotherapeutic agents in cancer. In: Macleod C (ed) Evaluation of chemotherapeutic agents. Columbia University Press, New York

    Google Scholar 

  • Kozma CM, Reeder CE et al (1993) Economic, clinical, and humanistic outcomes: a planning model for pharmacoeconomic research. Clin Ther 15(6):1121–1132, discussion 1120

    PubMed  CAS  Google Scholar 

  • Kulasingam SL, Myers ER (2003) Potential health and economic impact of adding a human papillomavirus vaccine to screening programs. JAMA 290(6):781–789

    Article  PubMed  Google Scholar 

  • Land SR, Wickerham DL, et al. (2006). Patient-reported symptoms and quality of life during treatment with tamoxifen or raloxifene for breast cancer prevention: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 Trial. JAMA 295(23):2742–2751

    Google Scholar 

  • Lauer MS (2010) The historical and moral imperatives of comparative effectiveness research. Stat Med 29:1982–1984

    Article  PubMed  Google Scholar 

  • Lauer MS, Collins FS (2010) Using science to improve the nation’s health system: NIH’s commitment to comparative effectiveness research. JAMA 303(21):2182–2183

    Article  PubMed  CAS  Google Scholar 

  • Levine MN, Ganz PA, Haller DG (2007) Economic evaluations in the Journal of Clinical Oncology: past, present, and future. J Clin Oncol 25(6):614–616

    Article  Google Scholar 

  • Lipscomb J, Donaldson MS et al (2004) Cancer outcomes research and the arenas of application. J Natl Cancer Inst Monogr 33:1–7

    Article  PubMed  Google Scholar 

  • Lipscomb J, Snyder CF (2002) The Outcomes of Cancer Outcomes Research: focusing on the National Cancer Institute’s quality-of-care initiative. Med Care 40(6 Suppl):III3–III10

    PubMed  Google Scholar 

  • Lipscomb J, Gotay CC, Snyder C (eds) (2005) Outcomes assessment in cancer: measures, methods, and applications. Cambridge University Press, Cambridge

    Google Scholar 

  • Litwin MS, Hays RD et al (1998) The UCLA Prostate Cancer Index: development, reliability, and validity of a health-related quality of life measure. Med Care 36(7):1002–1012

    Article  PubMed  CAS  Google Scholar 

  • Loeve F, Brown ML et al (2000) Endoscopic colorectal cancer screening: a cost-saving analysis. J Natl Cancer Inst 92(7):557–563

    Article  PubMed  CAS  Google Scholar 

  • Mandelblatt JS, Lawrence WF et al (2002) Benefits and costs of using HPV testing to screen for cervical cancer. JAMA 287(18):2372–2381

    Article  PubMed  Google Scholar 

  • Mandelblatt JS, Selby JV (2005) Short-term outcomes of chemoprevention, genetic susceptibility testing, and screening interventions: what are they? How are they measured? When should they be measured? In: Lipscomb J, Gotay CC, Snyder C (eds) Outcomes assessment in cancer: measures, methods, and applications. Cambridge University Press, Cambridge, pp 216–240

    Google Scholar 

  • McDowell I (2006) Measuring health: a guide to rating scales and questionnaires, 3rd edn. Oxford University Press, Oxford

    Book  Google Scholar 

  • Mukherjee S (2010) The emperor of all maladies: a biography of cancer. Scribner, New York

    Google Scholar 

  • Muñoz N, Manalastas R Jr et al (2009) Safety, immunogenicity, and efficacy of quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine in women aged 24–45 years: a randomised, double-blind trial. Lancet 373(9679):1949–1957

    Article  PubMed  Google Scholar 

  • National Cancer Institute (2012) Cancer trends progress report – 2011/2012 update. Available at: http://progressreport.cancer.gov

  • O’Brien BJ, Rusthoven J et al (1993) Impact of chemotherapy-associated nausea and vomiting on patients’ functional status and on costs: survey of five Canadian centres. CMAJ 149(3):296–302

    PubMed  Google Scholar 

  • Patient-Centered Outcomes Research Institute (2012) National priorities for research and research agenda. Available at: http://www.pcori.org/assets/PCORI-National-Priorities-and-Research-Agenda-2012-05-21-FINAL.pdf

  • Patrick DL, Deyo RA (1989) Generic and disease-specific measures in assessing health status and quality of life. Med Care 27(3 Suppl):S217–S232

    Article  PubMed  CAS  Google Scholar 

  • Pearson SD (2012) Cost, coverage, and comparative effectiveness research: the critical issues for oncology. J Clin Oncol 30(34):4275–4281

    Article  PubMed  Google Scholar 

  • Phillips KM, Jim HS et al (2011) Cognitive functioning after cancer treatment. Cancer 118(7):1925–1932

    Article  PubMed  Google Scholar 

  • Ramsey SD, Mandelson MT et al (2003) Cancer-attributable costs of diagnosis and care for persons with screen-detected versus symptom-detected colorectal cancer. Gastroenterology 125(6):1645–1650

    Article  PubMed  Google Scholar 

  • Ramsey SD, Fedorenko CR et al (2011) Cancer diagnosis as a risk factor for personal bankruptcy. J Clin Oncol 29((15) suppl):6007

    Google Scholar 

  • Reeve BB, Potosky AL et al (2009) Impact of cancer on health-related quality of life of older Americans. J Natl Cancer Inst 101(12):860–868

    Article  PubMed  Google Scholar 

  • Revicki DA, Osoba D et al (2000) Recommendations on health-related quality of life research to support labeling and promotional claims in the United States. Qual Life Res 9:887–900

    Article  PubMed  CAS  Google Scholar 

  • Selker HP, Wood AJJ (2009) Industry influence on comparative-effectiveness research funded through health care reform. N Engl J Med 361:2595–2597

    Article  PubMed  CAS  Google Scholar 

  • Sculpher M, Palmer MK et al (2000) Costs incurred by patients undergoing advanced colorectal cancer therapy. A comparison of raltitrexed and fluorouracil plus folinic acid. Pharmacoeconomics 17(4):361–370

    Article  PubMed  CAS  Google Scholar 

  • Siegel R, DeSantis C et al (2012) Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin 62(4):220–241

    Article  PubMed  Google Scholar 

  • Short PF, Moran JR, Punekar R (2011) Medical expenditures of adult cancer survivors aged <65 years in the United States. Cancer 117(12):2791–2800

    Article  PubMed  Google Scholar 

  • Short PF, Vasey JJ, Tunceli K (2005) Employment pathways in a large cohort of adult cancer survivors. Cancer 103(6):1292–1301

    Article  PubMed  Google Scholar 

  • Sirgy MJ, Michalos AC et al (2006) The quality-of-life (QOL) research movement: past, present, and future. Soc Indic Res 76:343–466

    Article  Google Scholar 

  • Staquet M, Aaronson N et al (1992) Health-related quality of life research. Qual Life Res 1:3

    Article  Google Scholar 

  • Streiner DL, Norman GR (2008) Health measurement scales: a practical guide to their development and use, 4th edn. Oxford University Press, New York

    Book  Google Scholar 

  • Taplin SH, Barlow W et al (1995) Stage, age, comorbidity, and direct costs of colon, prostate, and breast cancer care. J Natl Cancer Inst 87(6):417–426

    Article  PubMed  CAS  Google Scholar 

  • Tengs TO, Wallace A (2000) One thousand health-related quality-of-life estimates. Med Care 38(6):583–637

    Article  PubMed  CAS  Google Scholar 

  • Tosteson AN, Stout NK et al (2008) Cost-effectiveness of digital mammography breast cancer screening. Ann Intern Med 148(1):1–10

    Article  PubMed  Google Scholar 

  • Tsao H, Rogers GS et al (1998) An estimate of the annual direct cost of treating cutaneous melanoma. J Am Acad Dermatol 38(5 Pt 1):669–680

    Article  PubMed  CAS  Google Scholar 

  • Ubel P (2001) Pricing life: why it’s time for health care rationing. MIT Press, Cambridge

    Google Scholar 

  • US Food and Drug Administration (2009) Guidance for industry – patient-reported outcome measures: use in medical product development to support labeling claims. December 2009. Available at: http://www.fda.gov/downloads/Drugs/…/Guidances/UCM193282.pdf

  • Wagner JL (1997) Cost-effectiveness of screening for common cancers. Cancer Metastasis Rev 16(3–4):281–294

    Article  PubMed  CAS  Google Scholar 

  • Ware JE Jr (2000) SF-36 health survey update. Spine 25(24):3130–3139

    Article  PubMed  Google Scholar 

  • Ware J, Kosinski M, Keller S (1994) SF-36 physical and mental health summary scales: a user’s manual. The Health Institute, Boston

    Google Scholar 

  • Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483

    Article  PubMed  Google Scholar 

  • Weaver KE, Forsythe LP et al (2012) Mental and physical health-related quality of life among U.S. cancer survivors: population estimates from the 2010 National Health Interview Survey. Cancer Epidemiol Biomarkers Prev 21(11):2108–2117

    Article  PubMed  Google Scholar 

  • Willke RJ, Burke LB, Erickson P (2004) Measuring treatment impact: a review of patient-reported outcomes and other efficacy endpoints in approved product labels. Control Clin Trials 25:535–552

    Article  PubMed  Google Scholar 

  • Wu AW, Snyder C, Clancy CM, Steinwachs DM (2010) Adding the patient perspective to comparative effectiveness research. Health Aff 29(10):1863–1871

    Article  Google Scholar 

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Coons, S.J., Craig, B.M. (2014). Assessing Human and Economic Benefits of Cancer Prevention. In: Alberts, D., Hess, L. (eds) Fundamentals of Cancer Prevention. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38983-2_2

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