Breast cancer treatment costs in younger, privately insured women
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Younger women (under age 45 years) diagnosed with breast cancer often face more aggressive tumors, higher treatment intensity, lower survival rates, and greater financial hardship. The purpose of this study was to estimate breast cancer costs by stage at diagnosis during the first 18 months of treatment for privately insured younger women.
We analyzed North Carolina cancer registry data linked to claims data from private insurers from 2003 to 2010. Breast cancer patients were split into two cohorts: a younger and older group aged 21–44 and 45–64 years, respectively. We conducted a cohort study and matched women with and without breast cancer using age, ZIP, and Charlson Comorbidity Index. We calculated mean excess costs between breast cancer and non-breast cancer patients at 6, 12, and 18 months.
For younger women, AJCC 6th edition stage II cancer was the most common at diagnosis (40%), followed by stage I (34%). On the other hand, older women had more stage I (46%) cancer followed by stage II (34%). The excess costs for younger and older women at 12 months were $97,486 (95% confidence interval [CI] $93,631–101,341) and $75,737 (95% CI $73,962–77,512), respectively. Younger breast cancer patients had both a higher prevalence of later-stage disease and higher within-stage costs.
The study reports high costs of treatment for both younger and older women than a non-cancer comparison group; however, the estimated excess cost was significantly higher for younger women. The financial implications of breast cancer treatment costs for younger women need to be explored in future studies.
KeywordsBreast cancer Medical care costs Private insurance Younger women Cancer stage
Work on this study was supported by the Integrated Cancer Information and Surveillance System (ICISS), UNC Lineberger Comprehensive Cancer Center with funding provided by the University Cancer Research Fund (UCRF) via the State of North Carolina.
This research was supported by contract number 200-2008-27958 Task Order 38 from the Centers for Disease Control and Prevention.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
The findings and conclusions in this paper are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
- 1.US Cancer Statistics Working Group (2015) United States cancer statistics: 1999–2013 Cancer incidence and mortality data. http://www.cdc.gov/uscs
- 2.Chollet-Hinton L, Anders CK, Tse C-K, Bell MB, Yang YC, Carey LA, Olshan AF, Troester MA (2016) Breast cancer biologic and etiologic heterogeneity by young age and menopausal status in the Carolina Breast Cancer Study: a case-control study. Breast Cancer Res 18(1):79CrossRefPubMedPubMedCentralGoogle Scholar
- 5.Breast Cancer Education And Awareness Requires Learning Young (EARLY) act of 2009 (HR 1740 111th). http://www.govtrack.us/congress/bills/111/hr1740/text
- 20.Segel JE (2006) Cost-of-illness studies—a primer. RTI-UNC Cent Excell Health Promot Econ. http://www.rti.org/pubs/coi_primer.pdf
- 22.ICISS Data Resources. Integrated Cancer Information Center. http://iciss.unc.edu. Accessed 14 Oct 2015
- 26.American Joint Committee on Cancer (2009) Breast cancer staging, 7th ednGoogle Scholar
- 27.U.S. Bureau of Economic Data - National Data (2016) Table 1.1.9. Implicit price deflators for gross domestic products. http://www.bea.gov/iTable/iTable.cfm?ReqID=9&step=1#reqid=9&step=3&isuri=1&903=13. Accessed 9 Mar 2015
- 30.Aebi S, Davidson T, Gruber G, Cardoso F, Group EGW (2011) Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Anna oncol 22(suppl 6):12–24Google Scholar
- 35.US Preventative Services Task Force (2016). Final Recommendation Statement - Breast Cancer Screening Recommendations. http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening1. Accessed 15 Mar 2016
- 36.Centers for Disease Control and Prevention (2016) Bring Your Brave campaign. http://www.cdc.gov/cancer/breast/young_women/bringyourbrave/
- 38.Yabroff KR, Dowling EC, Guy GP Jr, Banegas MP, Davidoff A, Han X, Virgo KS, McNeel TS, Chawla N, Blanch-Hartigan D, Kent EE, Li C, Rodriguez JL, de Moor JS, Zheng Z, Jemal A, Ekwueme DU (2016) Financial hardship associated with cancer in the United States: findings From a population-based sample of adult cancer survivors. J Clin Oncol 34(3):259–267. doi: 10.1200/jco.2015.62.0468 CrossRefPubMedGoogle Scholar