Younger Patients, Higher Costs: The Changing Demographics of Cancer

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Net cancer-related healthcare costs were found to be higher for younger patients than for older patients in all 1-year and 5-year comparisons by type of cancer and stage of disease.
Net cancer-related healthcare costs were found to be higher for younger patients than for older patients in all 1-year and 5-year comparisons by type of cancer and stage of disease.

Cancer healthcare costs in the United States during the current decade are projected to increase by 27% when accounting for increasing prevalence and may grow by as much as 66% based on increasing treatment costs, according to Matthew P. Banegas, PhD, of the Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, and lead author of a recently published study on the economic burden of cancer.1

Cancer treatment has been shown to be more aggressive for patients younger than 65, but care cost estimates tend to focus on patients 65 and older. This disparity could be important considering that almost half of new diagnoses emerge from the younger age group.

Study Design

Healthcare costs associated with breast, colorectal, lung, and prostate cancers — the 4 invasive cancer types most commonly diagnosed in the United States — were evaluated by Banegas and colleagues. During the study period of January 1, 2000, through December 31, 2008, the researchers reviewed electronic health records of 45,522 adults with cancer diagnosed between January 1, 1988, and December 31, 2007, to estimate treatment costs.

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Costs related to cancer treatment were compared with noncancer treatment costs from controls comprising 314,887 patients whose data were binned for comparisons with costs for patients representing each of the 4 cancer types. All patients included in the study were enrolled in healthcare plans from one of the following: Group Health Cooperative (Seattle, Washington), Henry Ford Health System (Detroit, Michigan), Kaiser Permanente Colorado (Denver), or Kaiser Permanente Northwest (Portland, Oregon).

Comparisons were made between healthcare costs for patients aged 65 and older vs costs for patients younger than 65. Older patients comprised 57.7% of patients with prostate cancer, 59% of patients with colorectal cancer, and 64% of patients with lung cancer. Only 35.9% of patients with breast cancer were from the older group. Breast and prostate cancers were the most common cancer types in this study.

The Cost of Cancer

“Findings from this study address a significant knowledge gap by updating registry-based estimates of medical care costs among US patients with cancer [younger than] 65 years, and extending studies based on cancer survivors in the MEPS [Medical Expenditure Panel Survey] by providing cost estimates that incorporate key clinical information, such as stage of disease, as well as timing of cancer diagnosis and survival, which enabled estimation of monthly phase-of-care costs,” explained the researchers.

Net cancer-related healthcare costs were higher for younger patients than for older patients in all 1-year and 5-year comparisons by type of cancer and stage of disease. Net costs were considered to reflect cancer-specific costs and were calculated by subtracting the mean healthcare costs for patients in noncancer control populations from the total costs for patients with cancer. Net, rather than total, healthcare costs were emphasized in analyses because older-age categories typically showed higher overall healthcare costs.  

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