The financial impact of a breast cancer detected within and outside of screening: lessons from the Australian Lifepool cohort.
Adult
Aged
Australia
/ epidemiology
Breast Neoplasms
/ diagnosis
Carcinoma, Intraductal, Noninfiltrating
/ diagnosis
Cohort Studies
Early Detection of Cancer
/ economics
Female
Health Care Costs
/ statistics & numerical data
Health Services
/ economics
Humans
Mammography
/ economics
Mass Screening
/ economics
Middle Aged
Neoplasm Staging
Registries
breast cancer
costs
healthcare use
out-of-pocket
screening
Journal
Australian and New Zealand journal of public health
ISSN: 1753-6405
Titre abrégé: Aust N Z J Public Health
Pays: United States
ID NLM: 9611095
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
01
07
2019
revised:
01
12
2019
accepted:
01
01
2020
pubmed:
21
4
2020
medline:
25
7
2020
entrez:
21
4
2020
Statut:
ppublish
Résumé
To determine the government and out-of-pocket community costs (out-of-hospital medical services and prescription medicines) associated with screen-detected and community-detected cancers (i.e. cancers detected outside of Australia's organised screening program [BreastScreen]). We analyse administrative data on government-subsidised medical services and prescription medicines for 568 Victorian women diagnosed with breast cancer or ductal carcinoma in situ (DCIS). Using multivariable regression analysis, we estimate the government and out-of-pocket community costs incurred in the three years after diagnosis for screen-detected cancers and community-detected cancers. Additionally, we estimate the government costs associated with diagnosis within and outside of BreastScreen. Average government costs for breast cancer diagnosis were similar within and outside of BreastScreen [$808 (lower limit 676; upper limit 940) vs $837 (95%CI 671; 1,003) respectively]; however, women with community-detected cancers incurred an additional $254 (95%CI 175; 332) out-of-pocket. Controlling for differences in known cancer characteristics, compared to screen-detected cancers, community-detected breast cancers were associated with an additional $2,622 (95%CI 644; 4,776) in government expenditure in the three years following diagnosis. Adverse cancer characteristics that were more prevalent in community-detected cancers (high grade, lymph node involvement, HER2 positive receptor status) were associated with increased government and out-of-pocket costs. Community-detected breast cancers were associated with increased government and out-of-pocket costs. Implications for public health: These costs should be considered when evaluating current and alternative breast cancer screening strategies.
Identifiants
pubmed: 32311194
doi: 10.1111/1753-6405.12976
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
219-226Subventions
Organisme : Cancer Australia National Priority Grant
ID : 1066771
Informations de copyright
© 2020 The Authors.
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