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The financial impact of a breast cancer detected within and outside of screening: lessons from the Australian Lifepool cohort.
- Source :
-
Australian and New Zealand journal of public health [Aust N Z J Public Health] 2020 Jun; Vol. 44 (3), pp. 219-226. Date of Electronic Publication: 2020 Apr 20. - Publication Year :
- 2020
-
Abstract
- Objective: 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]).<br />Methods: 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.<br />Results: 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.<br />Conclusions: 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.<br /> (© 2020 The Authors.)
- Subjects :
- Adult
Aged
Australia epidemiology
Breast Neoplasms epidemiology
Carcinoma, Intraductal, Noninfiltrating epidemiology
Cohort Studies
Female
Health Services economics
Humans
Middle Aged
Neoplasm Staging
Registries
Breast Neoplasms diagnosis
Carcinoma, Intraductal, Noninfiltrating diagnosis
Early Detection of Cancer economics
Health Care Costs statistics & numerical data
Health Services statistics & numerical data
Mammography economics
Mass Screening economics
Subjects
Details
- Language :
- English
- ISSN :
- 1753-6405
- Volume :
- 44
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Australian and New Zealand journal of public health
- Publication Type :
- Academic Journal
- Accession number :
- 32311194
- Full Text :
- https://doi.org/10.1111/1753-6405.12976