MedicalResearch.com Interview with:
Benjamin Allaire MS
Research Triangle Park
Durham, NC, 27709
MedicalResearch.com: What is the background for this study?
Response: More than 22,000 women younger than 45 years of age were diagnosed with breast cancer in 2013. Although less than 10 percent of all breast cancers are diagnosed among women younger than age 45, the types of breast cancer these younger women face are typically more aggressive, are diagnosed at more advanced stages, and result in poorer survival compared to breast cancer in older women. Younger women may also require more intense treatment, exhibit cancers that are less responsive to treatment, and have distinct and more prevalent side effects from treatment than older women. These side effects can include poorer quality of life, fertility problems, and depression.
As a result, breast cancer treatment for younger women is expensive, making them vulnerable to financial hardship. Recent research has shown that 31.8 percent of cancer survivors are likely to have cancer treatment-induced financial troubles, with higher rates among younger cancer patients. These financial difficulties cause some survivors to forego or delay necessary medical treatments.
MedicalResearch.com: What are the main findings?
Response: Our study investigated the medical costs attributable to breast cancer for younger women and compared them with costs for older women. We linked claims data from the North Carolina Cancer Registry to private insurance medical claims. These data allowed us to look at what the total burden of breast cancer was, by stage at diagnosis, for these women.
For younger women, stage II cancer was the most common at diagnosis (40 percent), followed by stage I (34 percent). On the other hand, older women had more stage I (46 percent) cancer followed by stage II (34 percent). The excess costs for younger and older women at 12 months were $97,486 and $75,737, respectively. Younger breast cancer patients had both a higher prevalence of later-stage disease and higher within-stage costs.
MedicalResearch.com: What should readers take away from your report?
Response: The high cost of treatment underscores the importance obtaining and retaining insurance coverage for younger women. Psychological financial hardship, the mental distress related to meeting financial obligations, occurs much more frequently among the uninsured. In addition, insurance coverage may be associated with breast cancer diagnosed at an earlier stage, meaning that having insurance coverage could reduce the public health burden of treatment considerably. Researchers have found that cancer survivors with insurance are much less financially vulnerable than those without, especially among younger survivors.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research is needed to discern what the drivers of these costs are. Is it more intense cancer treatment? Is it for fertility preservation? Mental health side effects? The answers to these questions may help reduce the substantial burden for these women.
MedicalResearch.com: Is there anything else you would like to add?
Response: This research was supported by contract number 200-2008-27958 Task Order 38 from the Centers for Disease Control and Prevention. 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.
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Breast Cancer Res Treat. 2017 Apr 21. doi: 10.1007/s10549-017-4249-x.
Breast cancer treatment costs in younger, privately insured women.
Allaire BT1, Ekwueme DU2, Poehler D3, Thomas CC2, Guy GP Jr2, Subramanian S3, Trogdon JG4.
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