Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2015 Dec 24;108(5):djv382.
doi: 10.1093/jnci/djv382. Print 2016 May.

Annual Medical Expenditure and Productivity Loss Among Colorectal, Female Breast, and Prostate Cancer Survivors in the United States

Zhiyuan Zheng  1 , K Robin Yabroff  1 , Gery P Guy Jr  1 , Xuesong Han  1 , Chunyu Li  1 , Matthew P Banegas  1 , Donatus U Ekwueme  1 , Ahmedin Jemal  1
Affiliations
Comparative Study

Annual Medical Expenditure and Productivity Loss Among Colorectal, Female Breast, and Prostate Cancer Survivors in the United States

Zhiyuan Zheng et al. J Natl Cancer Inst. .

Abstract

Background: There are limited nationally representative estimates of the annual economic burden among survivors of the three most prevalent cancers (colorectal, female breast, and prostate) in both nonelderly and elderly populations in the United States.

Methods: The 2008 to 2012 Medical Expenditure Panel Survey data were used to identify colorectal (n = 540), female breast (n = 1568), and prostate (n = 1170) cancer survivors and individuals without a cancer history (n = 109 423). Excess economic burden attributable to cancer included per-person excess annual medical expenditures and productivity losses (employment disability, missed work days, and days stayed in bed). All analyses were stratified by cancer site and age (nonelderly: 18-64 years vs elderly: ≥ 65 years). Multivariable analyses controlled for age, sex, race/ethnicity, marital status, education, number of comorbidities, and geographic region. All statistical tests were two-sided.

Results: Compared with individuals without a cancer history, cancer survivors experienced annual excess medical expenditures (for the nonelderly population, colorectal: $8647, 95% confidence interval [CI] = $4932 to $13 974, P < .001; breast: $5119, 95% CI = $3439 to $7158, P < .001; prostate: $3586, 95% CI = $1792 to $6076, P < .001; for the elderly population, colorectal: $4913, 95% CI = $2768 to $7470, P < .001; breast: $2288, 95% CI = $814 to $3995, P = .002; prostate: $3524, 95% CI = $1539 to $5909, P < .001). Nonelderly colorectal and breast cancer survivors experienced statistically significant annual excess employment disability (13.6%, P < .001, and 4.8%, P = .001) and productivity loss at work (7.2 days, P < .001, and 3.3 days, P = .002) and at home (4.5 days, P < .001, and 3.3 days, P = .003). In contrast, elderly survivors of all three cancer sites had comparable productivity losses as those without a cancer history.

Conclusions: Colorectal, breast, and prostate cancer survivors experienced statistically significantly higher economic burden compared with individuals without a cancer history; however, excess economic burden varies by cancer site and age. Targeted efforts will be important in reducing the economic burden of colorectal, breast, and prostate cancer.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
A diagram of total annual economic burden measured in the current study. Medical expenditures include the sum of payments for ambulatory care, inpatient care, prescription medications, and other medical services provided during the year. Medical expenditures are measured at the event level for each participant and can also be itemized by source of payment (out-of-pocket [OOP], private health insurance, Medicare, Medicaid, or other). OOP includes all payments for health care services provided during the year that were paid by respondents. Productivity losses include employment disability, missed work days, and days stayed in bed. Monetary value of employment disability = year 2012 annual median wage ($34 764) × probability of employment disability; monetary value of number of missed work days = year 2012 median national daily wage (median hourly wage $16.7×6 hours) × number of missed work days; monetary value of days stayed in bed = year 2012 daily home productivity ($42) × number of days stayed in bed. Medical expenditures and measures of employment disability, missed work days, and days stayed in bed contained in the Medical Expenditure Panel Survey Household Component file.
Figure 2.
Figure 2.
Total adjusted annual economic burden of colorectal, female breast, and prostate cancer survivors, stratified by age (nonelderly: 18–64 years vs elderly: ≥65 years). The total economic burden is the sum of medical expenditures and productivity losses.
Figure 3.
Figure 3.
Total adjusted annual medical expenditures of colorectal, female breast, and prostate cancer survivors, stratified by age (nonelderly: 18–64 years vs elderly: ≥65 years). The annual medical expenditures are itemized by source of payment (out-of-pocket, private health insurance, Medicare, Medicaid, or other).
Figure 4.
Figure 4.
Total adjusted annual medical expenditures of colorectal, female breast, and prostate cancer survivors, stratified by age (nonelderly: 18–64 years vs elderly: ≥65 years). The annual medical expenditures are itemized by type of services (ambulatory care, inpatient care, prescription medications, or other services).
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. DeSantis CE, Lin CC, Mariotto AB, et al. Cancer Treatment and Survivorship Statistics, 2014. CA Cancer J Clin. 2014;64(4):252–271. - PubMed
    1. Mariotto AB, Robin Yabroff K, Shao Y, Feuer EJ, Brown ML. Projections of the Cost of Cancer Care in the United States: 2010–2020. J Natl Cancer Inst. 2011;103(2):117–128. - PMC - PubMed
    1. Guy GP, Ekwueme DU, Yabroff KR, et al. Economic Burden of Cancer Survivorship Among Adults in the United States. J Clin Oncol. 2013;31(30):3749–3757. - PMC - PubMed
    1. Yabroff KR, Lund J, Kepka D, Mariotto A. Economic Burden of Cancer in the United States: Estimates, Projections, and Future Research. Cancer Epidemiol Biomarkers Prev. 2011;20(10):2006–2014. - PMC - PubMed
    1. Ekwueme DU, Yabroff KR, Guy GP, Jr, et al. Medical costs and productivity losses of cancer survivors - United States, 2008–2011. MMWR Morb Mortal Wkly Rep. 2014;63(23):505–510. - PMC - PubMed

Publication types