Trends in the Cost of Cancer Care: Beyond Drugs

Laviana, Aaron A.; Luckenbaugh, Amy N.; Resnick, Matthew J.

doi:10.1200/jco.19.01963

Cited by 30 publications

(24 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With rising expenditures on cancer care outpacing other sectors of the US health system, 1 , 2 , 3 national attention has focused on identifying and promoting high-value cancer hospitals, ie, those that consistently deliver excellent outcomes at relatively low cost. 4 National Cancer Institute (NCI)–designated cancer centers (hereafter NCI centers) are academic hospitals recognized for their scientific and research leadership, training and education programs, and clinical expertise in cancer care.…”

Section: Introductionmentioning

confidence: 99%

Differences in Cancer Care Expenditures and Utilization for Surgery by Hospital Type Among Patients With Private Insurance

et al. 2021

View full text Add to dashboard Cite

Key Points Question Are there differences in insurer spending and care utilization for patients with private insurance undergoing cancer surgery at National Cancer Institute (NCI) centers vs community hospitals? Findings In this cross-sectional study of 66 878 patients with breast, colon, or lung cancer, surgery at NCI centers, compared with community hospitals, was associated with higher insurer prices paid and higher 90-day postdischarge payments, without differences in length of stay, emergency department use, or hospital readmission. Meaning In this study of patients with private insurance undergoing cancer surgery, insurer spending for a surgical episode was higher at NCI centers than community hospitals, without differences in care utilization.

show abstract

Section: Introductionmentioning

confidence: 99%

Differences in Cancer Care Expenditures and Utilization for Surgery by Hospital Type Among Patients With Private Insurance

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The magnitude of cancer as a global health problem has increased considerably in the last 3 decades, climbing from the sixth to the second worldwide cause for disability‐adjusted life‐years from 1990 to 2017 1 . Its burden is reflected in costs for healthcare systems such as in the United States, where they have increased at a higher rate than any other healthcare sector, from $27 billion in 1990 to an overall expenditure of $137 billion in 2017 2,3 . In Europe, where studies have consistently reported that spending on cancer care is associated with better outcomes, it grew from €52 billion in 1995 to €103 billion in 2018 4 …”

Section: Introductionmentioning

confidence: 99%

Tumour markers with clinically controlled cut‐offs for suspected cancer

Bosch

Molina

Marrades

et al. 2021

Eur J Clin Investigation

View full text Add to dashboard Cite

Background Due to insufficient scientific evidence, panels of tumour markers (TMs) are currently not recommended for use in suspected cancer. However, recent well‐designed studies have revealed a potential clinical value in lung cancer. We analysed the diagnostic accuracy of a panel of 11 circulating TMs with clinically controlled thresholds in the differentiation of cancer from nonmalignant diseases. Methods We prospectively recruited 4776 consecutive patients presenting with focal or nonspecific symptoms suggestive of cancer who underwent testing for 11 serum TMs before diagnosis was known. The study abided by 2015 STARD guidelines. Tumour markers included, among others, carbohydrate antigen 19‐9, carcinoembryonic antigen, alpha‐fetoprotein, squamous cell carcinoma‐associated antigen, prostate‐specific antigen (males), neuron‐specific enolase, progastrin‐releasing peptide and carbohydrate antigen 125. Thresholds were adjusted for the presence of kidney failure, liver disease, effusions and dermatological disorders. Results showing ≥1 TMs with concentrations above threshold were considered positive. Results Benign diseases were diagnosed in 3281 (68.7%) patients and cancer in 1495 (31.3%), with epithelial cancers in 1214 (77% at stage IV). When applying criteria for controlled thresholds, overall specificity was 98%. Overall sensitivity of the panel in epithelial cancers was 72.2%, positive predictive value 93% and negative predictive value 90.5%. The area under the receiver operating characteristic curve was 0.920 (95% confidence interval, 0.902‐0.924). Conclusions By using clinically controlled cut‐offs, the combined panel demonstrated an excellent ability to discriminate epithelial cancers from nonmalignant diseases. However, its use in clinical practice would need formal validation through a multicentre controlled trial assessing a panel‐guided strategy vs. standard diagnosis.

show abstract

“…1 Additionally, although cancer mortality has declined, the cost of diagnosing and managing cancer continues to increase and is estimated to account for 7% of all healthcare spending, outpacing all other sectors of healthcare. 3 These changes in cancer trends are leading to an urgency to identify and reverse the increase in incidence of certain types of cancer and reduce overall costs of managing an ever-growing population of cancer survivors. With the decline in tobacco use, dietary factors and obesity are becoming one of the leading causes of cancer.…”

mentioning

confidence: 99%

Ketogenic diet and cancer: Fad or fabulous?

Mundi

Elfadil

Patel

et al. 2021

J Parenter Enteral Nutr

View full text Add to dashboard Cite

As the prevalence of smoking continues to decline, dietary factors are rapidly becoming the leading preventable cause of disease. Diet and obesity are also leading to a shift in cancer prevalence with increases noted in breast, liver, pancreas, and uterine cancers. Once cancer is detected, obesity is also associated with poorer outcomes with therapy as well as higher morbidity and mortality. Key factors are associated with the link between obesity and cancer including chronic inflammation, change in sex hormones, alteration in insulin-IGF-1 axis, alteration in adipokines, as well as cancer stem cells that are derived from adipose tissue. Because of these associations, a great deal of effort is being placed in implementing lifestyle changes that mitigate obesityassociated factors that contribute to development of cancer, reduce side effects of treatment, and improve survival. Ketogenic diet is emerging as an attractive option in countering obesity-related tumor-promoting factors, as it is associated with weight loss as well as a reduction in insulin resistance and inflammation. Ketogenic diet can also deprive cancer cells of glucose, a fuel source that is predominantly used by many cancer lines through aerobic glycolysis in the setting of dysregulated mitochondria.Current manuscript reviews the theoretical benefits for use of ketogenic diet in cancer as well as the data available from clinical trials. K E Y W O R D Scancer, ketogenic diet, nutrition, obesity tion in incidence of certain cancers such as lung and colorectal cancer. Unfortunately, in women this decline has been offset by increasing rates of other cancers such as breast, liver, and uterine cancer, thus keeping the overall incidence rates stable. 1 Similarly, in men, reduc-© 2021 American Society for Parenteral and Enteral Nutrition tions in prostate, lung, and colorectal cancer have been noted, whereas rates of cancer of the liver, bile duct, pancreas, and melanoma have increased. 1 Additionally, although cancer mortality has declined, the cost of diagnosing and managing cancer continues to increase and is estimated to account for 7% of all healthcare spending, outpacing all other sectors of healthcare. 3 These changes in cancer trends are leading to an urgency to identify and reverse the increase in incidence of certain types of cancer and reduce overall costs of managing an ever-growing population of cancer survivors. With the decline in tobacco use, dietary factors and obesity are becoming one of the leading causes of cancer. 4 In fact,

show abstract

Trends in the Cost of Cancer Care: Beyond Drugs

Abstract: Author affiliations and support information (if applicable) appear at the end of this article.

Cited by 30 publications

References 47 publications

Differences in Cancer Care Expenditures and Utilization for Surgery by Hospital Type Among Patients With Private Insurance

Differences in Cancer Care Expenditures and Utilization for Surgery by Hospital Type Among Patients With Private Insurance

Tumour markers with clinically controlled cut‐offs for suspected cancer

Ketogenic diet and cancer: Fad or fabulous?

Contact Info

Product

Resources

About