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Economic outcomes of breast cancer survivorship: CALGB study 79804

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Abstract

Background. Over 80 of women diagnosed with breast cancer will be survivors. We sought to determine the economic consequences of surviving breast cancer.

Methods. Disease-free survivors who had received adjuvant chemotherapy for stage II breast cancer on CALGB study 8541 participated in a study of long-term outcomes. Survey responses were used to determine the types and frequency of medical resources used in follow-up, annual direct medical costs, and survivor perceptions of the personal economic impact of breast cancer.

Results. 245 of 314 (78%) invited breast cancer survivors (median follow-up 12.2 years, range 9.3–16.4) completed the surveys. Eighty-seven percent reported having cancer specialist follow-up in the past year. The following percentages of survivors reported having had, for breast cancer follow-up, at least once in the past year: breast examination 92%, mammogram 88, bone scan 18%, chest radiograph 59%, tumor marker studies 37%. When follow-up care included a medical oncologist, resources were more likely to be used at least according to published follow-up guidelines, or over-used. Median annual cost of follow-up per survivor was $630 (range $0–10,817) with higher costs associated with medical oncology follow-up, lower income, and younger age. Few women reported a negative impact of breast cancer on employment, but 16% reported being denied life insurance.

Conclusions. Among long-term breast cancer survivors, patient self-report data suggest that over-use of medical resources for follow-up appears common. When follow-up care included a medical oncologist, resources were more likely to be used appropriately, or over-used. Costs of follow-up are higher with medical oncology follow-up, lower income and among younger survivors. The annual cost of follow-up varies widely and may be driven by over-use of follow-up tests.

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Authors and Affiliations

  1. Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10021, USA

    Martee L. Hensley

  2. CALGB Statistical Center, Durham, NC, USA

    Jeannette Dowell & James E. Herndon II

  3. Dana Farber Cancer Institute, Boston, MA, USA

    Eric Winer & Jane C. Weeks

  4. Wake Forest University School of Medicine, Winston-Salem, NC, USA

    Nancy Stark

  5. The Ohio State University Medical Center, Columbus, OH, USA

    Electra Paskett

Authors
  1. Martee L. Hensley
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  2. Jeannette Dowell
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  3. James E. Herndon II
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  4. Eric Winer
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  5. Nancy Stark
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  6. Jane C. Weeks
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  7. Electra Paskett
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Correspondence to Martee L. Hensley.

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Hensley, M.L., Dowell, J., Herndon, J.E. et al. Economic outcomes of breast cancer survivorship: CALGB study 79804. Breast Cancer Res Treat 91, 153–161 (2005). https://doi.org/10.1007/s10549-004-6497-9

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  • DOI: https://doi.org/10.1007/s10549-004-6497-9

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