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National Cancer Institute

Projecting the Burden of Cancer Survivorship: Individual and Societal

Presentation 2: Describing the Economic Trajectory of Cancer Survivorship

Martin L. Brown, Ph.D.
Chief, Health Services and Economics Branch
National Cancer Institute, National Institutes of Health
Bethesda, MD

  • Cancer treatment can be divided into three phases—initial phase, continuing phase, and terminal phase—with each phase differing in economic burden.
  • The initial phase of cancer treatment, occurring shortly after diagnosis, is the most costly, due to aggressive care (surgery, chemotherapy and/or radiation therapy). Costs drop during the continuing phase of treatment, as less treatment is needed, then rise again upon recurrence of cancer, or as patients enter the terminal phase of care, again due to the costs of aggressive interventions.
  • Shortly before diagnosis, costs associated with cancer treatment also increase, due to screening and diagnostic services.
  • Cancer survivors have higher terminal care costs than noncancer patients, even if death is not due to cancer.
  • Approximately 20 percent of direct cancer costs can be attributed to patient time (based on average wage) spent undergoing treatment rather than working.
  • Long-term (greater than 5 years) colorectal cancer survivors have lifetime costs $19,516 higher than noncancer patients; surveillance procedures explain only a fraction of these costs.

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