What can population-based physician billing data tell us about the prevalence, costs and disorders associated with different types of cancers based on the 16 years prevalence of cancer diagnosis?

Abstract

Background: Annual rates of cancer diagnosis and costs are reported for specific cancers and age groups over 16 years using health utilization data in addition to the odds ratios for broad International Classification of Disease (ICD) categories of associated disorders.

Methods: Using physician assigned ICD diagnosis, annual cancer diagnosis rates of six cancers (colorectal, breast, prostate, lung, mesothelioma, and pancreatic) were measured for the period of 1994-2009 in the Calgary, Alberta catchment area. As well, the patient cohort diagnosed with any neoplasm (n = 261,896) was analyzed by year for three age groups: youth (< 25 years), adult (26 years – 69 years), and geriatric (≥ 70 years). Total direct cancer diagnosis costs and associated disorders costs were calculated by year and mean total costs compared by type of cancer. Odds ratio were calculated for each broad category of ICD diagnosis given the presence or absence of specified cancer types.

Results: Annual rates of diagnosis increased for all six cancers and all three age groups. All six cancers showed their annual rates of diagnosis to be at least 2.1 times greater in 2009 compared to 1994. Colorectal cancer maintained the highest annual cancer rate of diagnosis, the geriatric group had the highest annual rates of cancer diagnosis out of the three age groups, and the youth group annual rates of cancer diagnosis increased by a factor of 2.6. Breast cancer had the highest associated per patient costs whereas prostate cancer had the lowest. In addition to other neoplasms, odds ratios indicated that most cancer types were associated with disorders of the blood and blood producing organs.

Conclusion: Prevalence has been steadily increasing in the Calgary, AB catchment over the study period. Trends in annual rates of diagnosis have implications for future burden on healthcare systems and provide a basis for comparison of local rates and expenditures with other healthcare principalities.