Cancer Costs Top $121,000 Annually in End-of-Life Phase, ACS Study Reveals Stark Stage-Based Disparities
核心洞察
A large ACS and NCI study using SEER-Medicare data finds cancer (搜索)-attributable medical costs average $121,746 per year in the end-of-life phase, compared to $45,063 in the initial phase and $7,141 in continuing care.
Oral prescription drug costs rose sharply across all phases of care, with end-of-life drug costs climbing from $4,823 in 2013 to $11,620 in 2019, while hospitalization costs remained stable after inflation adjustment.
Distant-stage cancers incurred the highest costs; for example, first-year colorectal cancer (搜索) costs were $49,000 for early-stage versus $116,000 for advanced-stage disease.
A new study led by the American Cancer Society (ACS) and the National Cancer Institute (NCI) has quantified the staggering economic burden of cancer (搜索) among older adults in the United States, revealing that cancer-attributable medical costs soar to an average of $121,746 per year during the end-of-life phase. The findings, published in the Journal of the National Cancer Institute (JNCI), highlight dramatic cost variations by cancer type, stage at diagnosis, and phase of care, with advanced-stage cancers consistently driving the highest expenditures.
"Many advances in cancer (搜索) treatment introduced in the past decade have been groundbreaking, leading to improved patient outcomes, including survival. However, some of these novel treatments are also costly and frequently used in combination and for longer periods, which can lead to substantial increases in overall spending and high out-of-pocket costs for patients and their families," said Dr. Robin Yabroff, scientific vice president of health services research at the American Cancer Society and senior author of the study. "This study quantifies the economic burden of cancer and provides key inputs that can be used to study the value of cancer prevention and early detection."
Costs Across the Cancer (搜索) Care Continuum
Researchers analyzed linked SEER-Medicare data from individuals aged 66 years or older diagnosed with cancer (搜索) between 2008 and 2019, comparing them with matched controls without a cancer history based on demographic characteristics, comorbidity burden, and area-level socioeconomic status. Cancer-attributable costs were estimated for 2013–2019 according to cancer type, stage, age, sex, race, and calendar year.
The study defined three phases of care: initial (first 12 months after diagnosis), continuing, and end-of-life (final 12 months before death from cancer (搜索)). Net annual cancer-attributable costs for medical services were highest in the end-of-life phase at $121,746 on average, followed by the initial phase at $45,063 and the continuing phase at $7,141 per year.
Oral Drug Costs Surge While Hospitalization Costs Stabilize
A particularly striking trend emerged in prescription drug spending. Oral prescription drug costs increased over time across all phases of care, with the sharpest rise observed in the end-of-life phase, where costs climbed from $4,823 in 2013 to $11,620 in 2019. In contrast, medical service and hospitalization costs remained relatively stable after adjusting for inflation.
The Price of Late Detection
The study found that distant-stage cancers incurred the highest costs across the board, including cancers with effective screening tests—such as breast, cervical, colorectal, lung, and prostate cancers—as well as cancers without currently available effective screening, such as pancreatic cancer (搜索).
The cost disparities between early- and late-stage diagnoses were stark. Medical costs for colorectal cancer (搜索) in the first year after diagnosis totaled $49,000 for early-stage disease compared to $116,000 for advanced-stage disease. For female breast cancer (搜索), oral prescription drug costs in the first year after diagnosis were $700 for early-stage disease versus $25,000 for advanced-stage disease.
The highest cancer (搜索)-attributable costs overall were observed among patients with acute leukemia (搜索) and those with distant-stage cancers. Additionally, costs were higher among Black patients and patients of other races compared with White patients.
Long-Term Financial Consequences
"Additional research is needed to better understand the long-term economic burden for patients and families, including for cancer (搜索)-directed treatment, side effects and lasting conditions, and lost household income due to time away from work for patients and family caregivers," Yabroff added. "This burden frequently lasts many years after cancer diagnosis and increases the risk of financial hardship, including medical debt, stress and worry, and delayed and forgone care due to cost, which has been shown to result in worse outcomes for patients with cancer."
The study authors noted that the findings "highlight the importance of aligning treatment intensity with patient goals and providing critical inputs for simulation and cost-effectiveness analyses of cancer (搜索)-control interventions."
Policy Implications and the Case for Prevention
Lisa Lacasse, president of the American Cancer Society Cancer (搜索) Action Network (ACS CAN (搜索)), underscored the policy relevance of the findings. "These findings underscore the importance of effective cancer prevention and early detection in improving patient outcomes as well as avoiding the high costs of advanced cancer diagnoses. The availability of affordable, comprehensive health insurance options is critical so that individuals can access no-cost, evidence-based cancer prevention and early detection services and get needed follow-up care and treatment," Lacasse said. "ACS CAN will continue urging lawmakers at all levels of government to improve access to comprehensive health insurance."