The incremental healthcare cost associated with cancer in Belgium: A registry-based data analysis

Our plain-English summary of The incremental healthcare cost associated with cancer in Belgium: A registry-based data analysis, by V. Gorasso, S. Vandevijvere, J. Van der Heyden, et al (Cancer Medicine, 2024).

The study

• Authors: V. Gorasso, S. Vandevijvere, J. Van der Heyden, I. Pelgrims, H. Hilderink, W. Nusselder, C. Demoury, M. Schmidt, S. Vansteelandt, D. De Smedt, B. Devleesschauwer
• Journal: Cancer Medicine
• Published: 2024;13(3):e6659
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Similar to many countries, Belgium experienced a rapid increase in cancer diagnoses in the last years. Considering that a large part of cancer types could be prevented, our study aimed to estimate the annual healthcare burden of cancer per site, and to compare cost with burden of disease estimates to have a better understanding of the impact of different cancer sites in Belgium.

Methods: We used nationally available data sources to estimate the healthcare expenditure. We opted for a prevalence-based approach which measures the disease attributable costs that occur concurrently for 10-year prevalent cancer cases in 2018. Average attributable costs of cancer were computed via matching of cases (patients with cancer by site) and controls (patients without cancer). Years of life lost due to disability (YLD) were used to summarize the health impact of the selected cancers.

Results: The highest attributable cost in 2018 among the selected cancers was on average €15,867 per patient for bronchus and lung cancer, followed by liver cancer, pancreatic cancer, and mesothelioma. For the total cost, lung cancer was the most costly cancer site with almost €700 million spent in 2018. Lung cancer was followed by breast and colorectal cancer that costed more than €300 million each in 2018.

Conclusions: In our study, the direct attributable cost of the most prevalent cancer sites in Belgium was estimated to provide useful guidance for cost containment policies. Many of these cancers could be prevented by tackling risk factors such as smoking, obesity, and environmental stressors.

© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

In plain English

This study estimated the extra healthcare costs linked to 21 cancer sites, including mesothelioma, in Belgium in 2018. The authors linked the Belgian Cancer Registry to national health insurance cost data. They compared 27,758 people alive on January 1, 2018 who had a cancer diagnosis in the previous 10 years with 110,468 people without cancer, matched four to one by age, sex, region and reimbursement status. Mean total healthcare cost in 2018 was 12,407.7 euros for people with cancer and 5007.9 euros for controls. Bronchus and lung cancer had the highest average extra cost per patient (the text says €15,867; its table says 15,904) and the highest total cost, almost €700 million. Mesothelioma's average extra cost was 13,041 euros (95% confidence interval 12,623 to 13,459), and it had the highest years lived with disability per case (0.227). With 453 prevalent cases, its total cost was 5,913,007 euros. The article does not discuss asbestos. The authors stated that their data sources had no information on lifestyle risk factors and incomplete information on comorbidities, and that they did not count indirect costs.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Registry-based cost-of-illness study using a 10-year prevalence approach, with cancer cases matched to controls without cancer
• Who was studied: 138,226 Belgian residents: 27,758 people alive on January 1, 2018 with a diagnosis at one of 21 cancer sites in the previous 10 years (at most 1435 per site; 453 prevalent mesothelioma cases in Belgium), and 110,468 controls without cancer, matched four to one on age, sex, region of residence and reimbursement status; costs were for the year 2018
• Exposure: Having a cancer diagnosis at one of 21 sites, including mesothelioma (ICD-10 code C45, not divided into pleural or peritoneal), within the previous 10 years. Asbestos and fiber types are not mentioned.
• Main results:
  • In 2018, mean total healthcare cost was 12,407.7 euros (SD 20,025.9) for cancer cases and 5007.9 euros (SD 10,802.2) for controls
  • Bronchus and lung cancer had the highest average extra (attributable) cost per patient. The text gives €15,867; Table 3 gives 15,904 (95% CI 15,686 to 16,122).
  • Mesothelioma patients had an average extra cost of 13,041 euros (95% CI 12,623 to 13,459), the fourth highest of the 21 sites
  • Mesothelioma had the highest years lived with disability per case (0.227) and was among the cancers with the highest cost per case. Its total cost was 5,913,007 euros, with a prevalence of 453 and 103 total years lived with disability.
  • The authors described mesothelioma as having the lowest total health and economic burden. Their own table, however, lists a lower total cost for testis cancer (4,513,896 euros).
  • Bronchus and lung cancer had the highest total cost of any site, almost €700 million in 2018 (688,069,331 euros in the appendix table)
  • Among all cancer cases, those diagnosed 1 year or less before had higher costs than those diagnosed more than 8 years before (cost ratio 1.420, 95% CI 1.389 to 1.452)
  • Having cancer at more than one site was associated with higher costs
• The authors' conclusion: The authors concluded that bronchus and lung cancer had both the highest total and the highest average cost per patient. They concluded that mesothelioma had the highest years lived with disability per case and was among the cancers with the highest cost per case.
• Limitations the authors state:
  • Indirect costs, such as lost productivity and informal caregiving, were not included
  • The data sources had no lifestyle risk factors and incomplete comorbidity information, so confounding may not have been fully controlled
  • Selection bias was possible because cases had to survive to January 1, 2018. The authors say this may have led to underestimation of attributable costs.
  • Cost comparisons between cancer sites are partly affected by cases being at different disease stages, depending on site-specific mortality
  • The results are a one-year snapshot of costs, not lifetime costs

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Bronchus, Lung Cancer, Mesothelioma, Colorectal Cancer.

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