Spending on cancer care more than doubled since 1990.

Moral of the story: This is quickly becoming a moral issue about access to care due to its insane costs with a low benefit ratio in comparison to other treatments. People should take this into consideration.

Source: AMA Morning Rounds 3/17/2010

Spending on cancer care more than doubled since 1990.

USA Today (3/17, Szabo) reports that, according to research published in the Journal of the American Medical Association, "the cost of cancer treatment is 'skyrocketing' -- both for individual patients and the nation." Data indicate that "from 1990 to 2008, spending on cancer care soared to more than $90 billion from $27 billion." The trend may be due to advances in treatment that allow "older, frailer patients" to "have less invasive operations or more tightly focused radiation treatments...says" one analysis.

        The increase in spending on "cancer research and care...is straining the US health system and needs to be restrained, commentators said" in "six journal reports," Bloomberg News (3/17, Gibson) reports. Researchers suggested lowering the price of drugs by combining drug costs and other care in a single provider payment. They "also suggested...that doctors and hospitals should be grouped into accountable-care organizations" to "nudge physicians to act more cohesively."

        But, "in a commentary that accompanied" the "wide-ranging March 17 issue," MedPage Today (3/16, Frieden) reported that Susan Gapstur, PhD, MPH, and Michael Thun, MD, both of the American Cancer Society, "argued that comparing cancer rates in the US at any two time points 'can be misleading,'" because "such comparisons should 'take into account the more than 30% increase in the US population...since 1970.'" Gapstur and Thun concluded that "it is essential to move forward on multiple fronts simultaneously." AFP (3/16, Zeitvogel) also covered the story.

        Findings raise questions of cost-effectiveness of new colon cancer treatments. HealthDay (3/16, Preidt) reported, "New chemotherapy agents for metastatic colon cancer improve patient survival, but are costly," according to a study published online in the Archives of Internal Medicine. Researchers found that, "compared to those who received older chemotherapy agents, patients who received one or more of the six chemotherapy agents approved in the United States between 1996 and 2004 lived an average of 6.8 months longer." The investigators "calculated that the cost for each quality-adjusted life-year (a year of life in perfect health) gained was $99,100."

        Older colon cancer patients may be less likely to receive postoperative chemotherapy. The Los Angeles Times (3/16, Maugh) "Booster Shots" blog reported that a paper appearing in the Journal of the American Medical Association reveals that the "elderly are not treated as aggressively for colon cancer as younger people." UCLA researchers, alongside investigators at the Rand Corp., say that reality may be the result of "misguided compassion on the part of oncologists, who do not wish to subject older patients to the side effects associated with the most powerful treatments."

        There is also a pervasive feeling that older patients may not have much time left, according to Reuters (3/17, Allen). Some physicians are also leery of taking such measures because there is a dearth of data regarding chemo's efficacy in the elderly population.