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>> As noted in other parts
of the Cancer Trends Progress Report there've been a lot
of changes in incidence, survival, and the types
of treatment in the past several decades.
But a couple of years ago,
we realized that our cost assessments didn't really
reflect all of these changes in incidence, and survival
and treatment, so we worked together with a bunch
of colleagues-- statisticians, epidemiologists, and economists
to develop new methods, and also to use the most recent data
to try and estimate-- come up with better estimates
of the cost of cancer care in the U.S. When we think
about cost, one of the things we've looked
at is the trajectory of cost over time.
And in the initial period following diagnosis
and also among patients that die from cancer,
the period right before death, those are very expensive,
compared to the period in between.
And so we call those, those distinct periods--
we call them phase of care.
And so, it's really important to try and estimate the cost
of cancer in the U.S. to also understand the prevalence
or the number of people that are alive in each one of those phase
of care at any given point in time.
And so, a lot of the work
that we've been doing recently that's reflected
in these new cost estimates are based on new methods
for estimating cancer prevalence by phase of care.
These estimates that we're presenting this year
in 2010 are not directly comparable to other estimates
that have been presented previously.
What we do plan on doing
in the future is using these same methods
in reporting trends.
The idea is this would allow, this would allow projection
of the cost of cancer care
to the future using current population trends.
And we feel like those data may be very important for policy,
for plant resource allocation, for planning,
and for understanding what the future burden
of cancer is likely to be.
One of the things we're currently developing is use is--
is a public use projections website that would allow users
to make their own assumptions about trends in cancer incidents
and survival and cost and try and project what would happen
for different cancer sites or for all cancers overtime.
[ Pause ]
>> We use data from a variety of sources including SEER
which is Surveillance Epidemiology and End Results.
It's a tumor registry in the U.S. and it currently represents
about 26 percent of the U.S. population.
We use those data to estimate cancer prevalence by phase
of care, so using both incidence and survival
to estimate cancer prevalence.
And then we use data from SEER-Medicare which is a linkage
between the SEER tumor registry and Medicare claims which cover
about 97 percent of the U.S. elderly population among other,
there are also other populations that Medicare covers.
But importantly, it covers almost all
of the elderly population.
And that, of course, is the population
where cancer is most common, it's in the elderly.
So, we used the SEER-Medicare data to estimate cost by phase
of care, then we used population data from the U.S. Census Bureau
to look at population counts by age group.
We've applied the cost estimates to the prevalence estimates
to come up with estimates of cancer burden in 2006.
And in 2006, we estimated the cancer expenditures
to be approximately 104.1 billion dollars.
Included in this report, we also have information
from some studies looking at--
trying to estimate loss productivity due
to early death from cancer.
And so we included estimates from those studies
in this report as well.
One of the limitations of our approach is that we have
to estimate for under 65 population using data
from the over 65 population.
And that we used to try and make that estimate,
we use information from managed care studies
which included patients in both age groups.
But in general, younger patients tend to use more care, and so,
we estimate the cost to be a little higher
for younger populations compared to older populations.
So, one of the main things we did in this new,
in this new report is we used methods developed specifically
for estimating that burden of cancer.
But we also use the most recent data from SEER tumor registries
on incidence and survival.
We used the most recent population data
from the U.S. Census Bureau.
And we also used the most recent data from SEER-Medicare
which is SEER tumor registry information linked
to Medicare claims.
And currently, there are over 3
and half million cancer patients included in SEER-Medicare.
So, we feel like we've got a good--
we got a good estimates of what's going
on in cancer patients in the U.S.
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