Abstract 4375
Background
An estimated 12,820 women in the United States (US) will be diagnosed with cervical cancer this year, with 4,210 deaths from the disease. The economic and humanistic burden of cervical cancer has not been adequately studied.
Methods
This was a retrospective, cross-sectional analysis of Medical Expenditure Panel Survey (MEPS) data from 2006-2015. Cervical cancer cases were identified using ICD-9 CM code 180 or clinical classification software code 26. The control group consisted of women without a diagnosis of cancer. Study outcomes included healthcare resource use (institutional inpatient and outpatient, ER, and physician office visits), healthcare costs, activities of daily living (physical, cognitive, social, and activity limitations), quality of life measures (general health, SF-12v2 physical component score [PCS], mental component score [MCS], EQ-5D and SF-6D health utility, and PHQ-2 depression severity). Multivariate generalized linear models (GLMs) which controlled for key socio-demographic and clinical covariates were conducted to compare study outcomes in cervical cancer cases to non-cancer controls.
Results
The analytic cohort consisted of 275,246 cervical cancer cases and 146,061,609 non-cancer controls. Cervical cancer cases were significantly older (mean age: 42.03 vs 36.98 years), and had a higher comorbidity burden (mean Charlson comorbidity index: 1.06 vs 0.46) as compared to non-cancer controls (all p < 0.05). Results from the GLMs suggested that cervical cancer cases had significantly higher institutional outpatient costs ($1,610 vs $502), physician visit costs ($2,422 vs $1,321), and total healthcare costs ($10,031 vs $4,913) (all P < 0.05) compared to controls. Cervical cancer patients were 1.99 (odds ratio [OR]: 1.991; 95% CI: 1.23 to 3.22) and 2.56 (OR: 2.562; 95% CI: 1.78 to 3.68) times as likely to report activity limitations and poor general health as compared to non-cancer controls. Cervical cancer patients had a significantly lower PCS, MCS, EQ-5D health utility, and higher PHQ-2 depression severity (all P < 0.01).
Conclusions
Cervical cancer is associated with significant economic burden, activity limitations, and quality of life impairment among ambulatory women in the US.
Clinical trial identification
Legal entity responsible for the study
Merck & Co., Inc., Kenilworth, NJ, USA.
Funding
Merck & Co., Inc., Kenilworth, NJ, USA.
Editorial Acknowledgement
Disclosure
C. Nwankwo: Employee of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA and may own/hold stock/stock options in the company. R. Shah, Y. Kwon, S. Corman: Consultant for Merck & Co., Inc., Kenilworth, NJ, USA for this work.
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