Abstract
The incidence and prevalence of neuroendocrine tumors (NETs) are continually increasing. While it is known that NET symptoms often predate diagnosis, their prevalence and impact on resource utilization and costs are largely unknown. We identified 9,319 elderly patients diagnosed with NETs between 1/2003 and 12/2011 from the Surveillance, Epidemiology and End Results (SEER)-Medicare. We examined the patients’ conditions potentially associated with NET, resource utilization and costs during the year before diagnosis. We found that NET patients were more likely to have diagnoses of hypertension (63.8% vs. 53.3%), abdominal pain (22.2% vs. 7.6%), heart failure (11.7% vs. 8.0%), diarrhea (5.8% vs. 1.8%), peripheral edema (5.4% vs. 3.8%) and irritable bowel syndrome (1.2% vs. 0.5%) compared to the non-cancer control group. They also had much higher resource utilization including number of outpatient visits (mean: 22.1 vs. 17.2), percentage with ER visits (20.9% vs. 11.6%), and hospitalizations (28.4% vs. 17.0%). Similarly, NET patients incurred significantly higher total (mean: $14602 vs. $9464), outpatient (mean: $5987 vs. $4253), and inpatient costs (mean: $8615 vs. $5211). This first population-based study on the pre-diagnosis symptoms and healthcare utilization found that NET patients were more likely to have certain conditions and incur higher resource utilizations and costs.
Highlights
To diagnosis for neuroendocrine tumors (NETs) patients and identify areas where interventions may lead to diagnostic improvement
We found that NET patients were more likely to have potentially relevant symptoms and increased health care encounters leading to much higher health care costs compared to the non-cancer controls
We found that NET patients incurred much higher mean health care costs than the non-cancer control group during the 12 months before diagnosis, with around 70% of the cost difference coming from inpatient costs and 30% due to outpatient costs
Summary
To diagnosis for NET patients and identify areas where interventions may lead to diagnostic improvement. The objectives of our U.S population-based study were to examine the presence of common pre-existing symptoms, define the physician specialties involved, and estimate health care costs during the one year prior to diagnosis of NET among elderly patients.
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