ESTIMATION OF BREAST CANCER INCIDENT CASES AND MEDICAL CARE COSTS ATTRIBUTABLE TO ALCOHOL CONSUMPTION AMONG INSURED WOMEN UNDER AGE 45 YEARS IN THE UNITED STATES

• Published in: Value in health Vol. 20; no. 5; p. A285
• Main Authors: Ekwueme, D, Allaire, B, Parish, W, Thomas, C, Jr, G Guy, Lahoti, S, Fairley, T, Trogdon, J
• Format: Journal Article
• Language: English
• Published: Lawrenceville Elsevier Science Ltd 01.05.2017
• Subjects: Alcohol use; Breast cancer; Confidence intervals; Diagnosis; Drug abuse; Epidemiology; Health care expenditures; Health insurance; Medicaid; Medical diagnosis; Morbidity; National programmes; Polls & surveys; Risk factors; Surveillance; Womens health; Young women; United States > US
• ISSN: 1098-3015; 1524-4733

OBJECTIVES: To estimate the percent of breast cancer cases, total number of incident breast cancer cases, and the total annual medical care costs attributable to alcohol consumption among insured younger women by type of insurance (Medicaid, private, and both groups) and by stage at diagnosis. METHODS: We used data from the 2012-2013 National Survey on Drug Use and Health, the Centers for Disease Control and Prevention's National Program of Cancer Registries, the National Cancer Institute's Surveillance, Epidemiology, and End Results Program, and published literature to estimate: 1) the alcohol-attributable fraction of breast cancer cases among younger women aged 18-44 years by type of insurance; 2) the total number of breast cancer incident cases attributable to alcohol consumption by stage at diagnosis and insurance status; and 3) the total annual medical care costs of treating breast cancer incident cases attributable to alcohol consumption. All costs were expressed in 2013 US dollars. RESULTS: Among younger women enrolled in Medicaid, private insurance, and both groups, we estimated that 8.7%, (95% confidence interval [CI]:7.4-10.0%), 13.8% (95% CI:13.3-14.4%), and 12.3% (95% CI:11.4-13.1%) or l-in-12,1-in-7, and l-in-8 of all breast cancer cases were attributable to alcohol consumption. Across both insurance groups, the largest proportion of estimated attributable incident cases were in localized stage. The estimated total number of breast cancer incident cases attributable to alcohol consumption was 2,212 (95% CI: 2,125-2,303). These breast cancer incident cases accounted for estimated total annual medical care costs of $201.7 million (95% CI: $191.1-$212.2 million). CONCLUSIONS: Alcohol use in younger women is a modifiable risk factor for breast cancer. We estimate that breast cancer attributable to alcohol has medical care costs in excess of $200 million per year. Thus the findings from this study could be used to support evidence-based interventions to reduce alcohol consumption in younger women.