The economic burden of prostate cancer, California, 1998.
BACKGROUND
Prostate cancer is the most common malignancy diagnosed among men in the United States. This article reviews previous studies of the annual cost of all cancers and of prostate cancer in the United States and California and estimates the direct and indirect costs of prostate cancer in California in 1998.


METHODS
Hospitalization costs, including costs of primary and secondary diagnoses of prostate cancer, were derived from the California Hospital Discharge data set (CHDS). Charges were converted to costs using hospital specific cost-to-charge ratios and an imputed cost for Health Maintenance Organization hospitalizations. Other direct medical costs were derived from the 1997 Medical Expenditure Panel Survey. Indirect mortality costs are the product of the number of deaths and the expected value of a male's future earnings taking into account age at death, earning patterns at successive ages, labor force participation, imputed value of housekeeping services, and a 3% discount rate.


RESULTS
Prostate cancer direct health care costs in California were estimated at 180 million dollars, and lost productivity from premature death was estimated at 180 million dollars, for a total cost of 360 million dollars in 1998. The disease is largely one of older men; hospitalization costs account for three-fifths of total direct costs, and Medicare and private health insurance share almost equally in paying for hospital care.


CONCLUSIONS
It is critical to identify cost-effective screening efforts that permit early detection of prostate cancer to reduce illness, premature deaths, and the high costs of prostate cancer.
Max
Wendy
W
Institute for Health and Aging, School of Nursing, University of California-San Francisco, San Francisco, California 94118, USA. wmax@itsa.ucsf.edu
Rice
Dorothy P
DP
Sung
Hai-Yen
HY
Michel
Martha
M
Breuer
Wendy
W
Zhang
Xiulan
X
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005544:Forecasting; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006699:Home Care Services / Q000191:economics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000191:economics* / Q000401:mortality / Q000628:therapy