title: Complementary and alternative medicine provider use and expenditures by cancer treatment phase.
abstract: OBJECTIVE
  To assess the use of complementary and alternative medicine (CAM) providers and the associated expenditures by specific treatment phases among patients with cancer.
  
  
  METHODS
  Cross-sectional analysis of medical services utilization and expenditures during the 3 therapeutic phases of initial, continuing, and end-of-life life treatment.
  
  
  METHODS
  Analysis of an insurance claims database that had been matched to the Washington State Surveillance, Epidemiology, and End Results cancer registry.
  
  
  RESULTS
  Of 2900 registry-matched patients, 63.2% were female, the median age was 54 years, and 92.7% were of white race/ethnicity. Breast cancer was the most frequent diagnosis (52.7%), followed by prostate cancer (24.7%), lung cancer (10.1%), colon cancer (7.0%), and hematologic malignancies (5.6%). Patients using CAM providers represented 26.5%. The proportion of patients using CAM was similar during each treatment phase. All patients used some conventional care. Age, female sex, breast cancer diagnosis, and white race/ethnicity were significant predictors of CAM use. Diagnosis of a musculoskeletal problem occurred at some time during the study for 72.1% of patients. CAM provider visits represented 7.2% of total outpatient medical visits, and 85.1% of CAM visits resulted in a musculoskeletal diagnosis. Expenditures for CAM providers were 0.3%, 1.0%, and 0.1% of all expenditures during the initial, continuing, and end-of-life phases, respectively.
  
  
  CONCLUSIONS
  For patients with cancer, musculoskeletal issues were the most commonly listed diagnosis made by a CAM provider. Although expenditures associated with CAM are a small proportion of the total, additional studies are necessary to determine the importance that patients place on access to these services.
authors.affiliation: Department of Health Services, School of Public Health and Community Medicine, University of Washington, Box 357660, Seattle, WA 98195, USA. billlaf@u.washington.edu
authors.forename: William E
authors.initials: WE
authors.lastname: Lafferty
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Tyree
authors.forename: Sean M
authors.initials: SM
authors.lastname: Devlin
authors.forename: M Robyn
authors.initials: MR
authors.lastname: Andersen
authors.forename: Paula K
authors.initials: PK
authors.lastname: Diehr
mesh_terms: D000328:Adult; D000529:Complementary Therapies / Q000191:economics* / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics* / Q000628:therapy*