title: Clinical burden of illness in patients with neuroendocrine tumors.
abstract: OBJECTIVE
  The objective of this study was to evaluate the incremental risk of morbidities affecting the cardiovascular, hepatic, gastrointestinal, skeletal, and neuropsychiatric systems in patients with neuroendocrine tumors (NETs) compared with a noncancer cohort.
  
  
  METHODS
  In a retrospective, matched-control study using US claims databases, noncancer control subjects (n = 3524) were matched 2:1 with patients with newly diagnosed NET (n = 1762) on age, sex, region, hospital data availability, and index year. Rates of select morbidities were compared between patients with NET and control subjects. Incremental risks were analyzed using logistic regressions adjusting for baseline characteristics.
  
  
  RESULTS
  In the first 3 years after diagnosis in patients with NET versus matched control subjects without cancer, (1) the adjusted risk of cardiovascular morbidities was higher (odds ratio [OR], 1.26; P = 0.0206); (2) the adjusted risk of hepatic or gastrointestinal morbidities was higher (OR, 1.95, P < 0.0001); (3) the adjusted risk of osteoporosis/osteopenia was higher among those 50 years or younger (OR, 3.24; P = 0.0081); and (4) the adjusted risk of anxiety/depression was higher among those 65 years or younger (OR, 1.48; P = 0.0210).
  
  
  CONCLUSIONS
  Patients with NET have greater clinical burden of disease than matched control subjects with respect to conditions affecting the cardiovascular, hepatic, and gastrointestinal systems. Excess clinical burden of disease with respect to anxiety, depression, osteoporosis, and osteopenia was observed in patients with NET in the younger age groups.
authors.affiliation: SDI, Plymouth Meeting, Philadelphia, PA 19462, USA. Greg.Hess@Wharton.Upenn.edu
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Hess
authors.forename: Chi-Chang
authors.initials: CC
authors.lastname: Chen
authors.forename: Zhimei
authors.initials: Z
authors.lastname: Liu
authors.forename: James C
authors.initials: JC
authors.lastname: Yao
authors.forename: Alexandria T
authors.initials: AT
authors.lastname: Phan
authors.forename: Jerrold W
authors.initials: JW
authors.lastname: Hill
mesh_terms: D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D017281:Cost of Illness; D003863:Depression / Q000453:epidemiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018358:Neuroendocrine Tumors / Q000150:complications*; D016017:Odds Ratio; D010024:Osteoporosis / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors