title: Attributable costs of differentiated thyroid cancer in the elderly Medicare population.
abstract: BACKGROUND
  Little is known about costs associated with differentiated thyroid cancer (DTC) and follow-up care. This study used data from the Surveillance Epidemiology and End Results (SEER) database to examine cumulative costs attributable to disease stage and treatment options of DTC in elderly patients over 5 years.
  
  
  METHODS
  We identified 2,823 patients aged >65 years with DTC and 5,646 noncancer comparison cases from SEER Medicare data between 1995 and 2005. Cumulative costs were obtained by estimating average costs/patient in each month up to 60 months after diagnosis. We performed multivariate analyses of costs by fitting each monthly cost to linear models, controlling for demographics and comorbidities. Marginal effects of covariates were obtained by summing coefficients over 60 months.
  
  
  RESULTS
  Cumulative costs were $17,669/patient the first year and $48,989/patient 5 years after diagnosis. Regional disease was associated with higher costs at 1 year ($9,578) and 5 years ($8,902). Distant disease was associated with 1-year costs of $28,447 and 5-year costs of $20,103. Patients undergoing surgery and radiation had a decrease in cost of $722 at 5 years.
  
  
  CONCLUSIONS
  DTC in the elderly is associated with significant economic burden largely attributable to patient demographics, stage of disease, and treatment modalities.
authors: Division of Outcomes Research and Quality, Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA; Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA.
authors: Melissa M
authors: MM
authors: Boltz
authors: Christopher S
authors: CS
authors: Hollenbeak
authors: Eric
authors: E
authors: Schaefer
authors: David
authors: D
authors: Goldenberg
authors: Brian D
authors: BD
authors: Saunders
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000191:economics / Q000473:pathology / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000191:economics / Q000473:pathology / Q000628:therapy; D002291:Carcinoma, Papillary / Q000191:economics / Q000473:pathology / Q000628:therapy; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D006278:Medicare; D018426:SEER Program; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000191:economics* / Q000473:pathology / Q000628:therapy; D014481:United States