title: Breast Cancer in Young Women: Health State Utility Impacts by Race/Ethnicity.
abstract: BACKGROUND
  Little is known about the effect of breast cancers on health-related quality of life among women diagnosed between age 18 and 44 years. The goal of this study is to estimate the effect of breast cancer on health state utility by age at diagnosis (18-44 years versus ≥45 years) and by race/ethnicity.
  
  
  METHODS
  The analytic sample, drawn from the 2009 and 2010 Behavioral Risk Factor Surveillance System and analyzed in 2013, included women diagnosed with breast cancer between age 18 and 44 years (n=1,389) and age ≥45 years (n=6,037). Health state utility values were estimated using Healthy Days variables and a published algorithm. Regression analysis was conducted separately by age at diagnosis and race/ethnicity.
  
  
  RESULTS
  The breast cancer health state utility decrement within 1 year from date of diagnosis was larger for women diagnosed at age 18-44 years than for women diagnosed at age ≥45 years (-0.116 vs -0.070, p<0.05). Within the younger age-at-diagnosis group, Hispanic women 2-4 years after diagnosis had the largest health state utility decrement (-0.221, p<0.01), followed by non-Hispanic white women within 1 year of diagnosis (-0.126, p<0.01).
  
  
  CONCLUSIONS
  This study is the first to report estimates of health state utility values for breast cancer by age at diagnosis and race/ethnicity from a nationwide sample. The results highlight the need for separate quality of life adjustments for women by age at diagnosis and race/ethnicity when conducting cost-effectiveness analysis of breast cancer prevention, detection, and treatment.
authors.affiliation: Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: justintrogdon@unc.edu.
authors.forename: Justin G
authors.initials: JG
authors.lastname: Trogdon
authors.affiliation: Division of Cancer Prevention and Control, CDC, Atlanta, Georgia;
authors.forename: Donatus U
authors.initials: DU
authors.lastname: Ekwueme
authors.affiliation: Public Health Economics Program, RTI International, Research Triangle Park, North Carolina.
authors.forename: Linda
authors.initials: L
authors.lastname: Chamiec-Case
authors.affiliation: Division of Cancer Prevention and Control, CDC, Atlanta, Georgia;
authors.forename: Gery P
authors.initials: GP
authors.lastname: Guy
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D001943:Breast Neoplasms / Q000191:economics* / Q000208:ethnology* / Q000523:psychology; D015897:Comorbidity; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D044469:Racial Groups / Q000523:psychology / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D016387:Women's Health; D055815:Young Adult