Breast cancer epidemiology, prevention and costs of care - Implications for disease management programmes

Breast cancer is the most frequently diagnosed cancer in women and the seco nd leading cause of cancer mortality. It is estimated to account for approx imately 20% of all cancer expenditures, making the burden of disease relati vely high. One of the most important risk factors for developing breast can cer is age; with demographic trends towards an increasing elderly populatio n in the US, this burden is likely to increase. Recent trends in healthcare delivery have increased the emphasis on evaluating costs of providing care as well as the outcomes of that care. This paper reviews breast cancer epidemiology, primary and secondary preven tion and costs of breast cancer care by stage of disease at diagnosis and t ype of service, and discusses implications for the development of disease m anagement programmes. Implementation of disease management programmes, thro ugh the creation of a data infrastructure system, establishment of measurab le breast health and cancer care outcomes, and programme evaluation may be an important mechanism for managed-care organisations to provide quality an d cost-effective breast cancer management.