The impact of ductal carcinoma in situ on health services utilization

Purpose To determine the intermediate-term impact of diagnosis and treatment of ductal carcinoma in situ of the breast (DCIS) on health services utilization, we compared utilization by cases of DCIS to unaffected controls. Methods We identified a population-based cohort of Ontario females diagnosed...

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Bibliographic Details
Published in:Breast cancer research and treatment 2020-07, Vol.182 (1), p.159-168
Main Authors: Paszat, Lawrence, Sutradhar, Rinku, Rakovitch, Eileen
Format: Article
Language:English
Subjects:
Aged
Anxiety
Breast
Breast cancer
Breast Neoplasms - pathology
Breast Neoplasms - psychology
Breast Neoplasms - therapy
Breast surgery
Cancer
Cancer research
Carcinoma, Ductal
Carcinoma, Ductal, Breast - pathology
Carcinoma, Ductal, Breast - psychology
Carcinoma, Ductal, Breast - therapy
Carcinoma, Intraductal, Noninfiltrating - pathology
Carcinoma, Intraductal, Noninfiltrating - psychology
Carcinoma, Intraductal, Noninfiltrating - therapy
Care and treatment
Case-Control Studies
Comorbidity
Comparative analysis
Depression, Mental
Diagnosis
Epidemiology
Facilities and Services Utilization - statistics & numerical data
Female
Follow-Up Studies
Health aspects
Health care industry
Health services utilization
Humans
Mammography
Medical care
Medical diagnosis
Medical records
Medicine
Medicine & Public Health
Mental depression
Middle Aged
Oncology
Patient Acceptance of Health Care - psychology
Prognosis
Retrospective Studies
Surgery
Utilization
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Summary:Purpose To determine the intermediate-term impact of diagnosis and treatment of ductal carcinoma in situ of the breast (DCIS) on health services utilization, we compared utilization by cases of DCIS to unaffected controls. Methods We identified a population-based cohort of Ontario females diagnosed with DCIS between 2010 and 2015. We matched 5 controls without any history of cancer to each case, on the date of diagnosis of the case (the index date), by age, annual mammography history, socioeconomic status, and comorbidity. We identified billing claims and hospital records, during the interval 13 to 60 months prior to, and subsequent to the index date, and computed rates per 100 person-years during both intervals, to conduct a difference-in-differences analysis. We used negative binomial regression to test if the change in rates in health services differed between cases and controls. Results Visits with a breast diagnosis code, and claims for breast surgery and imaging, were significantly increased among cases compared to controls (all p values 
ISSN:0167-6806
1573-7217
DOI:10.1007/s10549-020-05664-9