(228) Comparisons of Twenty-Year Trends in Direct Costs, Absence Payments and Lost Time for Employees with Breast, Skin, GI, Female, Male, and "Other" Cancers

Publication Number: 902

Background: Limited data exists on cancer absence and direct and indirect cost trends over time and how different types of cancer compare with each other using objective data.

Objectives: To assess whether the twenty-year cost and absence trends for employees with various cancers had similar slopes.

Methods: Retrospective analysis of Workpartners Research Reference Database (RRDb, 2001—2020). For each year, employees with ICD-9/-10 codes within the 37 US Agency for Healthcare Research and Quality’s (AHRQ) cancer categories were identified. Non-specific cancer categories were excluded, remaining categories assigned to Cancer Categories (CCs): Breast (male+female), Female (cervix+uteris), GI, Male(prostate+testes), Skin, or “Other”. Employees had continuous eligibility for the calendar year they were identified. Analysis focused on “all cancer” (ALL) and each CC’s prevalence, the Charlson Comorbidity Index(CCI), medical and prescription costs, absence (percent utilizing, days, and cost [average and median as percent of salary]) due to all-cause leaves for: sick leave, short-/long-term disability (STD/LTD), and workers’ compensation (WC). Outcomes counted in claim start year. For each metric, trend lines were plotted and 95% confidence intervals [CIs] of the slopes were compared to determine slopes that differed from zero and differences in slopes between CCs.

Results: The twenty-year study period averaged 9084 employees/year with any cancer (Breast=14.6%,Female=32.2%, GI=7.5%, Male=8.7%, Skin=24.9%, “Other”=19.8%). CCs’ medical and prescription costs and SL-days had similar slopes to ALL and were increasing over time. CCs’ prevalence significantly increased(except Female), with ALL’s slope greater than Breast’s, GI’s, and Male’s. CCI slopes overlapped and were>0 for ALL, Female, GI, and Skin. The Male STD-utilization slope was < 0. The WC-utilization slopes were negative for all CCs except Breast and Skin. The slope for Male average STD-payments was >0. The slopes for ALL, Breast, Female, and Skin CCs’ median payments as a percent of salary were < 0.

Conclusions: This research found that while the rates of increase for costs were similar for all groups studied, prevalence and other metrics varied by cancer type.