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Breast Cancer and Autologous Bone Marrow Transplantation in the United States

Breast Cancer and Autologous Bone Marrow Transplantation in the United States. Prof Cindy Farquhar MD MPH University of Auckland, NZ. Breast Cancer and Autologous Bone Marrow Transplant (ABMT). 18 0 ,000 US women are diagnosed with breast cancer each year 46000 US women die annually

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Breast Cancer and Autologous Bone Marrow Transplantation in the United States

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  1. Breast Cancer and Autologous Bone Marrow Transplantationin the United States Prof Cindy FarquharMD MPH University of Auckland, NZ

  2. Breast Cancer and Autologous Bone Marrow Transplant (ABMT) • 180,000 US women are diagnosed with breast cancer each year • 46000 US women die annually • 60% of women with metastatic disease die within 10 years of diagnosis

  3. Questions • How many US women with breast cancer had autologous bone marrow transplantation ? • What was the mortality associated with the procedure ? • What was the cost of the procedure ?

  4. Methods 1: Health Care Utilization Project Database • National Inpatient Statistics of HCUP: discharge statistics from 22 states, weighted to give national estimates, commenced 1993 • Identified women with breast cancer using ICD-9 codes • Identified women with breast cancer and ABMT using ICD-9 codes

  5. Methods 2: American Bone Marrow Transplantation Registry • Voluntary registration of cases from clinics • Estimate that the register only collects data from 50-60% of cases • Commenced 1989

  6. HCUP data for number of women with breast cancer who had HDC & ABMT * x 1,000 Total=19795

  7. HCUP: In Hospital Mortality

  8. HCUP : Length of Stay & Charges * Hospital charges only

  9. HDC/ABMT1993-2001 for Breast Cancer

  10. Number of women with breast cancer and HDC/ABMT from registry data Figures estimated to be only 50-60% - total likely to be 30,000 – 40,000

  11. High Dose Chemotherapy and Autologous Bone Marrow or Stem Cell Transplant: Summary: • 1989-2001 approximately 30,000 – 40,000 women received an unproven, life-threatening and expensive treatment • It is estimated that at least 600 women died from the treatment • Hospital costs over 10 years are likely to be upwards of $2 billion

  12. Acknowledgements • Agency for Healthcare Research and Quality • Claudia Steiner • Robert Wood Johnson Foundation • RAND • The Commonwealth Fund

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