Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, USA.
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, USA.
Sci Rep. 2018 Nov 15;8(1):16863. doi: 10.1038/s41598-018-35340-4.
The incidence and prevalence of neuroendocrine tumors (NETs) are continually increasing. While it is known that NET symptoms often predate diagnosis, their prevalence and impact on resource utilization and costs are largely unknown. We identified 9,319 elderly patients diagnosed with NETs between 1/2003 and 12/2011 from the Surveillance, Epidemiology and End Results (SEER)-Medicare. We examined the patients' conditions potentially associated with NET, resource utilization and costs during the year before diagnosis. We found that NET patients were more likely to have diagnoses of hypertension (63.8% vs. 53.3%), abdominal pain (22.2% vs. 7.6%), heart failure (11.7% vs. 8.0%), diarrhea (5.8% vs. 1.8%), peripheral edema (5.4% vs. 3.8%) and irritable bowel syndrome (1.2% vs. 0.5%) compared to the non-cancer control group. They also had much higher resource utilization including number of outpatient visits (mean: 22.1 vs. 17.2), percentage with ER visits (20.9% vs. 11.6%), and hospitalizations (28.4% vs. 17.0%). Similarly, NET patients incurred significantly higher total (mean: $14602 vs. $9464), outpatient (mean: $5987 vs. $4253), and inpatient costs (mean: $8615 vs. $5211). This first population-based study on the pre-diagnosis symptoms and healthcare utilization found that NET patients were more likely to have certain conditions and incur higher resource utilizations and costs.
神经内分泌肿瘤（NET）的发病率和患病率持续上升。虽然已知 NET 症状通常先于诊断出现，但它们的患病率及其对资源利用和成本的影响在很大程度上尚不清楚。我们从监测、流行病学和最终结果（SEER）-医疗保险数据库中确定了 9319 名在 2003 年 1 月至 2011 年 12 月期间被诊断为 NET 的老年患者。我们研究了患者在诊断前一年可能与 NET 相关的疾病、资源利用和成本情况。我们发现，NET 患者更有可能被诊断出患有高血压（63.8%比 53.3%）、腹痛（22.2%比 7.6%）、心力衰竭（11.7%比 8.0%）、腹泻（5.8%比 1.8%）、外周水肿（5.4%比 3.8%）和肠易激综合征（1.2%比 0.5%）。与非癌症对照组相比，他们的资源利用也更高，包括门诊就诊次数（平均：22.1 比 17.2）、急诊就诊比例（20.9%比 11.6%）和住院率（28.4%比 17.0%）。同样，NET 患者的总费用（平均：$14602 比 $9464）、门诊费用（平均：$5987 比 $4253）和住院费用（平均：$8615 比 $5211）也显著更高。这是第一项关于 NET 患者诊断前症状和医疗保健利用情况的基于人群的研究，发现 NET 患者更有可能患有某些疾病，并产生更高的资源利用和成本。
