The epidemiology of cancer and the delivery of medical care services.

Data collected primarily for epidemiologic purposes can be used to address questions concerning medical care for cancer in the United States. This was done directly for the period 1969-71 through an interview survey of a sample of cancer patients identified in the Third National Cancer Survey to obtain information on length of hospital stay, cost of care, source of payment, and related issues. Since that time the Surveillance, Epidemiology, and End Results (SEER) Program was established by the National Cancer Institute to measure cancer incidence and cancer patient survival in 10 percent of the U.S. population on a continuing basis. Using the SEER data and those from the earlier cancer surveys, evidence is presented for the increasing need for medical care resources for some of the major cancers, such as cancers of the lung and prostate. Data from the National Hospital Discharge Survey for 1979 reveal an average length of stay of 12.3 days for each hospital discharge with a diagnosis of cancer, ranging from 8.5 days for those with cancer of the cervix uteri to 20 days for those with brain cancer. Some suggestions are made for applying hospital data on length of stay from the National Hospital Discharge Survey to estimates of cancer incidence from the SEER Program to obtain estimates of numbers of hospital days required during the first period of hospitalization for cancer. This estimate for the United States for 1983 was almost 11 million hospital days for all cancers combined.