Introduction Costs associated with cancer care are increasing. Cancer costs in the context of other common non-cancer diagnoses have not been extensively studied at the population level. Knowledge from such analyses can inform health care resource allocation and highlight strategies to reduce overall costs.Methods Using cross-sectional data from publicly available population-level administrative data sources (health insurance claims, physician billing, and hospital discharge abstracts), we calculated incidence-adjusted health care costs (in 2014 Canadian dollars) for cancers and common non-cancer diagnoses in the adult population in a large Canadian province. Subgroup analyses were also performed for various provincial health administrative regions.Results Total costs related to cancer care amounted to $495 million for the province, of which at least $67 million (14%) was attributable to radiation and chemotherapy. Of the various cancer subtypes, hematologic malignancies were most costly at $70 million, accounting for 14% of the total cancer budget. Colon cancer followed at $51 million (10%), and lung cancer, at $44 million (9%). Cancer costs (with and without costs for radiation and chemotherapy) exceeded those for cardiovascular disease, diabetes mellitus, mental health, and trauma (p < 0.001). In addition, the costs of specific cancer subtypes varied by region, but hematologic and lung cancers were typically the most costly no matter the health region.Conclusions Using provincial administrative data to establish cost trends can help to inform health care allocation and budget decisions, and can facilitate comparisons between provinces.
Context
Many patients with unilateral primary aldosteronism (PA) have normal adrenal imaging, but little is known about their outcome following adrenalectomy.
Objective
To evaluate biochemical and clinical outcomes after adrenalectomy in patients with unilateral PA and normal-appearing adrenal imaging.
Design
Retrospective cohort study of patients seen between January 2006 and May 2018.
Setting
A Canadian tertiary care PA referral center.
Patients
Consecutive individuals with PA, normal cross-sectional adrenal imaging, and lateralizing adrenal vein sampling (AVS) who underwent adrenalectomy during the study period.
Primary Outcome
Biochemical response to adrenalectomy graded according to the Primary Aldosteronism Surgical Outcome criteria.
Results
A total of 40 patients were included. Biochemical outcomes were available for 33 people (mean age, 54.7 years; 91% male; median follow-up, 2.7 months), with 28 (85%) showing a complete or partial response and 5 (15%) with no response. Clinical outcomes were available for 36 people (mean age, 54.6 years; 86% male; median follow-up, 9.8 months), with 31 (86%) demonstrating a complete or partial response and 5 (14%) with no response.
Conclusions
The prognosis after adrenalectomy is highly favorable for patients with unilateral PA and normal-appearing adrenal imaging. Patients with lateralizing disease should be considered for surgery despite apparently normal adrenal imaging.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.