A great deal is known about who gets cancer and who dies from it, but little data exist on the quality and cost of cancer care in California. This CHCF Almanac report looks at what we know in our state.
More than one million Californians alive today have a history of cancer. In 2009, more than 55,000 Californians died of cancer, and more than 147,000 new cases were diagnosed. Cancer treatment represents $125 billion in health care spending nationally. The good news is that cancer mortality rates have fallen 22% since 1989, and rates of new cancer diagnoses have dropped 9%.
The bad news is that while we know a great deal about who gets cancer and who dies from it, we do not know much about the quality of the care provided or its cost. The delivery of cancer care is complex, with teams of professionals providing care in a variety of settings and systems, from community practices to large-scale, comprehensive cancer centers. Among these providers, recommendations differ on the best approaches to and the timing of cancer screening and treatment. Significant racial and ethnic disparities also exist for both cancer incidence and mortality in California.
This report examines cancer in California, including trends and disparities in incidence and mortality, and costs, locations, and providers of care. The report also highlights available cancer quality measures and recent data on national health care spending on treatment.
Key findings include:
- In 2009, breast and prostate cancer together accounted for nearly half of all cancers in California.
- Mortality rates in California for African Americans were 30% to 90% higher than in other groups for all cancers, and two to six times higher for prostate cancer in 2009.
- Over the last 12 years, the majority of national spending on cancer care has shifted from hospital inpatient stays (64% in 1997) to outpatient and office-based care (58% in 2009).
- In 2010, the five most expensive cancers represented over half of all cancer spending nationally.
- In California in 2008, private insurance and Medicare were the two largest payers for cancer care, each accounting for 40% of all spending.
- In 2007, cancer patients in California were more likely to be admitted to the hospital or ICU in the last month of life than were patients across the US and less likely than patients in many other states to receive hospice care.
- Despite the recognized desire of most patients to die at home, one-third of Medicare cancer patients in California with a poor prognosis died in a hospital in 2007. California also used hospice less than many other states for cancer patients at the end of life.
Note: Data for the childhood cancer rates (slide 7) have been updated as of July 5, 2012.
The complete report, as well as all the charts found in the report, is available as a Document Download.