Health care expenditures among long-term survivors of pediatric solid tumors: Results from the French Childhood Cancer Survivor Study (FCCSS) and the French network of cancer registries (FRANCIM)

doi:10.1371/journal.pone.0267317

. 2022 May 26;17(5):e0267317.

doi: 10.1371/journal.pone.0267317. eCollection 2022.

Health care expenditures among long-term survivors of pediatric solid tumors: Results from the French Childhood Cancer Survivor Study (FCCSS) and the French network of cancer registries (FRANCIM)

Daniel Bejarano-Quisoboni^{1

2

3

4}, Nathalie Pelletier-Fleury^{2

3}, Rodrigue S Allodji^{1

3

4}, Brigitte Lacour^{5

6}, Pascale GrosClaude⁷; FRANCIM Group; Hélène Pacquement⁸, François Doz^{8

9}, Delphine Berchery¹⁰, Claire Pluchart¹¹, Piere-Yves Bondiau¹², Julie Nys^{1

4}, Angela Jackson^{1

3

4}, Charlotte Demoor-Goldschmidt^{1

13}, Agnès Dumas¹⁴, Cécile Thomas-Teinturier^{1

15}, Giao Vu-Bezin^{1

4}, Dominique Valteau-Couanet¹⁶, Nadia Haddy^{1

3

4}, Brice Fresneau^{1

3

16}, Florent de Vathaire^{1

3

4}

Affiliations

¹ Radiation Epidemiology Team, CESP, Inserm U1018, Villejuif, France.
² Primary care and Prevention Team, CESP, Inserm U1018, Villejuif, France.
³ Université Paris-Saclay, UVSQ, Inserm, CESP, Villejuif, France.
⁴ Department of Research, Gustave Roussy, Villejuif, France.
⁵ EPICEA, CRESS, INSERM UMR 1153, Université de Paris, Paris, France.
⁶ Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandoeuvre-lès-Nancy, France.
⁷ INSERM U1027, Toulouse, France.
⁸ SIREDO Center (Care, Research, Innovation in Pediatric, Adolescents and Young Adults Oncology), Institut Curie, Paris, France.
⁹ University of Paris, Paris, France.
¹⁰ Epidemiology Unit, Claudius Regaud Institute, Toulouse, France.
¹¹ Pediatric Oncology, Reims, France.
¹² Radiation Therapy, Antoine Lacassagne Cancer Center, Nice, France.
¹³ CHU Angers, Angers, France.
¹⁴ Université de Paris, ECEVE, UMR1123, Inserm, Paris, France.
¹⁵ Service d'Endocrinologie et Diabétologie Pédiatrique AP-HP, Université Paris Saclay, Gif-sur-Yvette, France.
¹⁶ Department of Children and Adolescent Oncology, Gustave Roussy, Villejuif, Paris, France.

PMID: 35617253
PMCID: PMC9135272
DOI: 10.1371/journal.pone.0267317

Health care expenditures among long-term survivors of pediatric solid tumors: Results from the French Childhood Cancer Survivor Study (FCCSS) and the French network of cancer registries (FRANCIM)

Daniel Bejarano-Quisoboni et al. PLoS One. 2022.

. 2022 May 26;17(5):e0267317.

doi: 10.1371/journal.pone.0267317. eCollection 2022.

Authors

Affiliations

¹ Radiation Epidemiology Team, CESP, Inserm U1018, Villejuif, France.
² Primary care and Prevention Team, CESP, Inserm U1018, Villejuif, France.
³ Université Paris-Saclay, UVSQ, Inserm, CESP, Villejuif, France.
⁴ Department of Research, Gustave Roussy, Villejuif, France.
⁵ EPICEA, CRESS, INSERM UMR 1153, Université de Paris, Paris, France.
⁶ Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandoeuvre-lès-Nancy, France.
⁷ INSERM U1027, Toulouse, France.
⁸ SIREDO Center (Care, Research, Innovation in Pediatric, Adolescents and Young Adults Oncology), Institut Curie, Paris, France.
⁹ University of Paris, Paris, France.
¹⁰ Epidemiology Unit, Claudius Regaud Institute, Toulouse, France.
¹¹ Pediatric Oncology, Reims, France.
¹² Radiation Therapy, Antoine Lacassagne Cancer Center, Nice, France.
¹³ CHU Angers, Angers, France.
¹⁴ Université de Paris, ECEVE, UMR1123, Inserm, Paris, France.
¹⁵ Service d'Endocrinologie et Diabétologie Pédiatrique AP-HP, Université Paris Saclay, Gif-sur-Yvette, France.
¹⁶ Department of Children and Adolescent Oncology, Gustave Roussy, Villejuif, Paris, France.

PMID: 35617253
PMCID: PMC9135272
DOI: 10.1371/journal.pone.0267317

Abstract

Background: Childhood cancer survivors (CCS) may require lifelong medical care due to late effects of cancer treatments. Little is known about of their healthcare utilization and expenditures at long-term especially in publicly funded health care system. We aim to estimate and describe the health care expenditures among long-term CCS in France.

Methods: A total of 5319 five-year solid CCS diagnosed before the age of 21 between 1945 and 2000 in France were identified in the French Childhood Cancer Survivors Study cohort (FCCSS) and the French cancer registry. Information about health care expenditure was taken from the French national health data system between 2011 and 2016, and was described according to survivors' characteristics. Generalized linear models were used to determine associations between health care expenditures and survivors' characteristics.

Results: Mean annual amount of healthcare expenditures was € 4,255. Expenditures on hospitalizations and pharmacy represents 60% of total expenditures. Mean annual of healthcare expenditures were higher at increasing age, among women survivors (€ 4,795 vs € 3,814 in men) and in central nervous system (CNS) tumor survivors (€ 7,116 vs € 3,366 in lymphoma and € 3,363 in other solid tumor survivors).

Conclusions: Childhood cancer survivorship is associated with a substantial economic burden in France. We found that female gender and CNS primary cancer were associated with increased healthcare expenditures.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

**Fig 1. Adjusted* annual health care expenditures by type of primary cancer.**
* Adjusted by age, sex, year of diagnosis, age at diagnosis, French index deprivation, cohort and type of primary cancer. Type of primary cancer: Kidney tumor, neuroblastoma, lymphoma, soft tissue sarcoma, bone sarcoma, central nervous system tumor (CNS), gonadal tumor, thyroid tumor, retinoblastoma and other solid cancer.

See this image and copyright information in PMC

Cited by

The Health Care Utilization and Medical Costs in Long-Term Follow-Up of Children Diagnosed With Leukemia, Solid Tumor, or Brain Tumor: Population-Based Study Using the National Health Insurance Claims Data.
Miser JS, Shia BC, Kao YW, Liu YL, Chen SY, Ho WL. Miser JS, et al. JMIR Public Health Surveill. 2023 Mar 2;9:e42350. doi: 10.2196/42350. JMIR Public Health Surveill. 2023. PMID: 36862495 Free PMC article.
Excess healthcare expenditure in adults treated for solid cancer in childhood: a cohort study in France.
Bejarano-Quisoboni D, Panjo H, Fresneau B, El-Fayech C, Doz F, Surun A, de Vathaire F, Pelletier-Fleury N. Bejarano-Quisoboni D, et al. Eur J Health Econ. 2024 Apr;25(3):513-523. doi: 10.1007/s10198-023-01606-6. Epub 2023 Jun 21. Eur J Health Econ. 2024. PMID: 37344685
Disparities of health expenditure associated with the experience of admission in long-term care hospital among patients with colorectal cancer in South Korea: A generalized estimating equation.
Lee WR, Son N, Yoo KB, Han KT. Lee WR, et al. PLoS One. 2023 Dec 21;18(12):e0296170. doi: 10.1371/journal.pone.0296170. eCollection 2023. PLoS One. 2023. PMID: 38127950 Free PMC article.
Alberta Childhood Cancer Survivorship Research Program.
Harper A, Schulte F, Guilcher GMT, Truong TH, Reynolds K, Spavor M, Logie N, Lee J, Fidler-Benaoudia MM. Harper A, et al. Cancers (Basel). 2023 Aug 2;15(15):3932. doi: 10.3390/cancers15153932. Cancers (Basel). 2023. PMID: 37568747 Free PMC article.
Long-term care, care needs and wellbeing of individuals after cancer in childhood or adolescence (VersKiK): study protocol of a large scale multi-methods non-interventional study.
Aleshchenko E, Swart E, Spix C, Voigt M, Trocchi P, Langer T, Calaminus G, Baust K, Glogner J, Ihle P, Küpper-Nybelen J, Lüpkes C, Kloppe T, Horenkamp-Sonntag D, Meier I, Marschall U, Dröge P, Klein M, Weiss A, Apfelbacher C. Aleshchenko E, et al. BMC Health Serv Res. 2022 Sep 20;22(1):1176. doi: 10.1186/s12913-022-08549-3. BMC Health Serv Res. 2022. PMID: 36127717 Free PMC article.

See all "Cited by" articles

References

1. Hjorth L, Haupt R, Skinner R, Grabow D, Byrne J, Karner S, et al.. Survivorship after childhood cancer: PanCare: a European Network to promote optimal long-term care. Eur J Cancer Oxf Engl 1990. 2015;51: 1203–1211. doi: 10.1016/j.ejca.2015.04.002 - DOI - PMC - PubMed
1. Landier W, Skinner R, Wallace WH, Hjorth L, Mulder RL, Wong FL, et al.. Surveillance for Late Effects in Childhood Cancer Survivors. J Clin Oncol Off J Am Soc Clin Oncol. 2018;36: 2216–2222. doi: 10.1200/JCO.2017.77.0180 - DOI - PMC - PubMed
1. Freyer DR. Transition of Care for Young Adult Survivors of Childhood and Adolescent Cancer: Rationale and Approaches. J Clin Oncol. 2010;28: 4810–4818. doi: 10.1200/JCO.2009.23.4278 - DOI - PMC - PubMed
1. Friedman DL, Freyer DR, Levitt GA. Models of care for survivors of childhood cancer. Pediatr Blood Cancer. 2006;46: 159–168. doi: 10.1002/pbc.20611 - DOI - PubMed
1. Nathan PC, Henderson TO, Kirchhoff AC, Park ER, Yabroff KR. Financial Hardship and the Economic Effect of Childhood Cancer Survivorship. J Clin Oncol Off J Am Soc Clin Oncol. 2018;36: 2198–2205. doi: 10.1200/JCO.2017.76.4431 - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

[1] Hjorth L, Haupt R, Skinner R, Grabow D, Byrne J, Karner S, et al.. Survivorship after childhood cancer: PanCare: a European Network to promote optimal long-term care. Eur J Cancer Oxf Engl 1990. 2015;51: 1203–1211. doi: 10.1016/j.ejca.2015.04.002 - DOI - PMC - PubMed

[2] Hjorth L, Haupt R, Skinner R, Grabow D, Byrne J, Karner S, et al.. Survivorship after childhood cancer: PanCare: a European Network to promote optimal long-term care. Eur J Cancer Oxf Engl 1990. 2015;51: 1203–1211. doi: 10.1016/j.ejca.2015.04.002 - DOI - PMC - PubMed

[3] Landier W, Skinner R, Wallace WH, Hjorth L, Mulder RL, Wong FL, et al.. Surveillance for Late Effects in Childhood Cancer Survivors. J Clin Oncol Off J Am Soc Clin Oncol. 2018;36: 2216–2222. doi: 10.1200/JCO.2017.77.0180 - DOI - PMC - PubMed

[4] Landier W, Skinner R, Wallace WH, Hjorth L, Mulder RL, Wong FL, et al.. Surveillance for Late Effects in Childhood Cancer Survivors. J Clin Oncol Off J Am Soc Clin Oncol. 2018;36: 2216–2222. doi: 10.1200/JCO.2017.77.0180 - DOI - PMC - PubMed

[5] Freyer DR. Transition of Care for Young Adult Survivors of Childhood and Adolescent Cancer: Rationale and Approaches. J Clin Oncol. 2010;28: 4810–4818. doi: 10.1200/JCO.2009.23.4278 - DOI - PMC - PubMed

[6] Freyer DR. Transition of Care for Young Adult Survivors of Childhood and Adolescent Cancer: Rationale and Approaches. J Clin Oncol. 2010;28: 4810–4818. doi: 10.1200/JCO.2009.23.4278 - DOI - PMC - PubMed

[7] Friedman DL, Freyer DR, Levitt GA. Models of care for survivors of childhood cancer. Pediatr Blood Cancer. 2006;46: 159–168. doi: 10.1002/pbc.20611 - DOI - PubMed

[8] Friedman DL, Freyer DR, Levitt GA. Models of care for survivors of childhood cancer. Pediatr Blood Cancer. 2006;46: 159–168. doi: 10.1002/pbc.20611 - DOI - PubMed

[9] Nathan PC, Henderson TO, Kirchhoff AC, Park ER, Yabroff KR. Financial Hardship and the Economic Effect of Childhood Cancer Survivorship. J Clin Oncol Off J Am Soc Clin Oncol. 2018;36: 2198–2205. doi: 10.1200/JCO.2017.76.4431 - DOI - PubMed

[10] Nathan PC, Henderson TO, Kirchhoff AC, Park ER, Yabroff KR. Financial Hardship and the Economic Effect of Childhood Cancer Survivorship. J Clin Oncol Off J Am Soc Clin Oncol. 2018;36: 2198–2205. doi: 10.1200/JCO.2017.76.4431 - DOI - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Health care expenditures among long-term survivors of pediatric solid tumors: Results from the French Childhood Cancer Survivor Study (FCCSS) and the French network of cancer registries (FRANCIM)

Affiliations

Health care expenditures among long-term survivors of pediatric solid tumors: Results from the French Childhood Cancer Survivor Study (FCCSS) and the French network of cancer registries (FRANCIM)

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Related information

LinkOut - more resources

Full Text Sources

Medical