The Prevalence Of Breast Cancer In Minnesota And Cottonwood County: Insurance Coverage, The Required Healthcare, And The Cost Of Treatment

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Introduction

High treatment costs, strenuous treatment plans, and emotional stress on the patient and on her family are the burdens women with breast cancer have to handle. Breast cancer is the most prevalent cancer among women in the US with 245,299 new cases and 41,487 deaths as a result in 2016 with higher rates present in both cottonwood county and in Minnesota (USCS, n.d.). This paper will evaluate the prevalence of breast cancer in Minnesota and Cottonwood county. It will also examine the insurance coverage, the required healthcare, and the cost of treatment for this cancer.

Description

Even though developed countries are now seeing a higher prevalence of chronic diseases, cancer has been around since 1600 BC; it is defined as the “uncontrolled growth and spread of abnormal immortal cells,” with these cells localized in the breasts in breast cancer (Farhadihosseinabadi et. al., 2018). This cancer is generally classified into two categories: in situ carcinomas and invasive carcinomas. Both types originate in the milk ducts of the breasts with in situ carcinomas staying in the ducts while invasive carcinomas spread from its original location in the milk ducts to the surrounding breast tissue (Farhadihosseinabadi et. al., 2018). A common symptom of this cancer are abnormal lumps located on the breast.

Prevalence of Breast Cancer

Breast cancer is the second most common cause of cancer death among women in the USA, and the most common cancer in women overall (Jacobs M.D., 2011, “Preface” para. 1). Throughout a lifetime, women have approximately a 12.5% (1/8) chance of getting breast cancer (Warner M.D., 2011, p. 1025), and in 2009, 192,500 women were diagnosed with invasive breast cancer while 62,300 were diagnosed with in situ breast cancer (Jacobs MD, “Preface” para. 1). In the USA from 2012-2016, the average incidence rate per 100,000 people was 127.5 (Cancer of the Breast, n.d.), and the mortality rate per 100,000 people was 20.6 (Healthy People 2020, n.d.), and approximately 3,477,866 women had breast cancer in 2016 (Cancer of the Breast, n.d.). Of the women who get breast cancer, 89.9% have lived for a minimum of 5 more years (Cancer of the Breast, n.d.).

Risk Factors

Social determinants, as defined by Healthy People 2020, are “the environments in which people are born, live, learn, work, play, worship, and age.” Activities and behaviors associated with these determinants, or risk factors, can increase a person’s chance of developing breast cancer. Gender and age are the greatest risk factors, along with obesity, lack of exercise, and alcohol consumption (Jacobs & Yang, 2011). Jacobs & Yang also state that breast cancer has a higher prevalence in white women compared to much lower rates in African American, Asian, and Hispanic populations (2011).

Genetics also play a big role in the likelihood of developing breast cancer. Jacobs & Yang (2011) state that “50% of women diagnosed with breast cancer report a relative of any degree with breast cancer,” with less than 10% of these patients actually carrying the genes BRCA1 and BRCA2 that are believed to cause this cancer. More genetic research needs to be conducted in order to grasp a better understanding of the role genetics has in this cancer’s development.

Effects/Rates

Cottonwood county has a rather high rate of poverty. As of 2018, there were 1,386 Cottonwood county citizens living in poverty, or 12.5 percent (Encounter Now, n.d.). Having high rates of poverty may put those people at a greater probability of developing risk factors, making them slightly more susceptible. However, according to a study on the affects one’s socioeconomic status has on their breast cancer diagnosis stage, “poverty has a strong effect on the probability of being diagnosed at the later stages,” (Campbell et al., 2009). A reason for this may be due to people living in poverty and not having enough time in their day to go to the hospital for screening. Mammograms may also be too expensive for them. This is scary for cottonwood county citizens because later stages are harder to treat compared to earlier stages

In Minnesota (MN), breast cancer incidence rate per 100,000 between 2012-2016 was 130.6, and the mortality rate per 100,000 between 2012-2016 was 18.2 (USCS, n.d.). Compared to the national average, Minnesota had a higher rate of incidence by 5.6 per 100,000 (see Figure 1), but a lower mortality rate by 2.4 per 100,000 (see Figure 2). For Cottonwood county, located in the southwestern part of Minnesota, the incidence rate for 2012-2016 was 170.8 per 100,000 and the mortality rate for 2012-2016 was 22.0 per 100,000 (Breast Cancer, 2019). Compared to Minnesota, Cottonwood county has a higher incidence rate by 40.2 per 100,000 (see Figure 1), and a higher mortality rate by 3.8 per 100,000 (see Figure 2).

Economic Burden of Breast Cancer

A research paper written by the CDC’s Division of Cancer Control and Prevention and other organizations set out to determine how many the Years of Potential Life Lost (YPLL) and loss of productivity (in 2008 US dollars) due to breast cancer between 1970-2008 (Ekwueme et al. 2014 p. 1). This paper primarily focused on the premature deaths of young women (20-49 years old). It was determined that with 225,866 deaths from breast cancer an estimated 7.98 million potential years of life were lost (Ekwueme et al. 2014 p. 5), and a range between $4.23 billion and $8.81 billion were lost in productivity per year, and each life lost was estimated to be $1.10 million (Ekwueme et al. 2014 p. 5). The study however only accounts for losses after death, and no other considerations that impact both the economy and the individual such as cost of treatment, productivity loss before death, or productivity loss by family members who must take care of patients (Ekwueme et al. 2014 p. 7). The study also only looked at women from the ages of 20-49 years old, which only accounts for approximately 11% of breast cancer deaths (American Cancer Society 2017, Table 1).

Treatment Cost

Being diagnosed with breast cancer can be very intimidating and the most common question that the patients will have concerns with is the cost. When determining the estimated cost for breast cancer, there are many different factors that come into play. Depending on the stage the cancer is at, how many visits and other medical aspects, and insured or not will establish the cost one would pay. With stage 0 starting at the lowest cost around $60,000, it can rise up to around $135,000 in stage 4, and the average cost for breast cancer usually ranges close to $86,000 (Elder, 2017). The biggest factor for treatment cost depends on how early the cancer was detected and what the person has to do on the side to help them become cancer free. Everyone has different procedures and outcomes, so the treatment cost varies from person to person.

Insurance Coverage

Breast cancer is one of the most common cancers that women are diagnosed with. Not only is it very common in women, but males also have a chance to be diagnosed with it. Since breast cancer is one of the largest cancers diagnosed, insurance does contribute to the cost. Health insurance pays a huge amount and is very important when being diagnosed with breast cancer. With being insured, many bills will be covered, reducing the price of the total payment. If someone is not insured and is diagnosed, there are still many ways that the individual can reduce the price. According to Courtney Elder, some of the ways the cost can be reduced is by, “asking for generic versions of the medication, payment plans, payment assistance from the government, and using free coupons” (2017). Breast cancer can be up to $100,000 or higher for payments out of pocket. This is a huge amount of money, but with people being insured, they usually pay around $5,000.

Special Healthcare

Breast cancer survivors and women continuing with treatments display certain symptoms that allow for special care needs. Females fight through psychological and physical health issues during and after breast cancer treatments. With special care needs, the society that is being affected is gaining support and therapy to help reduce the symptoms. When working in the healthcare field there are a lot of signs that people need to pay close attention too. According to, Zhang, Q., Xiao, S., Yan, L., Sun, L., Wang, Y., and Huang, M., “healthcare workers need to pay special attention to explore the potential of psychological interventions to effectively reduce the posttraumatic stress response, encourage the adoption of positive coping strategies, and hasten disability acceptance and return to society” (2019). Special healthcare is needed for multiple situations, but for breast cancer it continues to help the patient out day by day. With providing interventions for the physical and psychological needs, patients are able to fight through the symptoms faster and have a change in their lifestyle.

Conclusion

Breast cancer is constantly affecting women around the world and is increasing on a day to day basis. With certain determinants, people can help prevent the chance of developing breast cancer while others cannot due to genetics. Early detections and screenings are the number one procedures people should complete to receive the best outcomes. Due to different stages of breast cancer and treatments, the cost varies differently depending on one’s financial aid. Providing interventions for screenings and early diagnosis can help cure an individual with less treatments and a reduced cost.

References

American Cancer Society. (2017). Breast Cancer Facts & Figures 2017-2018. Atlanta: American Cancer Society, Inc. Retrieved from https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/breast-cancer-facts-and-figures-2017-2018.pdf.
Breast Cancer Infographic Data Tables. (2019). Retrieved from https://www.health.state.mn.us/data/mcrs/docs/bcafinfogtable.pdf
Cancer of the Breast (Female) – Cancer Stat Facts. (n.d.). Retrieved from https://seer.cancer.gov/statfacts/html/breast.html
Campbell, R. T., Li, X., Dolecek, T. A., Barrett, R. E., Weaver, K. E., & Warnecke, R. B. (2009). Economic, racial and ethnic disparities in breast cancer in the US: Towards a more comprehensive model. Health & Place, 15(3), 855–864. https://doi-org.ezproxy.usd.edu/10.1016/j.healthplace.2009.02.007
Farhadihosseinabadi, B., Hosseini, F., Larki, P., Bagheri, N., Abbaszadeh-Goudarzi, K., Sinehsepehr, K., Johari, B., & Abdollahpour-Alitappeh, M. (2018). Breast Cancer: Risk Factors, Diagnosis and Management. Medical Laboratory Journal, 12(5), 1–9. https://doi-org.ezproxy.usd.edu/10.29252/mlj.12.5.1
Elder, C. (2017, March 19). How much is breast cancer treatment in the U.S.? Retrieved from https://www.singlecare.com/blog/breast-cancer-treatment-cost-u-s/
Ekwueme, U. D. PhD, MS. et al. (January 2014). Health and economic impact of breast cancer mortality in young women, 1970–2008. AM J Prev Med, 46(1): 71–79. doi:10.1016/j.amepre.2013.08.016
Encounter Now. (n.d.). Retrieved from https://www.povertyusa.org/data/2018/MN/cottonwood-county
Jacobs, L., Finlayson, C. A., & Yang, S. C. (2011). Early diagnosis and treatment of cancer: Breast cancer. Philadelphia: Saunders.
USCS Data Visualizations – CDC. (n.d.). Retrieved from https://gis.cdc.gov/Cancer/USCS/DataViz.html
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Warner, E. (2011). Breast-cancer screening. The New England Journal of Medicine, 365(11), 1025-1032. doi:http://dx.doi.org/10.1056/NEJMcp1101540
ZHANG, Q., XIA0, S., YAN, L., SUN, L., WANG, Y., & HUANG, M. (2019). Psychosocial Predictors of Adjustments to Disability Among Patients with Breast Cancer: A Cross-Sectional Descriptive Study. Nursing Research, 27(2), e15. https://doi-org.ezproxy.usd.edu/10.1097/jnr.0000000000000283

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