肿瘤医学与实践杂志

Comparison of Healthcare Resource Utilization (HcRU) between Age Groups of Women Diagnosed with Gynecological Cancers in the U.S

Abstract

Godwin Okoye*, R. Vincent and H. Antwi

Objective: Previous studies have shown that older women are more likely to be diagnosed with gynecological cancers (GC) setting the precedent for more attention to be given to older women than younger women with GC. This study seeks to compare nationally representative healthcare use among younger women and older women diagnosed with gynecological cancer in the United States.

Methods: A retrospective cross-sectional repeated measures design was used to make comparisons between baseline characteristics of two age groups of women diagnosed with gynecological cancers. Data were extracted from the National Health Interview Survey (NHIS). A weighted sample of 2633569 responses who reported having at least one kind of GC was included from 2015 to 2018. GC was defined as those who reported having uterine, cervical, or ovarian cancer. Characteristics of patients were compared across two age groups. 1. Women less than 50 considered to be most likely premenopausal. 2. Women more than 50 considered to be most likely postmenopausal. Nine health services use were also quantified between both age groups and a multivariable logistic regression model was used to determine the likelihood of health care use among both age groups with the older women being the reference group.

Results: Among the baseline characteristics, alcohol use and smoking were seen to be most prevalent among the younger women with the following proportions 88% and 79.93% for alcohol use and 59.79% and 50.26% for smoking at p<0.01. Younger women had higher obstetrics and gynecologic visits OR 2.13 (1.59-2.84), Emergency room visits OR 1.55 (1.17-2.06), Hospitalization OR 1.57 (1.15-2.14), Preventive care OR 2.49 (1.88-3.31). Adjusting for Alcohol use and smoking yielded similar odds ratio. Patterns of hospitalization increased over time for younger women and use of surgery and surgical procedures wasn’t statistically significant among both age groups.

Conclusion: Based on this study, younger women tend to use comparable healthcare services as older women diagnosed with gynecologic cancer. Therefore, more studies should be conducted with the inclusion of younger women.