[Prognosis of population-related morbidity for common cancers in Germany--Effects on health care]

Abstract

Introduction: The demand for outpatient and inpatient oncology care will rise in the next years. In this analysis, the number of new cases and the prevalence in 2020, the number of hospital days, types of treatment, sickness costs, and the number of oncology specialists are prognosed.

Methods: Projections of incidence and prevalence of cancer overall and of the three most common cancers were conducted with data from the German Population-Based Cancer Registries and from the German Federal Statistics Office. The average number of hospital days was extrapolated until 2020 on the basis of these population projections. Outpatient care was analyzed with billing data obtained from the WINHO. Projections of sickness costs in 2020 were calculated based on data from the German Federal Statistics Office under the assumption that cost per prevalent case remains constant within a given age group over the projection period. Numbers of specialists in hematology and oncology were taken from the database of the Association of Statutory Health Insurance Physicians. These forecasts are based on a series of assumptions.

Results: The number of new cancer cases will increase by about 67,000 cases until 2020 (reference year 2008). Prevalent cases will increase by about 176,000 cases. The needed number of hospital days will increase about 13% to 15.513 million days in 2020. An increase of 30% in cytoreductive and 23% in chemotherapy treatment of lung cancer was shown between 2008 and 2011. The number of contracted doctors with focus in hematology and oncology has increased in 2011 compared to 2005. Between 2002 and 2008, sickness costs increased by 52% in the outpatient sector and by 31% in the inpatient sector. In 2020, the increase of sickness costs is expected to reach about 1.7 billion EUR/year.

Conclusions: Due to the increase of incident and prevalent cancer cases, the number of hospital days and sickness costs will increase. The results of the analyses show an increase of medical care services in the outpatient sector.