Changes in the Economic Burden of Breast Cancer Neoplasms in Colombia After the Cancer Control Model

OBJECTIVES: To determine changes in the economic burden of breast neoplasms in Colombia after the implementation of the "Model for Cancer Control".

METHODS: Interrupted time series study. 70,899 deaths were analyzed, from 1990 to 2019, with basic cause codes: 174.0-174.9 (ICDO9) and C50.0-C50.9 (ICDO-10), from the Departamento Administrativo Nacional de Estadísticas (DANE). With the Institute for Health Metrics and Evaluation methodology, YLLs, YLDs, DALYs, and their annual percentage variations were calculated. Using SPSS V24®, the ARIMA Model (AutoRegressive Integrated Moving Average) was used to determine the existence of significant changes in rates, taking as independent variables: period (year of occurrence) and phase (interruption point): 2006, the year from which the “Model for Cancer Control” began to be implemented in Colombia. The economic valuation of the DALYs was monetized in two scenarios: floor (annualized minimum salary), and ceiling (annual GDP per capita), both at constant 2019 prices

RESULTS: The standardized rates x 100,000 went from 421.9 to 3337.0, 16.8 to 24.0, and 438.7 to 360.9, for YLLs, YLDs, and DALYs, respectively. The ARIMA model estimates confirmed significant changes for YLDs and DALYs (p<0.05) When considering the percentage variation 1990-2005 Vs 2006-2019, the differences in the proportions were significant for DALYs: -18% to -3.1% (p: 0.0012), and YLDs: -16.8% to -1.8% (p:0.0007) but not for YLLs: 13.7% to 23.1% (p: 0.145). The loss of human capital due to breast cancer in Colombia from 1990 to 2019 ranged between (values in millions COP) $2,720 to $6,150,077 and the highest percentage increases occurred between 2008-2009: 298% and 1998-1999: 74.3%

CONCLUSIONS: Significant changes in the burden of breast cancer in Colombia were found, which may be due, among other factors, to epidemiological and strategic changes related to the Cancer Control Model.