1. Peterson-Kaiser Health System Tracker What are recent trends in cancer spending and outcomes?

2. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health status: Health status indicators", OECD Health Statistics (database). doi: 10.1787/data-00540-en (Accessed on January 22, 2016). Note: Comparable countries are defined as those with above median GDP and above median GDP per capita in at least on of the past ten years. Unlike the other leading causes of death, cancer mortality rates are lower in the U.S. than in comparable countries Age-adjusted major causes of mortality per 100,000 population, in years, 2010

3. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health status: Health status indicators", OECD Health Statistics (database). doi: 10.1787/data-00540-en (Accessed on January 22, 2016). Note: Comparable countries are defined as those with above median GDP and above median GDP per capita in at least on of the past ten years. Compared to similar countries, the U.S. has a relatively low mortality rate for cancers Age-adjusted neoplasm mortality rate per 100,000 population, in years, 2010

4. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health status: Health status indicators", OECD Health Statistics (database). doi: 10.1787/data-00540-en (Accessed on January 22, 2016). Notes: Comparable countries are defined as those with above median GDP and above median GDP per capita in at least on of the past ten years. Break in series in 1987 and 1997 for Switzerland; in 1995 for Switzerland; in 1996 for Netherlands; in 1998 for Australia, Belgium, and Germany; in 1999 for United States; in 2000 for Canada and France; and in 2001 in the United Kingdom. All breaks in series coincide with changes in ICD coding. The mortality rate for cancers has been falling in the U.S. and across comparable countries Age-adjusted neoplasms mortality rate per 100,000 population Comparable country average United States

5. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health status: Health status indicators", OECD Health Statistics (database). doi: 10.1787/data-00540-en (Accessed on January 22, 2016). Notes: Comparable countries are defined as those with above median GDP and above median GDP per capita in at least on of the past ten years. Data for breast and cervical cancers are for females. Mortality rates for breast and colorectal cancer in the U.S. are lower than in comparable countries Age-standardized mortality rate per 100,000 population for breast, colorectal, and cervical cancer, in years, (2010)

6. Peterson-Kaiser Health System Tracker Source: Surveillance, Epidemiology, and End Results Program (SEER) http://seer.cancer.gov/csr/1975_2012/browse_csr.php?sectionSEL=5&pageSEL=sect_05_table.08.html (Accessed on January 23, 2016). Notes: SEER 9 areas (San Francisco, Connecticut, Detroit, Hawaii, Iowa, New Mexico, Seattle, Utah, Atlanta). Based on follow-up of patients into 2012. Five-year survival for breast and colorectal cancers are increasing Percentage of age-adjusted five-year relative survival for breast, colorectal, and cervical cancer, all ages, in years 1990-1992 and 2005-2011

7. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health status: Health status indicators", OECD Health Statistics (database). doi: 10.1787/data-00592-en (Accessed on January 22, 2016). Notes: Comparable countries are defined as those with above median GDP and above median GDP per capita in at least on of the past ten years. Data for breast and cervical cancers are for females. Five-year survival rates for certain cancers are slightly higher in the U.S. than in comparable countries Percentage of age-adjusted five-year relative survival for breast, colorectal, and cervical cancer, ages 15-99, in years 2006-2011

8. Peterson-Kaiser Health System Tracker Source: Institute for Health Metrics and Evaluation. Global Burden of Disease Study Data Downloads, available here: http://ghdx.healthdata.org/global- burden-disease-study-2013-gbd-2013-data-downloads Cancer and circulatory diseases are the leading causes of premature death in the U.S. Age standardized years of life lost (YLL) rate per 100,000 population, both sexes, 2013

9. Peterson-Kaiser Health System Tracker Source: Institute for Health Metrics and Evaluation. Global Burden of Disease Study Data Downloads, available here: http://ghdx.healthdata.org/global- burden-disease-study-2013-gbd-2013-data-downloads Cancer is among the top three leading causes of disease burden in the U.S. Age standardized disability adjusted life years (DALYs) rate per 100,000 population, both sexes, 2013

10. Peterson-Kaiser Health System Tracker Source: Institute for Health Metrics and Evaluation. Global Burden of Disease Study Data Downloads, available here: http://ghdx.healthdata.org/global- burden-disease-study-2013-gbd-2013-data-downloads U.S. disease burden has decreased in past two decades for circulatory, cancer, injuries, and neonatal disorders Age standardized disability adjusted life years (DALYs) rate per 100,000 population, both sexes, 1990 and 2013

11. Peterson-Kaiser Health System Tracker Source: Institute for Health Metrics and Evaluation. Global Burden of Disease Study Data Downloads, available here: http://ghdx.healthdata.org/global- burden-disease-study-2013-gbd-2013-data-downloads Disease burden due to cancer is most caused by lung cancer; for both males and females MALES Age standardized disability adjusted life years (DALYs) rate per 100,000 population, males in the U.S., 2013 FEMALES Age standardized disability adjusted life years (DALYs) rate per 100,000 population, females in the U.S., 2013

12. Peterson-Kaiser Health System Tracker Source: Commission on Cancer, American College of Surgeons and American Cancer Society, National Cancer Data Base More women are receiving biopsy at the time of mastectomy or lumpectomy Percentage of women with clinical Stage I-IIb breast cancer who received axillary node dissection or sentinel lymph node biopsy (SLNB) at the time of surgery (lumpectomy or mastectomy), United States, 2004-2011

13. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health status: Health status indicators", OECD Health Statistics (database). doi: 10.1787/data-00349-en (Accessed on January 22, 2016). Notes: Break in series in 1999 for United States. Break in series coincides with changes in ICD coding. Recent decline in U.S. mortality rates largely reflects improvement for circulatory diseases Overall age-adjusted mortality rate per 100,000 population

14. Peterson-Kaiser Health System Tracker Source: Bureau of Economic Analysis Health Care Satellite Account (Blended Account) and National Health Expenditure Data Note: Spending on dental services, nursing homes, and prescriptions that cannot be allocated to a specific disease not included above. Data last updated January 25, 2016. Cancer spending accounts for about 7% of disease based health expenditures Total expenditures in US $ billions by disease category, 2012

15. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of Bureau of Economic Analysis Health Care Satellite Account (Blended Account) Note: Expenditures on nursing home and dental care are not included in health services spending by disease. Data last updated January 25, 2016. On a per capita basis, the U.S. spends about $394 per year to treat cancer, up from $219 in 2000 Per capita expenditures on the treatment of cancers and tumors (neoplasms), US $, 2000 - 2012

16. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of Bureau of Economic Analysis Health Care Satellite Account (Blended Account) Note: Expenditures on nursing home and dental care are not included in health services spending by disease. Data last updated January 25, 2016. While Cancer is one of the top contributors to disease burden, it is not a leading driver of medical services spending growth from 2000-2012 Contribution to medical services expenditure growth, by disease, 2000-2012

17. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of Bureau of Economic Analysis Health Care Satellite Account (Blended Account) Note: Expenditures on nursing home and dental care are not included in health services spending by disease. Data last updated January 25, 2016. Average growth in per capita spending for cancer was slightly lower than the average for all disease categories Average annual growth in expenditures by disease category (per capita), price index by disease category (cost to treat each case), and real expenditures by disease category (number of treated cases), 2000 - 2012

18. Peterson-Kaiser Health System Tracker Diagnosis with a serious or chronic health condition is associated with higher health spending Source: Kaiser Family Foundation analysis of Medical Expenditure Panel Survey, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services Average health spending per person based on diagnosis status, in U.S. Dollars, 2013

19. Peterson-Kaiser Health System Tracker People with a diagnosis of a serious or chronic health condition face higher average out-of-pocket costs Source: Kaiser Family Foundation analysis of Medical Expenditure Panel Survey, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services Average out-of-pocket spending per person based on diagnosis status, in U.S. Dollars, 2013

20. Peterson-Kaiser Health System Tracker Source: Express Scripts 2014 Drug Trend Report Cancer medications were among the top 3 conditions for specialty drug spending in 2014 Express Scripts per-member-per-year spending, top 10 specialty therapy class drugs, 2014

21. Peterson-Kaiser Health System Tracker Source: World Lung Foundation and The American Cancer Society. The Tobacco Atlas. Available at: http://www.tobaccoatlas.org/topic/cigarette-use- globally/ (Accessed on January 5, 2016).http://www.tobaccoatlas.org/topic/cigarette-use- globally/ Per capita cigarette consumption is lower in the United States than in comparably wealthy countries Number of cigarettes smoked per capita per year, age 15+, 2014

22. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of data from the University of Washington Institute for Health Metrics and Evaluation. Available at: http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads (Accessed on November 23, 2015). http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads The U.S. has higher than average disease burden from lung cancer Lung, tracheal, and bronchus cancer age-standardized disability adjusted life years (DALY) rate per 100,000 population, 2013