The effect of the COVID-19 health disruptions on breast cancer mortality for older women: a semi-Markov modelling approach
The effect of the COVID-19 health disruptions on breast cancer mortality for older women: a semi-Markov modelling approach
Public health measures necessitated by the COVID-19 pandemic have affected cancer pathways by halting screening, delaying diagnostic tests and reducing the numbers starting treatment. Specifically, this moves individuals from observed and treated pathways to unobserved and untreated pathways. We introduce a semi-Markov model that includes both, extending an industry-based multiple state model used for life and critical illness insurance. Our model includes events related to cancer diagnosis and progression based on publicly available population data for women aged 65–89 in England and on relevant medical literature. We quantify age-specific excess deaths, for a period up to 5 years, along with years of life expectancy lost and changes in cancer mortality by cancer stage. Our analysis suggests a 3–6% increase in breast cancer deaths, and a 4–6% increase in registrations of advanced breast cancer, robust under sensitivity analysis. This should be applicable to actuarial work in areas where longevity and advanced age morbidity affect healthcare, retirement and insurance.
Breast cancer, COVID-19 pandemic, cancer insurance, cancer mortality, excess deaths, semi-Markov model
Arik, Ayse
7d54e4e9-c8df-46af-becc-3a7beb61a9b6
Cairns, Andrew J.G.
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Dodd, Erengul
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Macdonald, Angus S.
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Streftaris, George
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13 May 2024
Arik, Ayse
7d54e4e9-c8df-46af-becc-3a7beb61a9b6
Cairns, Andrew J.G.
27945b1c-4bb5-4b9c-9e4e-84ff6d590237
Dodd, Erengul
b3faed76-f22b-4928-a922-7f0b8439030d
Macdonald, Angus S.
c66b0677-4c66-4c1f-952c-aa05fea0cae9
Streftaris, George
a941afc0-43f6-48d2-970d-3d8db7ca3ae4
Arik, Ayse, Cairns, Andrew J.G., Dodd, Erengul, Macdonald, Angus S. and Streftaris, George
(2024)
The effect of the COVID-19 health disruptions on breast cancer mortality for older women: a semi-Markov modelling approach.
Scandinavian Actuarial Journal.
(doi:10.1080/03461238.2024.2340964).
Abstract
Public health measures necessitated by the COVID-19 pandemic have affected cancer pathways by halting screening, delaying diagnostic tests and reducing the numbers starting treatment. Specifically, this moves individuals from observed and treated pathways to unobserved and untreated pathways. We introduce a semi-Markov model that includes both, extending an industry-based multiple state model used for life and critical illness insurance. Our model includes events related to cancer diagnosis and progression based on publicly available population data for women aged 65–89 in England and on relevant medical literature. We quantify age-specific excess deaths, for a period up to 5 years, along with years of life expectancy lost and changes in cancer mortality by cancer stage. Our analysis suggests a 3–6% increase in breast cancer deaths, and a 4–6% increase in registrations of advanced breast cancer, robust under sensitivity analysis. This should be applicable to actuarial work in areas where longevity and advanced age morbidity affect healthcare, retirement and insurance.
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The effect of the COVID-19 health disruptions on breast cancer mortality for older women a semi-Markov modelling approach
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Accepted/In Press date: 5 April 2024
e-pub ahead of print date: 13 May 2024
Published date: 13 May 2024
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Publisher Copyright:
© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Keywords:
Breast cancer, COVID-19 pandemic, cancer insurance, cancer mortality, excess deaths, semi-Markov model
Identifiers
Local EPrints ID: 489291
URI: http://eprints.soton.ac.uk/id/eprint/489291
ISSN: 0346-1238
PURE UUID: 27c13b96-3e9b-474a-80ad-58081f838f5c
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Date deposited: 19 Apr 2024 16:35
Last modified: 07 Jun 2024 01:45
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Author:
Ayse Arik
Author:
Andrew J.G. Cairns
Author:
Angus S. Macdonald
Author:
George Streftaris
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