Insurance coverage of complementary and alternative medicine (CAM) is expanding. However, to the authors' knowledge, little is know concerning CAM utilization among cancer patients under the insurance model of financing. In this study, the authors evaluated how cancer patients used CAM services in a state that requires including alternative practitioners in private and commercial insurance products.

Of 357,709 claimants in Washington state, 7915 claimants (2.3%) had a cancer diagnosis. Among cancer patients, 7.1% had a claim for naturopathy, acupuncture, or massage; and 11.6% had a claim for chiropractic during the study year. Naturopathy and acupuncture were more common, and chiropractic was less common for cancer patients compared with those without cancer. No significant differences were noted in the use of massage between the two groups.

Factors associated with nonchiropractic alternative provider use were female gender, the presence of metastatic cancer, hematologic malignancy and chemotherapy. Increased use of naturopathic physicians accounted for much of this trend. Musculoskeletal pain was the most common diagnosis at the CAM provider visit. Billed amounts for alternative services were less than 2% of the overall medical bills for cancer patients.

The authors conclude that a substantial number of insured cancer patients will use alternative providers if they are given the choice. The cost of this treatment is modest compared with conventional care charges. For individuals with cancer, CAM providers do not appear to be replacing conventional providers but instead are integrated into overall care.