﻿Cancer patient surveillance posttreatment is an area with few well-accepted standards, high costs, and few studies comparing the costs and benefits for various levels of intensity of follow-up. The aim of this study was to determine the range of recommended follow-up strategies for prostate, lung, and colorectal cancer patients treated with curative intent, estimate the costs of follow-up, and compare costs across sites. Economic analyses were conducted of the costs associated with all follow-up strategies identified from a Medline search of the literature for a minimum 10-year period per cancer site and a search of major textbooks. Charge data obtained from the Part B Medicare Annual Data file and the Hospital Outpatient Bill file were used as a proxy for cost. Nationwide Medicare-allowed charges and an actual-charge proxy for 5 years of surveillance after treatment were the main outcome measures. Actual charges for 5 years of follow-up after curative therapy for prostate cancer ranged from a $927 to $7703 (7.3-fold difference). For lung cancer, total charges ranged from $1,533 to $9,145 (5-fold difference). For colorectal cancer, total charges ranged from $910 to $26,717 (28-fold difference). The cost implications of a lack of consensus regarding follow-up for prevalent cancers are staggering if one considers that in the U.S. annually, an estimated 180,400 individuals develop prostate cancer, 164,100 develop lung cancer, and 130,200 develop colorectal cancer. Seventy, 20, and 75 percent of these patients, respectively, are treated with curative intent and enter follow-up.
Learning Objectives: At the conclusion of the session, the participant (learner) will recognize the cost implications of wide variations in posttreatment surveillance practice patterns for patients with cancers of the lung, prostate, or colorectum and will understand that much of current practice is not evidence-based
Keywords: Cancer, Cost Issues
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 128th Annual Meeting of APHA