Ahmad, S.; Phillips, E.; Vellacott, K.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA94
Academic Journal
The objective of this paper is to compare the cost of treating early colorectal neoplasia, to that of late neoplasia with on attempt to show that treating early colorectal neoplasia is more economical in comparison to late colorectal neoplasia. While we are debating the most effective method of screening in order to improve survival, very few people have explored the economical aspects of treating colorectal cancer (CRC) at different stages of its progression. In current literature there is no evidence to suggest that treating early CRC is more cost economical. The majority of the medical literature concerning the treatment of CRC concentrates on the best available options in terms of patient outcome rather than the cost incurred. While this should inevitably be the case, it is important that in an increasingly cost conscious health service, the price of the treatment must also be a consideration. A retrospective analysis of 471 patients over a 3 year period was performed by calculating the cost of inaugural treatment and the subsequent management during a 5 year follow up phase or until the death of the patient with CRC or polyps. Among these, 304 had adenomotous polyps or early carcinoma (adenomas, Duke's A and B) and 167 had late stage cancer (Duke's C, D and T4). The median cost of treatment and follow up was significantly lower for early than late stage colorectal neoplasia (10607 and 13 891, respectively, Mann-Whitney U test, p 0.0002). The main contributors to the high cost of the late stage cancer were oncological treatment, more admissions with complications or local recurrences, non-clinical cost (eg stoma care, palliative care), and in certain cases, oncological surgery. In view of these findings, early detection is certainly the desired goal. The growing popularity of screening is justified considering it would be both instrumental in decreasing the mortality as well as the cost of treatment of CRC.


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