Cost of patient follow-up after potentially curative colorectal cancer treatment

K. S. Virgo, A. M. Vernava, W. E. Longo, L. W. McKirgan and F. E. Johnson
Department of Surgery, Saint Louis University Health Sciences Center, MO 63110-0250, USA.

OBJECTIVE--To estimate the cost of follow-up among colorectal cancer patients treated with curative intent based on the broad spectrum of surveillance strategies suggested in the literature. DESIGN--Economic analysis of the costs associated with 11 separate surveillance strategies. Charge data were obtained from the Part B Medicare Annual Data file and the Hospital Outpatient Bill file. SETTING--Ambulatory care. MAIN OUTCOME MEASURES--Medicare-allowed charges and an actual-charge proxy for 5 years of follow-up after treatment for colorectal cancer patients on a nationwide basis. RESULTS--Medicare-allowed charges varied widely for the 5 years of posttreatment follow-up from a low of $561 to a high of $16,492. When Medicare-allowed charges were converted to a proxy for actual charges using a conversion ratio of 1.62, the range was $910 to $26,717, a 28-fold difference in charges. CONCLUSIONS--Charges vary extensively across follow-up strategies, with no indication that higher-cost strategies increase survival or quality of life.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Postoperative Surveillance in Patients With Colorectal Cancer Who Have Undergone Curative Resection: A Prospective, Multicenter, Randomized, Controlled Trial
Rodriguez-Moranta et al.
JCO 2006;24:386-393.
ABSTRACT | FULL TEXT  

Colorectal Cancer Screening and Treatment: Review of Outcomes Research
Provenzale and Gray
J Natl Cancer Inst Monogr 2004;2004:45-55.
ABSTRACT | FULL TEXT  

Surveillance Strategies after Curative Treatment of Colorectal Cancer
Pfister et al.
NEJM 2004;350:2375-2382.
FULL TEXT  

Follow-Up for Patients With Colorectal Cancer After Curative-Intent Primary Treatment
Johnson et al.
JCO 2004;22:1363-1365.
FULL TEXT  

Cost effectiveness analysis of intensive versus conventional follow up after curative resection for colorectal cancer
Renehan et al.
BMJ 2004;328:81.
ABSTRACT | FULL TEXT  

Patients' views on follow up of colorectal cancer: implications for risk communication and decision making
Papagrigoriadis and Heyman
Postgrad. Med. J. 2003;79:403-407.
ABSTRACT | FULL TEXT  

Cancer physicians' attitudes toward colorectal cancer follow-up
Earle et al.
Ann Oncol 2003;14:400-405.
ABSTRACT | FULL TEXT  

Guidelines for follow up after resection of colorectal cancer
Scholefield and Steele
Gut 2002;51:v3-5.
FULL TEXT  

Percutaneous Self-expanding Metal Stents versus Endoscopic Polyethylene Endoprostheses for Treating Malignant Biliary Obstruction: Randomized Clinical Trial
Pinol et al.
Radiology 2002;225:27-34.
ABSTRACT | FULL TEXT  

Ectopic Expression of Guanylyl Cyclase C in CD34+ Progenitor Cells in Peripheral Blood
Fava et al.
JCO 2001;19:3951-3959.
ABSTRACT | FULL TEXT  

Follow-up in Lung Cancer: How Often and for What Purpose?
Younes et al.
Chest 1999;115:1494-1499.
ABSTRACT | FULL TEXT  

Recommended Colorectal Cancer Surveillance Guidelines by the American Society of Clinical Oncology
Desch et al.
JCO 1999;17:1312-1312.
ABSTRACT | FULL TEXT  

Costs of Posttreatment Surveillance for Patients With Upper Aerodigestive Tract Cancer
Virgo et al.
Arch Otolaryngol Head Neck Surg 1998;124:564-572.
ABSTRACT | FULL TEXT  

COST OF PATIENT FOLLOW-UP AFTER POTENTIALLY CURATIVE LUNG CANCER TREATMENT
Virgo et al.
J. Thorac. Cardiovasc. Surg. 1996;112:356-363.
ABSTRACT | FULL TEXT  

WHICH FOLLOW-UP STRATEGY AFTER COLORECTAL CANCER TREATMENT?
JWatch General 1995;1995:1-1.
FULL TEXT