TY - JOUR
T1 - Cancer-Attributable Costs of Diagnosis and Care for Persons with Screen-Detected Versus Symptom-Detected Colorectal Cancer
AU - Ramsey, Scott D.
AU - Mandelson, Margaret T.
AU - Berry, Kristin
AU - Etzioni, Ruth
AU - Harrison, Robert
N1 - Funding Information:
Supported by the Aetna Research Foundation Quality Care Research Fund and the Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute.
PY - 2003/12
Y1 - 2003/12
N2 - Background & Aims: Colorectal cancer screening is effective and cost-effective, but little data from health plan settings are available inform decision-makers regarding direct economic implications of colorectal cancer screening programs. The purpose of this study was to compare the prediagnosis evaluation and first-year treatment costs of persons diagnosed with colorectal cancer, stratified by whether the cancer was detected by screening using fecal occult blood testing or evaluation of symptoms. Methods: This retrospective study analyzed persons diagnosed with colorectal cancer from 1993 to 1999 in Group Health Cooperative, a large health maintenance organization in Washington state. Total health care costs during 3 months before and 12 months following diagnosis were compared for screen-detected versus symptom-detected individuals. Results: During this time, 206 cancers were detected by screening and 717 by symptoms. In the 3 months before diagnosis, total costs were $7346 for persons with screen-detected versus $10,042 for those with symptom-detected cancer (P < 0.01). Stratified by stage, diagnosis costs were significantly lower for persons with stage B cancer ($7282 vs. $11,682; P < 0.01) and nonsignificantly lower for other stages. A total of 53% of screen-detected cases were Dukes' stage A or in situ at diagnosis versus 30% of symptom-detected cases (P < 0.01). Overall costs were lower for the screen-detected group in the 12 months following diagnosis ($22,369 vs. $29,471; P < 0.01). Conclusions: Colorectal cancer screening can substantially reduce prediagnosis evaluation costs. These savings are of interest to health plans and should be factored into cost-effectiveness evaluations of screening programs.
AB - Background & Aims: Colorectal cancer screening is effective and cost-effective, but little data from health plan settings are available inform decision-makers regarding direct economic implications of colorectal cancer screening programs. The purpose of this study was to compare the prediagnosis evaluation and first-year treatment costs of persons diagnosed with colorectal cancer, stratified by whether the cancer was detected by screening using fecal occult blood testing or evaluation of symptoms. Methods: This retrospective study analyzed persons diagnosed with colorectal cancer from 1993 to 1999 in Group Health Cooperative, a large health maintenance organization in Washington state. Total health care costs during 3 months before and 12 months following diagnosis were compared for screen-detected versus symptom-detected individuals. Results: During this time, 206 cancers were detected by screening and 717 by symptoms. In the 3 months before diagnosis, total costs were $7346 for persons with screen-detected versus $10,042 for those with symptom-detected cancer (P < 0.01). Stratified by stage, diagnosis costs were significantly lower for persons with stage B cancer ($7282 vs. $11,682; P < 0.01) and nonsignificantly lower for other stages. A total of 53% of screen-detected cases were Dukes' stage A or in situ at diagnosis versus 30% of symptom-detected cases (P < 0.01). Overall costs were lower for the screen-detected group in the 12 months following diagnosis ($22,369 vs. $29,471; P < 0.01). Conclusions: Colorectal cancer screening can substantially reduce prediagnosis evaluation costs. These savings are of interest to health plans and should be factored into cost-effectiveness evaluations of screening programs.
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U2 - 10.1053/j.gastro.2003.09.032
DO - 10.1053/j.gastro.2003.09.032
M3 - Article
C2 - 14724816
AN - SCOPUS:0344628831
SN - 0016-5085
VL - 125
SP - 1645
EP - 1650
JO - Gastroenterology
JF - Gastroenterology
IS - 6
ER -