A cost-effectiveness approach to the Norwegian follow-up programme in colorectal cancer.
BACKGROUND
Today, continued periodic follow-up of patients treated for colorectal cancer (CRC) seems often to be routine because of tradition, rather than its demonstrated value. Recently, the Norwegian Gastrointestinal Cancer Group (NGICG) has recommended a standard surveillance programme in this malignancy. In this protocol patients are suggested followed for four years with CEA monitoring, ultrasound of the liver, chest radiograph and colonoscopy at regular intervals.


METHODS
In this study, the cost-effectiveness of this programme was addressed employing Norwegian cost data and data from the Cancer Registry of Norway. Clinical data from the existing English language literature was used in the analysis.


RESULTS
The basic cost of the NGICG recommended programme was 1,232 Pounds per patient. Including extended investigation due to suspected relapse in 45% of cases, the figure raised to 1,943 Pounds per patient. The cost per life year saved was indicated to 9,525 Pounds-16,192 Pounds. The corresponding cost per quality adjusted life year (QALY) was indicated to 11,476 Pounds-19,508 Pounds.


CONCLUSIONS
We conclude the NGICG recommended follow-up programme in CRC cost-effective. Excluding CEA monitoring may improve the cost-effectiveness.
Norum
J
J
Department of Oncology, University Hospital of Tromsø, Norway.
Olsen
J A
JA
D002272:Carcinoembryonic Antigen / Q000032:analysis / Q000191:economics; D003110:Colonic Neoplasms / Q000191:economics* / Q000401:mortality / Q000628:therapy; D003113:Colonoscopy; D003362:Cost-Benefit Analysis; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009664:Norway; D019057:Quality-Adjusted Life Years; D012004:Rectal Neoplasms / Q000191:economics* / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome
D002272:Carcinoembryonic Antigen