The clinical value and the cost-effectiveness of follow-up in endometrial cancer patients.
The aim of the present article was to evaluate the cost-effectiveness of follow-up in endometrial cancer patients. A literature review was performed regarding the studies that addressed routine follow-up of endometrial cancer. For each published study, the costs of the follow-up program were calculated according to Belgium standards. A mean total of 13% relapsed. Symptomatology and clinical examination detected over 83% of the recurrences. The follow-up cost in euro after 5 and 10 years ranged between 127.68 and 2,028.78 and between 207.48 and 2,353.48, respectively. Based on the available data, there is little evidence of routine follow-up improving survival rates. Multiple protocols are used in practice without an evidence base. There is an urgent need for prospective randomized studies to evaluate the value of the current so-called 'standard medical practice of follow-up.' It is to be expected that the cost of follow-up could be reduced considerably, for instance, by tailoring to low- and high-risk groups, or by abandoning routine follow-up. Symptomatic patients, however, should be evaluated immediately. A reduction in the number of visits and examinations would mean an enormous reduction in costs. This economic benefit would be warmly welcomed in the times of increased health costs and decreased budgets.
Tjalma
W A A
WA
Department of Gynaecology and Gynaecological Oncology, University Hospital Antwerp, 2650 Edegem, Antwerp, Belgium.
van Dam
P A
PA
Makar
A P
AP
Cruickshank
D J
DJ
D014408:Biomarkers, Tumor / Q000032:analysis / Q000191:economics*; D003362:Cost-Benefit Analysis; D003952:Diagnostic Imaging / Q000191:economics*; D016889:Endometrial Neoplasms / Q000191:economics* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D010808:Physical Examination / Q000706:statistics & numerical data; D016019:Survival Analysis
D014408:Biomarkers, Tumor