title: Costs in primary care of investigating symptoms suspicious of cancer in a defined population.
abstract: OBJECTIVE
  To calculate total cost of investigating symptoms related to one of the four most common cancers: prostate, breast, colorectal, and pulmonary. Special attention was given to two non-specific and common symptoms: vertigo/dizziness and tiredness/fatigue.
  
  
  METHODS
  Retrospective examination of patient records in a defined population.
  
  
  METHODS
  Primary health care (PHC) and hospital care.
  
  
  METHODS
  Investigation costs of selected ICD codes.
  
  
  RESULTS
  In total 6812 patients with 14,541 ICD codes were investigated to a total cost per registered ICD code, with one of the selected diagnostic measures, of SEK 800. Some 50% of the costs were due to X-ray examinations of which colonic X-ray was the most expensive single procedure. Symptoms related to colorectal cancer were the most expensive to investigate with vertigo/dizziness and tiredness/fatigue examined separately. Tiredness/fatigue symptoms cost SEK 395 and vertigo/dizziness SEK 197 per registered code to investigate and none of them yielded a detected malignancy. The incidence of cancer was 0.7%. The average cost of diagnosing one malignancy was SEK 236,700, if all diagnostic activities could be justified only for detection of malignancies.
  
  
  CONCLUSIONS
  A high cost of diagnosing malignancy can be expected and justified, but many symptoms presented in PHC, such as tiredness/fatigue and vertigo/dizziness, have a relatively high investigation cost but detected no case of cancer in this study.
authors.affiliation: Primary Health Care Centre Husläkarna i Kungsbacka, County Council Halland, Sweden. jorgen.mansson@lthalland.se
authors.forename: Jörgen
authors.initials: J
authors.lastname: Månsson
authors.forename: Bertil
authors.initials: B
authors.lastname: Marklund
authors.forename: Per
authors.initials: P
authors.lastname: Carlsson
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000191:economics; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000191:economics; D003365:Costs and Cost Analysis; D019937:Diagnostic Techniques and Procedures / Q000191:economics* / Q000706:statistics & numerical data; D004244:Dizziness / Q000175:diagnosis; D005194:Family Practice / Q000191:economics; D005221:Fatigue / Q000175:diagnosis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000191:economics; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000191:economics; D012189:Retrospective Studies; D014717:Vertigo / Q000175:diagnosis