Cost of care of colorectal cancers according to health care patterns and stage at diagnosis in France.
Little is known about the economic burden associated with colorectal cancer in France. The aim of this study was to evaluate the effects of age, stage at diagnosis, health care pattern and level of comorbidities on the mean cost of the management of colorectal cancers, using data from a population-based registry and the French health care system. We estimated the direct costs of medical care for 384 colorectal cancers diagnosed in 2004, using the three main databases of the National Health Insurance. The cost of management was defined as the sum of all health expenditures over the 12 months following the date of diagnosis. The mean cost for first-year management was 24,966 euro (SE 1,195 euro). There was no significant difference in overall costs in relation to sex, age, Charlson index score, cancer location or health care pattern. Costs increased significantly with cancer extension from 17,596 euro for stage I to 35,059 euro for stage IV. Hospitalisation charges represented the greatest economic burden (55.2%), followed by medical purchases (24.4%), outpatient care (17.8%) and transportation (2.5%). These results confirm the major economic burden of colorectal cancer and indicate that total costs depend mainly on the stage at diagnosis. By improving stage at diagnosis, mass screening could contribute to decreasing the cost of managing colorectal cancers.
Clerc
Laurence
L
Registre Bourguignon des Cancers Digestifs [INSERM U866], Faculté de Médecine, BP 87 900, 21079 Dijon Cedex, France.
Jooste
Valérie
V
Lejeune
Catherine
C
Schmitt
Bernard
B
Arveux
Patrick
P
Quantin
Catherine
C
Faivre
Jean
J
Bouvier
Anne-Marie
AM
D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000191:economics* / Q000473:pathology; D005260:Female; D005602:France; D017048:Health Care Costs; D019538:Health Care Surveys; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries