Preference values associated with stage III colon cancer and adjuvant chemotherapy.
OBJECTIVE
To elicit preference values for health states associated with Stage III colon cancer (CRC) and to explore the effect of neuropathy associated with current adjuvant treatment.


METHODS
We used time trade-off (TTO) techniques to elicit preferences from 49 CRC patients and 49 community members. We elicited preferences for 7 health states: remission; adjuvant therapy with no, mild, moderate, and severe neuropathy; metastatic stable; and metastatic progressive disease. Mean TTO values were adjusted for the covariates age, education, and current health.


RESULTS
Patients' adjusted mean TTO value for remission was 0.83; adjuvant chemotherapy health states ranged from 0.48 to 0.61. Significant differences were observed for both patient and community groups between TTO for remission and all adjuvant health states (P < 0.001), and between adjuvant therapy with no neuropathy and metastatic health states (P < or = 0.001). Across all health states, patients' values were on average 0.12 higher than community members (P < 0.05).


CONCLUSIONS
The findings highlight the trade-offs between the disutility of adjuvant treatment, the higher utility of remission, and the severe utility loss during metastatic disease. The preference values obtained from this study will be useful for informing patients' treatment decisions and payer cost-utility analyses of adjuvant treatment for colon cancer.
Best
Jennie H
JH
University of Washington, Seattle, WA, USA. bestj@uw.edu
Garrison
Louis P
LP
Hollingworth
William
W
Ramsey
Scott D
SD
Veenstra
David L
DL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D057240:Patient Preference / Q000523:psychology*; D019057:Quality-Adjusted Life Years; D012720:Severity of Illness Index; D016019:Survival Analysis