title: Estimation of Life-Year Loss and Lifetime Costs for Different Stages of Colon Adenocarcinoma in Taiwan.
abstract: OBJECTIVE
  Life-expectancy of colon cancer patients cannot be accurately answered due to the lack of both large datasets and long-term follow-ups, which impedes accurate estimation of lifetime cost to treat colon cancer patients. In this study, we applied a method to estimate life-expectancy of colon cancer patients in Taiwan and calculate the lifetime costs by different stages and age groups.
  
  
  METHODS
  A total of 17,526 cases with pathologically verified colon adenocarcinoma between 2002 and 2009 were extracted from Taiwan Cancer Registry database for analysis. All patients were followed-up until the end of 2011. Life-expectancy, expected-years-of-life-lost and lifetime costs were estimated, using a semi-parametric survival extrapolation method and borrowing information from life tables of vital statistics.
  
  
  RESULTS
  Patients with more advanced stages of colon cancer were generally younger and less co-morbid with major chronic diseases than those with stages I and II. The LE of stage I was not significantly different from that of the age- and sex-matched general population, whereas those of stages II, III, and IV colon cancer patients after diagnosis were 16.57 ± 0.07, 13.35 ± 0.07, and 4.05 ± 0.05 years, respectively; the corresponding expected-years-of-life-lost were 1.28 ± 0.07, 5.93 ± 0.07 and 16.42 ± 0.06 years, significantly shorter than the general population after accounting for lead time bias. Besides, the lifetime cost of managing stage II colon cancer patients would be US $8,416 ± 1939, 14,334 ± 1,755, and 21,837 ± 1,698, respectively, indicating a big saving for early diagnosis and treatment after stratification for age and sex.
  
  
  CONCLUSIONS
  Treating colon cancer at younger age and earlier stage saves more life-years and healthcare costs. Future studies are indicated to apply these quantitative results into the cost-effectiveness evaluation of screening program for colon cancers.
authors.affiliation: Division of Colorectal Surgery and General Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Po-Chuan
authors.initials: PC
authors.lastname: Chen
authors.affiliation: Division of Colorectal Surgery and General Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Jenq-Chang
authors.initials: JC
authors.lastname: Lee
authors.affiliation: Departments of Internal Medicine and Occupational and Environmental Medicine, National Cheng Kung University Hospital, and Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Jung-Der
authors.initials: JD
authors.lastname: Wang
mesh_terms: D000230:Adenocarcinoma / Q000191:economics / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D002908:Chronic Disease / Q000453:epidemiology; D003110:Colonic Neoplasms / Q000191:economics / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008017:Life Expectancy; D009367:Neoplasm Staging; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology