Long-Term Secondary Care Costs of Endometrial Cancer: A Prospective Cohort Study Nested within the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).
BACKGROUND
There is limited evidence on the costs of Endometrial Cancer (EC) by stage of disease. We estimated the long-term secondary care costs of EC according to stage at diagnosis in an English population-based cohort.


METHODS
Women participating in UKCTOCS and diagnosed with EC following enrolment (2001-2005) and prior to 31st Dec 2009 were identified to have EC through multiple sources. Survival was calculated through data linkage to death registry. Costs estimates were derived from hospital records accessed from Hospital Episode Statistics (HES) with additional patient level covariates derived from case notes and patient questionnaires. Missing and censored data was imputed using Multiple Imputation. Regression analysis of cost and survival was undertaken.


RESULTS
491 of 641 women with EC were included. Five year total costs were strongly dependent on stage, ranging from £9,475 (diagnosis at stage IA/IB) to £26,080 (diagnosis at stage III). Stage, grade and BMI were the strongest predictors of costs. The majority of costs for stage I/II EC were incurred in the first six months after diagnosis while for stage III / IV considerable costs accrued after the first six months.


CONCLUSIONS
In addition to survival advantages, there are significant cost savings if patients with EC are detected earlier.
King's Health Economics, David Goldberg Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
Mark
M
Pennington
Department of Women's Cancer, Institute for Women's Health, University College London, London, United Kingdom.
Aleksandra
A
Gentry-Maharaj
Department of Women's Cancer, Institute for Women's Health, University College London, London, United Kingdom.
Chloe
C
Karpinskyj
Department of Health Services Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Alec
A
Miners
Department of Women's Cancer, Institute for Women's Health, University College London, London, United Kingdom.
Julie
J
Taylor
Barts Cancer Institute, Queen Mary University of London, London, United Kingdom.
Ranjit
R
Manchanda
Department of Women's Cancer, Institute for Women's Health, University College London, London, United Kingdom.
Rema
R
Iyer
Department of Women's Cancer, Institute for Women's Health, University College London, London, United Kingdom.
Michelle
M
Griffin
Department of Women's Cancer, Institute for Women's Health, University College London, London, United Kingdom.
Andy
A
Ryan
Department of Women's Cancer, Institute for Women's Health, University College London, London, United Kingdom.|University of New South Wales, Sydney, New South Wales, Australia.
Ian
I
Jacobs
Department of Women's Cancer, Institute for Women's Health, University College London, London, United Kingdom.
Usha
U
Menon
Department of Health Services Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Rosa
R
Legood
D000368:Aged; D017281:Cost of Illness; D055088:Early Detection of Cancer / Q000191:economics* / Q000706:statistics & numerical data; D042241:Early Diagnosis; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000191:economics* / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011446:Prospective Studies; D012044:Regression Analysis; D063127:Secondary Health Care / Q000191:economics*; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D013997:Time Factors; D006113:United Kingdom