title: Cost of Cutaneous Melanoma by Tumor Stage: A Descriptive Analysis.
abstract: OBJECTIVE
  The basis for optimal resource allocation is an understanding of requirements during the diagnostic and treatment phases. Costs associated with the rising incidence of cutaneous melanoma are considerable. We undertook an up-to-date analysis of the cost of diagnosis, treatment, and follow-up according to tumor stage.
  
  
  METHODS
  We constructed descriptive tables following a theoretical model of direct costs based on amounts published in directives for the Spanish national health system and in international guidelines for managing cutaneous melanoma according to stage at diagnosis and clinical course. The tables allowed us to calculate the cost of treating individual patients as well as the expected cost for all patients with tumors in the same stage.
  
  
  RESULTS
  Individual patients would generate costs ranging from €1689 (for a stage I tumor) to €88, 268 (stage IV). The largest differences were between stages IA and IB-IIA and between stages III and IV. Costs differed greatly between patients with early-stage tumors and favorable outcomes and those with recurring tumors, which cost 50-fold more in the first year and 20-fold more after 10 years of follow-up.
  
  
  CONCLUSIONS
  The high cost of diagnosing advanced-stage cutaneous melanoma calls attention to the need to promote primary prevention and early detection. Our findings provide the knowledge base for cost-effectiveness studies in this disease.
authors.affiliation: Departamento de Ciencias de la Salud, Universidad Pública de Navarra, Pamplona, España; Departamento de Medicina Nuclear, Complejo Hospitalario de Navarra, Pamplona, España. Electronic address: pserraarbeloa@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Serra-Arbeloa
authors.affiliation: Applied Medical Reseach Program, Universidad de Navarra, Pamplona, España.
authors.forename: Á O
authors.initials: ÁO
authors.lastname: Rabines-Juárez
authors.affiliation: Departamento de Medicina Nuclear, Hospital Miguel Servet, Zaragoza, España.
authors.forename: M S
authors.initials: MS
authors.lastname: Álvarez-Ruiz
authors.affiliation: Departamento de Ciencias de la Salud, Universidad Pública de Navarra, Pamplona, España.
authors.forename: F
authors.initials: F
authors.lastname: Guillén-Grima
mesh_terms: D017048:Health Care Costs; D006801:Humans; D008545:Melanoma / Q000191:economics* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D012878:Skin Neoplasms / Q000191:economics* / Q000473:pathology / Q000628:therapy
keywords: Cost analysis; Costes; Cutaneous melanoma; Diagnosis-treatment; Diagnóstico-tratamiento; Estadios tumorales; Follow-up; Melanoma cutáneo; Seguimiento; Tumor staging