title: The cost of colorectal cancer according to the TNM stage.
abstract: BACKGROUND
  The aim of this study was to measure the cost of treatment of colorectal cancer in the Basque public health system according to the clinical stage.
  
  
  METHODS
  We retrospectively collected demographic data, clinical data and resource use of a sample of 529 patients. For stagesi toiii the initial and follow-up costs were measured. The calculation of cost for stageiv combined generalized linear models to relate the cost to the duration of follow-up based on parametric survival analysis. Unit costs were obtained from the analytical accounting system of the Basque Health Service.
  
  
  RESULTS
  The sample included 110 patients with stagei, 171 with stageii, 158 with stageiii and 90 with stageiv colorectal cancer. The initial total cost per patient was 8,644€ for stagei, 12,675€ for stageii and 13,034€ for stageiii. The main component was hospitalization cost. Calculated by extrapolation for stageiv mean survival was 1.27years. Its average annual cost was 22,403€, and 24,509€ to death. The total annual cost for colorectal cancer extrapolated to the whole Spanish health system was 623.9million€.
  
  
  CONCLUSIONS
  The economic burden of colorectal cancer is important and should be taken into account in decision-making. The combination of generalized linear models and survival analysis allows estimation of the cost of metastatic stage.
authors.affiliation: Unidad de Investigación AP-OSI, Hospital Alto Deba, Arrasate-Mondragón, Gipuzkoa, España; Unidad de Gestión Sanitaria, Hospital Alto Deba, Arrasate-Mondragón, Gipuzkoa, España; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC), Bilbao, Bizkaia, España; Instituto Biodonostia, Donostia-San Sebastián, Gipuzkoa, España. Electronic address: javier.marmedina@osakidetza.net.
authors.forename: Javier
authors.initials: J
authors.lastname: Mar
authors.affiliation: Servicio de Cirugía, Hospital Universitario de Álava, Vitoria-Gasteiz, Álava, España.
authors.forename: Jose
authors.initials: J
authors.lastname: Errasti
authors.affiliation: Unidad de Investigación AP-OSI, Hospital Alto Deba, Arrasate-Mondragón, Gipuzkoa, España.
authors.forename: Myriam
authors.initials: M
authors.lastname: Soto-Gordoa
authors.affiliation: Unidad de Investigación AP-OSI, Hospital Alto Deba, Arrasate-Mondragón, Gipuzkoa, España.
authors.forename: Gilen
authors.initials: G
authors.lastname: Mar-Barrutia
authors.affiliation: Departamento de Contabilidad, Hospital Alto Deba, Arrasate-Mondragón, Gipuzkoa, España.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Martinez-Llorente
authors.affiliation: Servicio de Oncología Médica, Hospital Universitario de Álava, Vitoria-Gasteiz, Álava, España.
authors.forename: Severina
authors.initials: S
authors.lastname: Domínguez
authors.affiliation: Servicio de Farmacia, Hospital Universitario de Álava, Vitoria-Gasteiz, Álava, España.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: García-Albás
authors.affiliation: Unidad de Investigación AP-OSI, Hospital Alto Deba, Arrasate-Mondragón, Gipuzkoa, España; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC), Bilbao, Bizkaia, España; Instituto Biodonostia, Donostia-San Sebastián, Gipuzkoa, España.
authors.forename: Arantzazu
authors.initials: A
authors.lastname: Arrospide
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000191:economics* / Q000473:pathology*; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies
keywords: Burden; Carga económica; Clinical stage; Colorectal cancer; Costes; Costs; Cáncer colorrectal; Estadio clínico; Supervivencia; Survival