Document Detail


The impact of detection and treatment on lifetime medical costs for patients with precancerous polyps and colorectal cancer.
MedLine Citation:
PMID:  19142856     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Understanding the costs associated with early detection of disease is important for determining the fiscal implications of government-funded screening programs. We estimate the lifetime medical costs for patients with screen-detected versus undetected polyps and early-stage colorectal cancer. Typically, cost-effectiveness studies of screening account only for the direct costs of screening and cancer care. Our estimates include costs for unrelated conditions. We applied the Kaplan-Meier Smoothing Estimator to estimate lifetime costs for beneficiaries with screen-detected polyps and cancer. Phase-specific costs and survival probabilities were calculated from the Surveillance, Epidemiology, and End Results-Medicare database for Medicare beneficiaries aged >or=65. We estimate costs from the point of detection onward; therefore, our results do not include the costs associated with screening. We used a modified version of the model to estimate what lifetime costs for these patients would have been if the polyps or cancer remained undetected, based on assumptions about the 'lead time' for polyps and early-stage cancer. For younger patients, polyp removal is cost saving. Treatment of early-stage cancer is cost increasing.
Authors:
David H Howard; Florence K Tangka; Laura C Seeff; Lisa C Richardson; Donatus U Ekwueme
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Health economics     Volume:  18     ISSN:  1099-1050     ISO Abbreviation:  Health Econ     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-12     Completed Date:  2010-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9306780     Medline TA:  Health Econ     Country:  England    
Other Details:
Languages:  eng     Pagination:  1381-93     Citation Subset:  IM    
Copyright Information:
(c) 2009 John Wiley & Sons, Ltd.
Affiliation:
Department of Health Policy and Management, Emory University, Atlanta, GA 30322, USA. david.howard@emory.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Colorectal Neoplasms / prevention & control*
Costs and Cost Analysis
Female
Health Expenditures / statistics & numerical data*
Humans
Male
Mass Screening / economics*
Polyps / diagnosis*
Precancerous Conditions / diagnosis*
Preventive Medicine / economics*
Grant Support
ID/Acronym/Agency:
06-075-01-CPHPS//PHS HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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