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. 1993 Nov;68(5):965–968. doi: 10.1038/bjc.1993.462

Screening and the costs of treating colorectal cancer.

D K Whynes 1, A R Walker 1, J O Chamberlain 1, J D Hardcastle 1
PMCID: PMC1968731  PMID: 8217610

Abstract

The objective of this paper is to compare the hospital costs of treating patients with colorectal cancers detected as a result of a faecal occult blood screening programme with those of patients whose cancers present symptomatically (control group). Patient-specific cost estimates are made, using case records and hospital accounts, for 360 patients over 3 years. Mean treatment costs for the group offered screening and for the control group are calculated to be 3,179 pounds and 2,966 pounds respectively, although the difference between these means is insignificant. Low treatment costs in the case of screen-detected cancers are largely accounted for by polypectomy with no subsequent readmission; in the control group case, they tend to be accounted for by early patient death. For the sample as a whole, the costs of treating very early-, and very late-, stage cancer are significantly lower than those of treating cancers in the intermediate stages. On the basis of trial evidence, the introduction of mass screening for colorectal cancer is unlikely to give rise to substantial economies in the costs of treatment.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allison J. E., Feldman R. Cost benefits of hemoccult screening for colorectal carcinoma. Dig Dis Sci. 1985 Sep;30(9):860–865. doi: 10.1007/BF01309517. [DOI] [PubMed] [Google Scholar]
  2. Barry M. J., Mulley A. G., Richter J. M. Effect of workup strategy on the cost-effectiveness of fecal occult blood screening for colorectal cancer. Gastroenterology. 1987 Aug;93(2):301–310. doi: 10.1016/0016-5085(87)91019-5. [DOI] [PubMed] [Google Scholar]
  3. Eddy D. M., Nugent F. W., Eddy J. F., Coller J., Gilbertsen V., Gottlieb L. S., Rice R., Sherlock P., Winawer S. Screening for colorectal cancer in a high-risk population. Results of a mathematical model. Gastroenterology. 1987 Mar;92(3):682–692. doi: 10.1016/0016-5085(87)90018-7. [DOI] [PubMed] [Google Scholar]
  4. Finkler S. A. The distinction between cost and charges. Ann Intern Med. 1982 Jan;96(1):102–109. doi: 10.7326/0003-4819-96-1-102. [DOI] [PubMed] [Google Scholar]
  5. Hardcastle J. D., Farrands P. A., Balfour T. W., Chamberlain J., Amar S. S., Sheldon M. G. Controlled trial of faecal occult blood testing in the detection of colorectal cancer. Lancet. 1983 Jul 2;2(8340):1–4. doi: 10.1016/s0140-6736(83)90001-6. [DOI] [PubMed] [Google Scholar]
  6. Hardcastle J. D., Thomas W. M., Chamberlain J., Pye G., Sheffield J., James P. D., Balfour T. W., Amar S. S., Armitage N. C., Moss S. M. Randomised, controlled trial of faecal occult blood screening for colorectal cancer. Results for first 107,349 subjects. Lancet. 1989 May 27;1(8648):1160–1164. doi: 10.1016/s0140-6736(89)92750-5. [DOI] [PubMed] [Google Scholar]
  7. Heine J. A., Rothenberger D. A. Cost-effective management of colon and rectal cancer. World J Surg. 1991 Sep-Oct;15(5):597–604. doi: 10.1007/BF01789205. [DOI] [PubMed] [Google Scholar]
  8. Jatzko G., Lisborg P., Wette V. Improving survival rates for patients with colorectal cancer. Br J Surg. 1992 Jun;79(6):588–591. doi: 10.1002/bjs.1800790641. [DOI] [PubMed] [Google Scholar]
  9. Langer J. C., Cohen Z., Taylor B. R., Stafford S., Jeejeebhoy K. N., Cullen J. B. Management of patients with polyps containing malignancy removed by colonoscopic polypectomy. Dis Colon Rectum. 1984 Jan;27(1):6–9. doi: 10.1007/BF02554062. [DOI] [PubMed] [Google Scholar]
  10. Lotfi A. M., Spencer R. J., Ilstrup D. M., Melton L. J., 3rd Colorectal polyps and the risk of subsequent carcinoma. Mayo Clin Proc. 1986 May;61(5):337–343. doi: 10.1016/s0025-6196(12)61950-8. [DOI] [PubMed] [Google Scholar]
  11. Morson B. C., Whiteway J. E., Jones E. A., Macrae F. A., Williams C. B. Histopathology and prognosis of malignant colorectal polyps treated by endoscopic polypectomy. Gut. 1984 May;25(5):437–444. doi: 10.1136/gut.25.5.437. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Neugut A. I., Forde K. A. Screening colonoscopy: has the time come? Am J Gastroenterol. 1988 Mar;83(3):295–297. [PubMed] [Google Scholar]
  13. Pollard S. G., Macfarlane R., Everett W. G. Surgery for recurrent colorectal carcinoma--is it worthwhile? Ann R Coll Surg Engl. 1989 Sep;71(5):293–298. [PMC free article] [PubMed] [Google Scholar]
  14. Russell J. B., Chu D. Z., Russell M. P., Chan C. H., Thompson C., Schaefer R. F. When is polypectomy sufficient treatment for colorectal cancer in a polyp? Am J Surg. 1990 Dec;160(6):665–668. doi: 10.1016/s0002-9610(05)80771-8. [DOI] [PubMed] [Google Scholar]
  15. Walker A. R., Whynes D. K., Chamberlain J. O., Hardcastle J. D. The hospital costs of diagnostic procedures for colorectal cancer. J Clin Epidemiol. 1991;44(9):907–914. doi: 10.1016/0895-4356(91)90053-c. [DOI] [PubMed] [Google Scholar]
  16. Whynes D. K., Walker A. R., Hardcastle J. D. Cost-effective screening strategies for colorectal cancer. J Public Health Med. 1992 Mar;14(1):43–49. [PubMed] [Google Scholar]

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