Table 5.

Comparison of 2017 medicare costs associated with adhering to the NCCN and ESMO oncologic surveillance schedules and the costs that would be incurred if 95% of all recurrences were captured.

Surveillance strategy and risk group	2017 Total medicare Costs†	Cost per recurrence case detected
2018 NCCN#§ (with ability to capture 11.3% of the recurrences)
All patients	1,642.66	42,578.64
2015 NCCN#§ (with ability to capture 31.5% of the recurrences)
T1–2*	2,179.81	62,088.70
T3–4*	4,484.69	44,863.95
N0–1*	3,254.07	49,595.65
N2–3*	4,484.69	46,220.58
2012 ESMO# (with ability to capture 27.4% of the recurrences)
T1–2*	1,642.66	73,329.76
T3–4*	3,747.87	40,423.99
To capture 95% of all recurrences‡
T1–2*	6,264.65	50,338.69
T3–4*	5,712.88	19,912.48
N0–1*	6,253.04	31,597.83
N2–3*	6,237.52	17,187.99

NCCN, National Comprehensive Cancer Network; ESMO, European Society for Medical Oncology.

^#The total cost in the first 10 years after treatment were estimated when strictly adhering to surveillance guideline.

^§The 2018 and 2015 NCCN recommended annual low-dose chest CT for patients with high risk of lung cancer which represents only 4.82% of the whole patients, so the cost of chest imaging associated adhering to the 2018 and 2015 NCCN was ignored.

^*According to the 7th edition of the International Union against Cancer/American Joint Committee on Cancer (UICC/AJCC) system.

^†Estimates based on total costs in dollars incurred by a single patient who has strictly followed and completed the recommended surveillance schedules as outlined in Table 1. H&P exam included both costs of a complete head and neck exam and fiberotic examination.

^‡Cost was calculated based on followed estimation: Frequency of H&P exam was similar to that the 2018 and 2015 recommended; baseline imaging included annually head and neck MRI, bone imaging included annually skeletal scintigraphy, chest imaging included annually chest CT, abdomen imaging included annually abdomen CT.