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  1. Home
  3. Cost-effectiveness Of Surveillance Intervals After Curative Resection Of Colorectal Cancer.
  1. Home
  3. Cost-effectiveness Of Surveillance Intervals After Curative Resection Of Colorectal Cancer.

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Cost-effectiveness of surveillance intervals after curative resection of colorectal cancer.

Yuji Takayama1, Shunsuke Tsukamoto1, Yozo Kudose1

  • 1Department of Colorectal Surgery, National Cancer Center, Tokyo, Japan.

Japanese Journal of Clinical Oncology
|February 20, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

This study determined optimal colorectal cancer surveillance post-surgery. Strategy 4 is most cost-effective for Stage I, while Strategy 3 is best for Stages II and III.

Keywords:
colorectal cancercost-effectivenessincremental cost-effectiveness ratioquality-adjusted life yearssurveillance

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Area of Science:

  • Oncology
  • Health Economics
  • Medical Decision Making

Background:

  • Current colorectal cancer (CRC) guidelines recommend 5-year postoperative surveillance.
  • Guidelines vary on examination intervals and stage-specific approaches.
  • No studies have evaluated the cost-effectiveness of different CRC surveillance schedules.

Purpose of the Study:

  • To identify the most cost-effective surveillance intervals after curative resection of colorectal cancer.
  • To compare the cost-effectiveness of various surveillance strategies based on disease stage.

Main Methods:

  • A cost-effectiveness analysis was performed on 3701 patients who underwent curative CRC surgery.
  • A state-transition model using Monte Carlo simulation calculated expected medical costs and quality-adjusted life years (QALYs).
  • Incremental cost-effectiveness ratios (ICERs) were determined for five surveillance strategies, comparing them against a threshold of $43,500–$52,200 USD per QALY.

    • Main Results:

    • For Stage I CRC, Strategy 4 yielded the lowest ICER ($26,555/QALY), outperforming Strategies 3 and 2 which exceeded the threshold.
    • For Stages II and III CRC, Strategy 3 demonstrated the most cost-effectiveness, with ICERs ranging from $18,358 to $22,230 per QALY.

    Conclusions:

    • Intensive surveillance for Stage I colorectal cancer is not cost-effective; Strategy 4 is recommended.
    • Strategy 3 represents the most cost-effective surveillance approach for patients with Stage II and III colorectal cancer.