Original article—alimentary tractLifetime and Treatment-Phase Costs Associated With Colorectal Cancer: Evidence from SEER-Medicare Data
Section snippets
Data Sources
This study used 3 data sources: (1) the linked Surveillance Epidemiology and End Results (SEER)–Medicare database (a collaborative effort of the National Cancer Institute, the SEER registries, and the Centers for Medicare and Medicaid Services); (2) the SEER*Stat database, containing clinical and survival data from the SEER registries; and (3) survival data for the general population from US life-tables.
SEER is a US cancer surveillance system consisting of population-based tumor registries
Patient Characteristics
We identified 56,838 CRC patients (41,256 colon cancer [CC], 15,582 rectal cancer [RC]) who met our selection criteria. Demographic and clinical characteristics for CC patients, RC patients, the combined CRC cohort, and the comparison cohort are presented in Table 1. The mean ± SD age was 77.7 ± 7.1 years; about 55% of patients in both cohorts were women and 86% were white.
Lifetime Cost Estimates
Total lifetime cancer-related costs were $28,500, with an inverted U-shaped pattern by stage and a U-shaped pattern by age (
Discussion
This study evaluated lifetime and phase-specific excess costs among elderly patients with CRC in the United States. We found that lifetime CRC-related costs are substantial and vary by cancer subsite, stage at diagnosis, age at diagnosis, and treatment phase. Excess lifetime costs show an inverted U-shaped pattern by stage at diagnosis, and a U-shaped pattern by age at diagnosis for both CC and RC. Costs for RC patients are lower than costs for CC patients in stage 0, higher in stages I to III,
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The authors disclose the following: This study was sponsored by a grant from GE Healthcare, Waukesha, WI. D.W.L. is an employee of GE Healthcare; K.L., L.M.L., J.R.K., and J.M. received research funding from GE Healthcare; and C.C.E. is a consultant for Boston Health Economics.