A COST-EFFECTIVENESS APPROACH TO THE NORWEGIAN FOLLOW-UP PROGRAM IN COLORECTAL-CANCER

Background: Today, continued periodic follow-up of patients treated fo r colorectal cancer (CRC) seems often to be routine because of traditi on, rather than its demonstrated value. Recently the Norwegian Gastroi ntestinal Cancer Group (NGICG) has recommended a standard surveillance programme in this malignancy. In this protocol patients are suggested followed for four years with CEA monitoring, ultrasound of the liver, chest radiograph and colonoscopy at regular intervals. Material and m ethods. In this study, the cost-effectiveness of this programme was ad dressed employing Norwegian cost data and data from the Cancer Registr y of Norway. Clinical data from the existing English language literatu re was used in the analysis. Results. The basic cost of the NGICG reco mmended programme was pound 1,232 per patient. Including extended inve stigation due to suspected relapse in 45% of cases, the figure raised to pound 1,943 per patient. The cost per life year saved was indicated to pound 9,525-pound 16,192. The corresponding cost per quality adjus ted life year (QALY) was indicated to pound 11,476-pound 19,508. Concl usion: We conclude the NGICG recommended follow-up programme in CRC co st-effective. Excluding CEA monitoring may improve the cost-effectiven ess.