Researchers from the USA compared the effectiveness and costs of intensive versus standard surveillance strategies following potentially curative resection of colorectal cancer.
They reported their findings at DDW 2002, held this week in San Francisco, California, USA.
Using MEDLINE and bibliographies from relevant studies, the team identified 5 prospective, randomized, controlled trials investigating standard versus intensive surveillance strategies.
These represented a total of 1342 patients (n = 666 intensive, n = 676 standard).
It was found that more patients in the intensive surveillance group (33%) underwent repeat resections for recurrences than did patients in the standard follow-up group (11%).
Furthermore, survival rates of patients who underwent repeat resection in the intensive and standard groups were 45% and 18%, respectively.
The survival rate for all patients with recurrences was also higher in the intensive follow-up group (14% vs 1%).
Intensive surveillance: 71%
Overall, the cumulative 5-year survival rate was 71% for the intensive group and 65% in the standard group.
The researchers discovered that the average total costs over 5 years were $11,338 ($2268 per year) for intensive surveillance and $4123 ($825 per year) for standard surveillance.
Marginal cost of surveillance over 5 years averaged $95,921 per additional colorectal cancer survivor, or $19,184 per year.
Author Richard A. Del Rio said on behalf of his colleagues, "Based on data from prospective trials, a more intensive surveillance method for colorectal cancer survivors is associated with a survival benefit over a standard follow-up regimen."
"The additional surveillance costs appear reasonable when compared to other accepted strategies," he concluded.