Costs of Posttreatment Surveillance for Patients With Upper Aerodigestive Tract Cancer

Virgo, Katherine S.; Paniello, Randal C.; Johnson, Frank E.

doi:10.1001/archotol.124.5.564

Cited by 32 publications

(25 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a study analysing different strategies for the follow-up period, Virgo et al found that there were no data to demonstrate greater efficiency for higher cost strategies. 50 They recommended a minimalist approach towards follow up but also added that their analysis was not done on actual patients and prospectively studied.…”

Section: Cost-benefit Analysismentioning

confidence: 99%

Current concepts of surveillance and its significance in head and neck cancer

Manikantan

Dwivedi

Sayed

et al. 2011

annals

View full text Add to dashboard Cite

Follow-up in head and neck cancer (HNC) is essential to detect and manage locoregional recurrence or metastases, or second primary tumours at the earliest opportunity. A variety of guidelines and investigations have been published in the literature. This has led to oncologists using different guidelines across the globe. The follow-up protocols may have unnecessary investigations that may cause morbidity or discomfort to the patient and may have significant cost implications. In this evidencebased review we have tried to evaluate and address important issues like the frequency of follow-up visits, clinical and imaging strategies adopted, and biochemical methods used for the purpose. This review summarises strategies for follow-up, imaging modalities and key investigations in the literature published between 1980 and 2009. A set of recommendations is also presented for cost-effective, simple yet efficient surveillance in patients with head and neck cancer.

show abstract

Section: Cost-benefit Analysismentioning

confidence: 99%

Current concepts of surveillance and its significance in head and neck cancer

Manikantan

Dwivedi

Sayed

et al. 2011

annals

View full text Add to dashboard Cite

show abstract

“…Regarding the importance of patient education and cancer detection in the follow-up system, there is conflicting evidence as to whether patient surveillance versus routine clinic surveillance results in a survival advantage [4,5,17,18]. Some authors claim that up to two-thirds of recurrences can be detected through increased patient self-awareness [1,4].…”

Section: Discussionmentioning

confidence: 99%

The follow-up of patients with head and neck cancer: an analysis of 1,039 patients

Kothari

Trinidade

Hewitt

et al. 2010

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

In all cancer specialities, there has been much debate about the best follow-up regime. The provision of a service that meets high standards whilst being cost-effective is increasingly pertinent. The objectives of the study were to examine: whether routine follow-up facilitates early diagnosis and recurrence; whether there is a cohort of patients who require a more intensive follow-up regime; whether follow-up should be customised to individual patients. A total of 1,039 consecutive outpatient consultations were prospectively analysed in a multicentre study. All adult patients who had undergone multidisciplinary, multimodality management for head and neck cancer were included. The case mix was representative of all head and neck tumour sites and stages. Suspicion of recurrence was noted in 10% (n = 96/951) of patients seen routinely. This rose to 68% (n = 60/88) for the subset of patients who had requested an appointment. Most recurrences were found within the first follow-up year (n = 64/156, 54%). Only 0.3% (n = 3/1,039) of asymptomatic patients attending routine appointments were suspected of having a recurrence, and two (0.2%) were found to have an actual recurrence following investigation. Of the total number of patients reporting a new suspicious symptom, recurrence was suspected in 56% (n = 152/270). Patients thus had a 98.1% sensitivity to raising suspicion for a recurrence based on the reporting of new symptoms with a 99.6% negative predictive value. Our data show that the efficiency of the current follow-up regime at detecting suspected recurrence of head and neck cancer is low, suggesting the need for a customised, more focused follow-up regime, tailored to individual cases. Patient education and close relationships with clinicians and allied health-care professionals are essential for early diagnosis and management of cancer recurrence. Follow-up regimes within the first year should be most intensive as recurrence is most likely within this time, and it serves to alleviate patient anxiety in the early post-treatment period. More research needs to be carried out to investigate the role of patient self-reporting and surveillance of cancer recurrence.

show abstract

“…Posttreatment surveillance refers to the various follow-up strategies employed in the monitoring of patients following treatment for HNC.The costs of these services have also been assessed.For example,Virgo, Paniello and Johnson [53] studied the range of follow-up strategies for HNC patients treated with curative intent and their associated costs.Thirty-one different strategies were evaluated. The actual charges ranged from $US1,198 (€2,029) to $22,807 (€38,621) per patient.…”

Section: Costs Of Follow-upmentioning

confidence: 99%

Economic burden of head and neck cancer

Lee

Turini

Botteman

et al. 2004

The European Journal of Health Economics

View full text Add to dashboard Cite

This literature review presents the economics of head and neck cancer (HNC), the world's sixth most common neoplasm. HNC economics is complicated by the involvement of multiple body sites, multiple medical specialties, and multiple treatment modalities. Economic analyses of HNC published in English between 1990 and 2002 were identified from electronic data sources. Additional studies were identified manually from bibliographies of retrieved articles. Study characteristics and findings were analyzed. We identified 51 studies that reported original cost data. Most were cost-identification or cost-comparison studies; only one evaluated cost-effectiveness. Few assessed the overall economic burden of HNC or cost effectiveness of current treatments, thus making appropriate comparisons impossible. Systematic measurement of the cost of HNC and its treatment in existing practice settings would be valuable. Inclusion of economic components in clinical trials and the conduct of retrospective or prospective observational studies, such as patient registries, would yield important new information.

show abstract

Costs of Posttreatment Surveillance for Patients With Upper Aerodigestive Tract Cancer

Abstract: Charges vary extensively across surveillance strategies, particularly if site-specific strategies are considered, although the potential benefit of more intensive, higher-cost strategies on survival or quality of life has yet to be demonstrated.

Cited by 32 publications

References 34 publications

Current concepts of surveillance and its significance in head and neck cancer

Current concepts of surveillance and its significance in head and neck cancer

The follow-up of patients with head and neck cancer: an analysis of 1,039 patients

Economic burden of head and neck cancer

Contact Info

Product

Resources

About