Estimation of Life-Year Loss and Lifetime Costs for Different Stages of Colon Adenocarcinoma in Taiwan

Abstract

Backgrounds and aimsLife-expectancy of colon cancer patients cannot be accurately answered due to the lack of both large datasets and long-term follow-ups, which impedes accurate estimation of lifetime cost to treat colon cancer patients. In this study, we applied a method to estimate life-expectancy of colon cancer patients in Taiwan and calculate the lifetime costs by different stages and age groups.MethodsA total of 17,526 cases with pathologically verified colon adenocarcinoma between 2002 and 2009 were extracted from Taiwan Cancer Registry database for analysis. All patients were followed-up until the end of 2011. Life-expectancy, expected-years-of-life-lost and lifetime costs were estimated, using a semi-parametric survival extrapolation method and borrowing information from life tables of vital statistics.ResultsPatients with more advanced stages of colon cancer were generally younger and less co-morbid with major chronic diseases than those with stages I and II. The LE of stage I was not significantly different from that of the age- and sex-matched general population, whereas those of stages II, III, and IV colon cancer patients after diagnosis were 16.57±0.07, 13.35±0.07, and 4.05±0.05 years, respectively; the corresponding expected-years-of-life-lost were 1.28±0.07, 5.93±0.07 and 16.42±0.06 years, significantly shorter than the general population after accounting for lead time bias. Besides, the lifetime cost of managing stage II colon cancer patients would be US $8,416±1939, 14,334±1,755, and 21,837±1,698, respectively, indicating a big saving for early diagnosis and treatment after stratification for age and sex.ConclusionsTreating colon cancer at younger age and earlier stage saves more life-years and healthcare costs. Future studies are indicated to apply these quantitative results into the cost-effectiveness evaluation of screening program for colon cancers.

Health expenditures spent for prevention, economic performance, and social welfare

“…We search PubMed, Medicine, EconLit, and Google Scholar for empirical studies published between November 15 2009, and November 15 2015, with search terms of “prevention and economic growth”, “prevention and social welfare”, and “prevention and macroeconomics”. We found many prevention studies have attempted to present the healthcare expenditures saved from early detection of specific diseases [ 1 , 4 , 5 ]. There are also many studies conducted evidence-based analyses for efficient healthcare — whether prevention or treatment — and then encourage the appropriate delivery of efficient interventions [ 2 , 31 ].…”

“…Screening and detection of oral, cervical and colorectal cancer at premalignant stage, stage 0, and/or earlier stages would save life-years [ 3 – 5 ], quality of life [ 6 ], and healthcare costs [ 4 , 5 ]. Prevention of end-stage renal disease would save costs of dialysis [ 7 ] and long term care [ 8 ].…”

Long Term Survival of Pathological Thoracolumbar Fractures Treated with Vertebroplasty: Analysis Using a Nationwide Insurance Claim Database

“…In the comorbidity analysis, we found all cancer disclosed an aHR nearly 2-3 times greater than no cancer, except for colon cancer. This may be partially explained by the fact that colon cancer that is treated early (especially at Stage I) shows little or no loss of life expectancy [35,36] and Taiwan has had a national screening campaign for more than a decade. Patients with kidney failure who receive regular hemodialysis are prone to osteoporotic fractures accompanied by increased morbidity and mortality [37], and this could explain why the aHR increased up to 1.96.…”

Phytochemicals based chemopreventive and chemotherapeutic strategies and modern technologies to overcome limitations for better clinical applications

“…The therapeutic response follows an inverse relationship with the patient's survival as the disease progresses. That is, more the advanced disease, poor is the therapeutic outcome and survival rate (Chen, Lee, & Wang, 2015;Ganesh, Talole, Dikshit, Badwe, & Dinshaw, 2008;Prat et al, 2014;Song et al, 2015). Advanced stage diseases are quite difficult to treat in the clinic and various vital factors such as disease stage, treatment modality, comorbidity, and genetic make-up of an individual play crucial role in the overall outcome of anticancer therapy.…”