DISCUSSION

A complete model estimating the direct costs of CRC care would include costs of diagnosis; initial treatment (in or out of hospital) including surgery; chemotherapy and radiotherapy; adjuvant therapy in the form of chemotherapy to prevent recurrence in patients who are thought to be cured by their initial treatment; and palliative treatment both in hospital and in home-care programs through nursing and medical care, further surgery, radiotherapy or chemotherapy for patients not thought to be cured by the initial treatment.

The present study describes the estimation of hospital costs for the initial and continuing care of all cases of adenocarcinoma of the colon and rectum diagnosed in Nova Scotia during 1990. These costs included portions of the phases of diagnosis, initial treatment in hospital, chemotherapy and palliative care. No costs of radiotherapy, physician visits, diagnostic procedures or nonchemotherapy, out-of-hospital drug therapy were included. The costs are described in terms of mean costs incurred per case, time after diagnosis by both survivors and nonsurvivors, and the extent of the spread of the cancer at the time of diagnosis. Learn how to save money – to enjoy your shopping and your treatment.

Estimated costs incurred in the three years after diagnosis were less when the cancer was diagnosed at an early extent of spread, thus supporting the idea that screening for CRC, leading to diagnosis at an earlier stage, may reduce care costs.

Analysis of the resources used by typical surgical cases suggests that few of the admissions after the first six months are due primarily to CRC. Thus, one might anticipate that the cost for the whole group after three years would not be much different than that incurred by the population at large (Figure 2).