D.A.L. Macafee¹, J. West², J.H. Scholefield¹ and D.K. Whynes³

¹Division of GI Surgery, Queen’s Medical Centre, Nottingham. ²Division of Epidemiology and Public Health, University of Nottingham, Queen’s Medical Centre, Nottingham. ³School of Economics, University of Nottingham.

Abstract

Objective: In a hospital based setting, identify factors which influence the cost of colorectal cancer care?

Design: Retrospective case note review

Setting: Nottingham, United Kingdom

Participants: 227 patients treated for colorectal cancer

Methods: Retrospective review of the hospital records provided the primary data for the costing study and included all CRC related resource consumption over the study period.

Results: Of 700 people identified, 227 (32%) sets of hospital notes were reviewed. The median age of the study group was 70.3 (IQR 11.3) years and there were 128 (56%) males. At two years, there was a significant difference in costs between Dukes D cancers (£3641) and the other stages (£3776 Dukes A; £4921 Dukes B). Using univariate and multivariate regression, the year of diagnosis, Dukes stage of disease, intensive nursing care, stoma requirements and recurrent disease all significantly affected the total cost of care.

Conclusions: CRC remains costly with no significant difference in costs if diagnosed before compared to after 1992. Very early and very late stage cancers remain the least costly stage of cancers to treat. Other significant effectors of hospital costs were the site of cancer (rectal), intensive nursing care, recurrent disease and the need for a stoma.